This bill would change parts of title 10 of the United States Code that govern TRICARE pharmacy benefits. It would let eligible covered beneficiaries elect to receive non-generic maintenance prescriptions by any means described in the statute referenced (paragraph (2)(E)). It would require TRICARE pharmacy contractors to reimburse retail pharmacies at least the pharmacy's actual acquisition cost (or a proxy not lower than the national average acquisition cost when listed) plus a professional dispensing fee equal to the State Medicaid (title XIX) dispensing fee. The bill would bar contractors from imposing fees on TRICARE retail pharmacies. It also requires annual audits by the Comptroller General of reimbursement data, price concessions, and network adequacy (including continuity of care and geographic access, with special consideration for rural and underserved areas). The Secretary must provide a plan for implementing these changes to congressional defense committees within 90 days of enactment.
No publicly available information on estimated federal costs, savings, or budgetary effects is included in the bill text.
The text of the bill states its purpose is to improve access, fairness, and transparency under the TRICARE pharmacy benefits program by expanding beneficiary options, setting minimum reimbursement standards for retail pharmacies, banning certain contractor fees, and requiring audits of reimbursement and network adequacy.
No publicly available information.