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To direct the Secretary of Defense to carry out a pilot program under which a TRICARE Prime beneficiary may access obstetrical and gynecological care without a referral, and for other purposes.
Summary
This bill directs the Department of Defense to establish a five-year pilot program allowing TRICARE Prime beneficiaries to access obstetrical and gynecological care without requiring a referral from their primary care doctor. Female TRICARE Prime beneficiaries participating in the pilot can also designate an OB/GYN provider as an additional designated primary care manager, giving them direct access to obstetrical and gynecological care and related items and services. The pilot program must begin within 180 days of the bill's enactment. The Secretary of Defense must report to Congress within four years on the pilot's effects, including any changes to TRICARE Prime enrollment, associated costs of providing OB/GYN care, and other relevant findings. The pilot will help evaluate whether removing referral requirements improves access to women's health care under TRICARE.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Sponsor (1)
16 cosponsors
- Rep. Bacon, Don [R-NE-2] (R-NE)
- Rep. Fitzpatrick, Brian K. [R-PA-1] (R-PA)
- Rep. Goodlander, Maggie [D-NH-2] (D-NH)
- Rep. Gottheimer, Josh [D-NJ-5] (D-NJ)
- Rep. Haridopolos, Mike [R-FL-8] (R-FL)
- Rep. Houlahan, Chrissy [D-PA-6] (D-PA)
- Rep. Jacobs, Sara [D-CA-51] (D-CA)
- Rep. Johnson, Henry C. "Hank" [D-GA-4] (D-GA)
- Rep. Johnson, Julie [D-TX-32] (D-TX)
- Rep. Kim, Young [R-CA-40] (R-CA)
- Rep. Lawler, Michael [R-NY-17] (R-NY)
- Rep. McBride, Sarah [D-DE-At Large] (D-DE)
- Rep. Salazar, Maria Elvira [R-FL-27] (R-FL)
- Rep. Strickland, Marilyn [D-WA-10] (D-WA)
- Rep. Tokuda, Jill N. [D-HI-2] (D-HI)
- Rep. Turner, Michael R. [R-OH-10] (R-OH)
Actions (2)
- Feb 27, 2025 Referred to the House Committee on Armed Services. · house
- Feb 27, 2025 Introduced in House
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Text versions (1)
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Full text
IN THE HOUSE OF REPRESENTATIVES
February 27, 2025
Mr. Horsford (for himself, Ms. Houlahan, Ms. Salazar, Ms. Strickland, Ms. Jacobs, Ms. Tokuda, Mr. Turner of Ohio, Mr. Johnson of Georgia, Ms. Goodlander, and Ms. McBride) introduced the following bill; which was referred to the Committee on Armed Services
A BILL
To direct the Secretary of Defense to carry out a pilot program under which a TRICARE Prime beneficiary may access obstetrical and gynecological care without a referral, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “TRICARE OBGYN Treatment and Access without Lags in Care Act” or the “TOTAL Care Act”.
SEC. 2. PILOT PROGRAM ON ACCESS TO OBSTETRICAL AND GYNECOLOGICAL CARE UNDER TRICARE PRIME PROGRAM.
(a) Pilot Program.—Beginning not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall carry out a pilot program under which—
(1) the referral requirement in section 1095f(a)(1) of title 10, United States Code, does not apply with respect to obstetrical and gynecological care for covered participants, including the ordering of related obstetrical and gynecological items and services; and
(2) covered participants may elect to designate an obstetrical or gynecological care provider under the TRICARE program as an additional designated primary care manager under such section.
(b) Duration.—The Secretary shall carry out the pilot program for a period of five years.
(c) Report.—Not later than four years after the date of the enactment of this Act, the Secretary shall submit to the congressional defense committees a report on the pilot program that includes the following:
(1) An assessment of any increases or decreases to TRICARE Prime enrollment during the period in which the Secretary carries out the pilot program.
(2) An assessment of any changes in the associated costs of providing obstetrical and gynecological care under TRICARE Prime.
(3) Any other matters the Secretary determines appropriate.
(d) Definitions.—In this section:
(1) The term “congressional defense committees” has the meaning given that term in section 101(a)(16) of title 10, United States Code.
(2) The term “covered participant” means a female beneficiary enrolled in TRICARE Prime who elects to participate in the pilot program.
(3) The terms “TRICARE Prime” and “TRICARE program” have the meaning given those terms in section 1072 of title 10, United States Code. <all>
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