Page:United States Statutes at Large Volume 111 Part 2.djvu/741

 PUBLIC LAW 105-85—NOV. 18, 1997 111 STAT. 1821 SEC. 746. COMPTROLLER GENERAL STUDY OF ADEQUACY AND EFFECT OF MAXIMUM ALLOWABLE CHARGES FOR PHYSICIANS UNDER CHAMPUS. (a) STUDY REQUIRED. —The Comptroller General shall conduct a study regarding the adequacy of the maximum allowable charges for physicians established under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) and the effect of such charges on the participation of physicians in CHAMPUS. The study shall include an evaluation of the following: (1) The methodology used by the Secretary of Defense to establish maximum allowable charges for physicians under CHAMPUS, and whether such methodology conforms to the requirements of section 1079(h) of title 10, United States Code. (2) The differences between the established charges under CHAMPUS and reimbursement rates for similar services under title XVIII of the Social Security Act and other health care programs. (3) The basis for physician complaints that the CHAMPUS established charges are too low. (4) The difficultly of CHAMPUS in ensuring physician compliance with the CHAMPUS established charges in the absence of legal mechanisms to enforce complismce, and the effect of noncompliance on patient out-of-pocket expenses. (5) The effect of the estabhshed charges under CHAMPUS on the participation of physicians in CHAMPUS, and the extent and success of Department of Defense efforts to increase physician participation in areas with low participation rates. (b) SUBMISSION OF REPORT.— Not later than March 1, 1998, the Comptroller General shall submit to Congress a report containing the results of the study required by subsection (a). SEC. 747. COMPTROLLER GENERAL STUDY OF DEPARTMENT OF DEFENSE PHARMACY PROGRAMS. (a) STUDY.— Not later than March 31, 1998, the Comptroller General shall submit to Congress a study evaluating the pharmacy programs of the Department of Defense. The study shall examine the impact of such pharmacy programs on the aggregate cost, quality, and accessibility of health care provided to covered beneficiaries under chapter 55 of title 10, United States Code, and shall include an examination of the following: (1) The merits and feasibility of establishing a uniform formulary for military treatment facility pharmacies and civilian contractor pharmacy benefit administrators. (2) The reasons that military treatment facilities deny covered beneficiaries access to pharmacy care and shift such beneficiaries to other sources of pharmacy care. (3) The merits and feasibility of using private sector cost control mechanisms implemented by authorized civilian contractors in the Department of Defense medical programs, and the existence of any barriers to the use of such mechanisms, including factors that may undermine the incentives of such contractors to optimize treatment outcomes in managing the care of covered beneficiaries without exceeding budgeted resources. (4) The cost impacts, if any, of the use of commercial managed c£U"e methods of furnishing pharmaceuticals to covered beneficiaries by TRICARE program contractors instead of

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