TRICARE; Notice of TRICARE Plan Program Changes for Calendar Year (CY) 2024, 70959-70961 [2023-22790]
Download as PDF
<![CDATA[
Federal Register / Vol. 88, No. 197 / Friday, October 13, 2023 / Notices
• Brent Penny—Assistant Inspector
General for Management and
Administration.
• Larry Reinkemeyer—Assistant
Inspector General for Audits and
Evaluations.
• Gopala Seelamneni—Deputy
Assistant Inspector General for
Management and Administration/Chief
Technology.
• Chris Wilber—Counselor to the
Inspector General.
Dated: October 1, 2023.
Douglas Holt,
Executive Director, Training Institute.
Department of the Army
Board of Visitors, United States
Military Academy (USMA)
Department of the Army, DoD.
Meeting cancellation notice.
Under the provisions of the
Federal Advisory Committee Act of
1972, the Government in the Sunshine
Act of 1976 the Department of Defense
announces that the following Federal
advisory committee meeting will not
take place.
SUMMARY:
Monday, October 16, 2023. Time:
9–11:30 a.m.
DATES:
ADDRESSES:
Location: Haig Room, Jefferson Hall,
758 Cullum Road, West Point, NY.
Reason for Cancellation: Due to the
uncertainty of the schedule of the House
of Representatives in Washington, DC,
the USMA Board of Visitors meeting
originally scheduled for Monday,
October 16, 2023, is cancelled.
The
Committee’s Designated Federal Officer
or Point of Contact is Ms. Deadra
Ghostlaw, (845) 938–6534,
Deadra.Ghostlaw@westpoint.edu.
FOR FURTHER INFORMATION CONTACT:
Due to
circumstances beyond the control of the
Department of Defense and the
Designated Federal Officer, the United
States Military Academy Board of
Visitors is unable to provide public
notification required by 41 CFR 102–
3.150(a) concerning the cancellation of
its October 16, 2023, meeting.
Accordingly, the Advisory Committee
Management Officer for the Department
of Defense, pursuant to 41 CFR 102–
lotter on DSK11XQN23PROD with NOTICES1
VerDate Sep<11>2014
16:55 Oct 12, 2023
Jkt 262001
BILLING CODE 3711–02–P
DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE; Notice of TRICARE Plan
Program Changes for Calendar Year
(CY) 2024
This notice provides
information regarding TRICARE Plan
Program Changes for CY 2024.
DATES: TRICARE health plan
information in this notice is valid for
services during CY 2024 (January 1,
2024–December 31, 2024).
ADDRESSES: Defense Health Agency,
TRICARE Health Plan Division, 7700
Arlington Boulevard, Suite 5101, Falls
Church, Virginia 22042–5101.
FOR FURTHER INFORMATION CONTACT: Ms.
Debra Fisher, phone: (703) 275–6224.
SUPPLEMENTARY INFORMATION: A final
rule published in the Federal Register
(FR) on February 15, 2019, (84 FR 4326–
4333) that established the requirement
for the Director, Defense Health Agency
(DHA), to provide public notice to
Military Health System (MHS)
beneficiaries each calendar year in
connection with the annual open season
enrollment period with a summary of
changes to the TRICARE program. The
following changes or improvements to
the TRICARE program benefits apply for
CY 2024.
SUMMARY:
DEPARTMENT OF DEFENSE
SUPPLEMENTARY INFORMATION:
[FR Doc. 2023–22615 Filed 10–12–23; 8:45 am]
Office of the Secretary of
Defense, Department of Defense (DoD).
ACTION: Notice; TRICARE plan program
changes for CY 2024.
BILLING CODE 6820–C9–P
ACTION:
James W. Satterwhite Jr.,
Army Federal Register Liaison Officer.
AGENCY:
[FR Doc. 2023–22542 Filed 10–12–23; 8:45 am]
AGENCY:
3.150(b), waives the 15-calendar day
notification requirement.
Announcement of Open Season
Open Season is an annual period
when beneficiaries can enroll in or
make changes to their healthcare,
dental, and vision coverage for the next
calendar year.
During the TRICARE Open Season
that runs from November 13, 2023,
through December 12, 2023, qualified
MHS beneficiaries may enroll in or
change their TRICARE Prime or
TRICARE Select plan.
