Page:United States Statutes at Large Volume 112 Part 3.djvu/230

 112 STAT. 2060 PUBLIC LAW 105-261—OCT. 17, 1998 10 USC 1073 SEC. 713. SYSTEM FOR TRACKING DATA AND MEASURING PERFORM- note. ANCE IN MEETING TRICARE ACCESS STANDARDS. (a) REQUIREMENT TO ESTABLISH SYSTEM.— (1) The Secretary of Defense shall establish a system— (A) to track data regarding access of covered beneficiaries under chapter 55 of title 10, United States Code, to primary health care under the TRICARE program; and (B) to measure performance in increasing such access against the primary care access standards established by the Secretary under the TRICARE program. (2) In implementing the system described in paragraph (1), the Secretary shall collect data on the timeliness of appointments and precise waiting times for appointments in order to measure performance in meeting the primary care access standards established under the TRICARE program. (b) DEADLINE FOR ESTABLISHMENT.— The Secretary shall establish the system described in subsection (a) not later than April 1, 1999. SEC. 714. ESTABLISHMENT OF APPEALS PROCESS FOR CLAIMCHECK DENIALS. (a) ESTABLISHMENT OF APPEALS PROCESS. —Not later than January 1, 1999, the Secretary of Defense shall establish an appeals process in cases of denials through the ClaimCheck computer software system (or giny other claims processing system that may be used by the Secretary) of claims by civilian providers for pa3anent for health care services provided under the TRICARE program. (b) REPORT. —Not later than March 1, 1999, the Secretary shall submit to Congress a report on the implementation of this section. 10 USC 1106 SEC. 715. REVIEWS RELATING TO ACCESSIBILITY OF HEALTH CARE note. UNDER TRICARE. (a) REVIEW OF REHABILITATIVE SERVICES FOR HEAD INJURIES. — The Secretary of Defense shall review policies under the TRICARE program (including a review of the TRICARE policy manual) to determine if policies addressing the availability of rehabilitative services for TRICARE patients suffering from head injuries are adequate and appropriately address consideration of certification by an attending physician that such services would be beneficial for such a patient. (b) REVIEW OF ADEQUACY OF PROVIDER NETWORK. — The Secretary of Defense shall review the administration of the TRICARE Prime health plans to determine whether, for each region covered by such a plan, there is a sufficient number, distribution, and variety of qualified participating health care providers to ensure that covered health care services, including specialty services and rehabilitative services, are accessible in the vicinity of the residence of the enrollees and available in a timely manner to such enrollees, regardless of where such enrollees are located within the TRICARE region. (c) REPORT. —Not later than April 1, 1999, the Secretary of Defense shall submit to the Committee on Armed Services of the Senate and the Committee on National Security of the House of Representatives a report on the results of the reviews required by subsections (a) and (b), together with a description of any actions taken or directed as a result of those reviews.

