Page:United States Statutes at Large Volume 111 Part 2.djvu/728

 Ill STAT. 1808 PUBLIC LAW 105-85—NOV. 18, 1997 (A) covered items and services beyond those provided under a traditional fee-for-service program; (B) any beneficiary cost sharing; and (C) any maximum hmitations on out-of-pocket expenses. (2) The net monthly premium, if any, under the entity. (3) The service area of the entity. (4) To the extent available, quality and performance indicators for the benefits under the entity (and how they compare to such indicators under the traditional fee-for-service programs in the area involved), including— (A) disenrollment rates for enrollees electing to receive benefits through the entity for the previous two years (excluding disenrollment due to death or moving outside the service area of the entity); (B) information on enrollee satisfaction; (C) information on health process and outcomes; (D) grievance procedures; (E) the extent to which an enrollee may select the health care provider of their choice, including health care providers within the network of the entity and out-of-network health care providers (if the entity covers out-of- network items and services); and (F) an indication of enrollee exposure to balance billing and the restrictions on coverage of items and services provided to such enrollee by an out-of-network health care provider. (5) Whether the entity offers optional supplemental benefits and the terms and conditions (including premiums) for such coverage. (6) An overall summary description as to the method of compensation of participating physicians. Subtitle B—TRICARE Program SEC. 711. ADDITION OF DEFINITION OF TRICARE PROGRAM TO TITLE 10. Section 1072 of title 10, United States Code, is amended by adding at the end the following new paragraph: "(7) The term 'TRICARE program' means the managed health care program that is established by the Department of Defense under the authority of this chapter, principally section 1097 of this title, and includes the competitive selection of contractors to financially underwrite the delivery of health care services under the Civilian Health and Medical Program of the Uniformed Services.". SEC. 712. PLAN FOR EXPANSION OF MANAGED CARE OPTION OF TRICARE PROGRAM. (a) PLAN FOR EXPANSION OF TRICARE PRIME.— The Secretary of Defense shall prepare a plan for the expansion of the managed care option of the TRICARE Program, known as TRICARE Prime, into areas of the United States located outside of the catchment areas of medical treatment facilities of the uniformed services, but in which the managed care option is a cost-effective alternative because of—

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