During the Federal Employee Dental
and Vision Insurance Program (FEDVIP)
Open Season that runs from November
13, 2023, through December 11, 2023,
qualified MHS beneficiaries, including
TRICARE for Life beneficiaries, may
enroll in or make changes to their dental
PO 00000
Frm 00040
Fmt 4703
Sfmt 4703
70959
and vision plans. FEDVIP is operated by
the U.S. Office of Personnel
Management.
Any changes MHS beneficiaries make
during Open Season will take effect on
January 1, 2024. If a beneficiary remains
eligible and does not make any changes
during Open Season, then their coverage
will stay the same for 2024. TRICARE
enrollees can ensure they receive
important health plan information by
promptly listing any change in address
and other information in the Defense
Enrollment Eligibility Reporting System
(DEERS).
Annual Announcements
The following TRICARE program
features are subject to a year-to-year
determination and are announced each
year prior to the annual TRICARE Open
Season.
Urgent Care Visits: There continues to
be no limit to the number of urgent care
visits a covered beneficiary enrolled in
TRICARE Prime may receive without a
referral for Plan Year 2024. They may
receive urgent care from any TRICAREauthorized urgent care center (UCC),
either network or non-network, without
a referral. They may also receive urgent
care from any TRICARE network
provider. If the TRICARE Prime enrollee
seeks care from a non-network TRICARE
authorized provider (outside of a
TRICARE-authorized UCC), the usual
TRICARE Prime Point of Service (POS)
deductible and cost-shares shall apply.
Private Sector care for Active Duty
Service Members is subject to different
rules. Covered beneficiaries who want
assistance on decisions to seek urgent
care in the United States (U.S.), except
those enrolled in the Uniformed
Services Family Health Plan (USFHP),
may call the MHS Nurse Advice Line
(NAL) for health care guidance from a
specially trained registered nurse. The
NAL is available 24/7 to all non-USFHP
TRICARE beneficiaries. Beneficiaries
who live overseas can call the NAL for
health care advice when traveling in the
U.S. but must coordinate care with their
Overseas Regional Call Center. For
additional information, call the
servicing TRICARE contractor or visit
https://www.tricare.mil/ContactUs and
click on ‘‘MHS Nurse Advice Line.’’
Prime Service Area Changes: Prime
Service Areas (PSAs) are geographic
areas around military medical treatment
facilities and Base Realignment and
Closure sites. PSAs support the medical
readiness of active duty members of the
Uniformed Services by adding to the
capability and capacity of military
hospitals and clinics. There are no
changes to the existing PSAs for CY
2024.
E:\FR\FM\13OCN1.SGM
13OCN1
lotter on DSK11XQN23PROD with NOTICES1
70960
Federal Register / Vol. 88, No. 197 / Friday, October 13, 2023 / Notices
What’s New
The following changes or
improvements to the TRICARE program
benefits apply to CY 2024 (although
some changes were implemented in
2023):
Elimination of Cost-Sharing for
Female Tubal Sterilization as Preventive
Care: Effective January 1, 2023,
TRICARE eliminated cost-sharing for
female tubal sterilization as a preventive
service when it is performed by innetwork TRICARE-authorized providers.
Preconception and Prenatal Carrier
Screening: TRICARE covers
preconception and prenatal carrier
screening tests for cystic fibrosis, spinal
muscular atrophy, fragile X syndrome,
Tay-Sachs Disease, hemoglobinopathies,
and conditions linked with Ashkenazi
Jewish descent for beneficiaries with a
limit of one test per condition per
lifetime.
Breastfeeding Supplies: Effective
January 25, 2023, in keeping with
industry norms of shipping packages of
100 versus the earlier-covered 90 breast
milk bags, TRICARE began cost-sharing
for 100 breast milk bags every thirty
days following the birth event for
breastfeeding TRICARE Prime and
TRICARE Select enrollees.
USFHP: USFHP is an additional
TRICARE Prime option available
through networks of community-based,
not-for-profit health care systems
(designated providers) in six geographic
areas of the U.S. Beneficiaries are
encouraged to review the information at
https://www.tricare.mil/Plans/Enroll/
USFHP and other available resources to
determine whether they are in a USFHP
eligible ZIP Code.
