STANDARDIZATION OF CLAIMS PROCESSING UNDER TRICARE PROGRAM AND MEDICARE PROGRAM.

SEC. 731. STANDARDIZATION OF CLAIMS PROCESSING UNDER TRICARE PROGRAM AND MEDICARE PROGRAM.(a) In General.—Effective beginning with the next contract option period for managed care support contracts under the TRICARE program, the claims processing requirements under the TRICARE program on the matters described in subsection (b) shall be identical to the claims processing requirements under the Medicare program on such matters.(b) Covered Matters.—The matters described in this subsection are as follows:(1) The utilization of single or multiple provider identification numbers for purposes of the payment of health care claims by Department of Defense contractors.120 STAT. 2296(2) The documentation required to substantiate medical necessity for items and services that are covered under both the TRICARE program and the Medicare program.(c) Report on Collection of Amounts Owed.—Not later than March 1, 2007, the Secretary of Defense shall submit to the congressional defense committees a report setting forth a detailed description of the following:(1) All TRICARE policies and directives concerning collection of amounts owed to the United States pursuant to section 1095 of title 10, United States Code, from third party payers, including—(A) collection by military treatment facilities from third-party payers; and(B) collection by contractors providing managed care support under the TRICARE program from other insurers in cases of private insurance liability for health care costs of a TRICARE beneficiary.(2) An estimate of the outstanding amounts owed from third party payers in each of fiscal years 2002, 2003, and 2004.(3) The amounts collected from third party payers in each of fiscal years 2002, 2003, and 2004.(4) A plan of action to streamline the business practices that underlie the policies and directives described in paragraph (1).(5) A plan of action to accelerate and increase the collections or recoupments of amounts owed from third party payers.(d) Annual Reports on Claims Processing Standardization.—(1) In general.—Not later than October 1, 2007, and annually thereafter, the Secretary of Defense shall submit to the congressional defense committees a report setting forth a complete list of the claims processing requirements under the TRICARE program that differ from claims processing requirements under the Medicare program.(2) Elements.—Each report under paragraph (1) shall include, for each claims processing requirement listed in such report, a business case that justifies maintaining such requirement under the TRICARE program as a different claims processing requirement than that required under the Medicare program.(e) Definitions.—In this section:(1) The term “Medicare program” means the program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).(2) The term “TRICARE program” has the meaning given that term in section 1072(7) of title 10, United States Code.