TRICARE Prime enrollees who reside
in a ZIP Code where a USFHP service
area and a PSA served by a TRICARE
regional contractor overlap may change
between the two at any time. This will
be considered a Primary Care Manager
(PCM) change and can be changed by
phone, online, or by mail. Beneficiaries
who are not enrolled in TRICARE Prime
but wish to enroll in USFHP can contact
the USFHP in their area to make
enrollment changes during Open Season
or as a result of a Qualifying Life Event
(QLE). A QLE is a certain change in the
beneficiary’s life, such as marriage, birth
of a child, or retirement from active
duty, which may mean different
TRICARE health plan options are
available. A QLE opens a 90-day period
for beneficiaries to make eligible
enrollment changes.
TRICARE Managed Care Support
Contracts for East and West Regions
Change: A set of new TRICARE
Managed Care Support contracts that
VerDate Sep<11>2014
16:55 Oct 12, 2023
Jkt 262001
facilitate health care in the private
sector will serve beneficiaries in the
East and West regions. Under the new
contracts, beneficiaries residing in
Arkansas, Illinois, Louisiana, Oklahoma,
Texas, and Wisconsin will shift from the
East to the West region. Beneficiaries
with questions about this transition can
seek more information at https://
newsroom.tricare.mil/News/TRICARENews/Article/3254092/changes-totricare-expected-in-2024.
Reimbursement and Coverage of
Services Provided by Freestanding EndStage Renal Disease (ESRD) Facilities:
Effective January 12, 2023, TRICARE
now recognizes freestanding end-stage
renal disease facilities as authorized
institutional providers, with an
accompanying reimbursement
methodology.
Planned Changes
Low Back Pain Physical Therapy
Demonstration Ends: This three-year
demonstration operating in ten states
ends on December 31, 2023. The
demonstration addresses the ongoing
issue of low back pain among TRICARE
enrollees and was designed to test the
impact of waiving cost-shares associated
with the first three physical therapy
visits for low back pain. Information can
be found at https://www.tricare.mil/
Plans/SpecialPrograms/LowBackPain.
Laboratory Developed Test
Demonstration Extended: The
Laboratory Developed Test (LDT)
Demonstration to assess whether
submitted LDTs without United States
Food and Drug Administration approval
or clearance otherwise meet TRICARE
coverage criteria, i.e., proven safety and
effectiveness for its intended use, was
slated to terminate on July 18, 2023.
However, DHA has opted to extend the
LDT Demonstration through July 18,
2028, to allow the Agency additional
time to determine how to address LDT
coverage long-term and allow continued
coverage of these tests for TRICARE
beneficiaries in the interim.
Coronavirus Disease (COVID–19)
Response Changes: The U.S. National
Emergency responding to the COVID–19
pandemic, originally declared in March
2020, ended on April 10, 2023. The
Secretary of Health and Human Services
(HHS) then ended the corresponding
Public Health Emergency (PHE) on May
11, 2023. DoD had implemented certain
flexibility for the MHS for the pendency
of the National Emergency and HHS
PHE that were to sunset with the
termination of such emergency statuses.
On termination of the National
Emergency, DoD resumed requiring a
three-day acute care hospital stay prior
to admission to a skilled nursing facility
PO 00000
Frm 00041
Fmt 4703
Sfmt 4703
and requiring TRICARE Prime enrollees
seek referrals to acquire COVID–19
vaccines from non-network, authorized
providers without incurring point-ofservices charges; and discontinued
coverage of National Institute of Allergy
and Infectious Disease (NIAID)sponsored clinical trials (note: eligible
beneficiaries who enrolled in a covered
trial on or before April 10, 2023 will
continue to have their care covered
through the end of the trial). DoD also
discontinued coverage of the treatment
use of investigational drugs under
expanded access for all new episodes of
treatment and eliminated the temporary
waiver of certain interstate and
international licensing requirements for
providers practicing both in person and
via telehealth.
On termination of the HHS PHE, DoD
discontinued its temporary coverage of
facilities registered with Medicare
Hospitals Without Walls initiative. DoD
also discontinued its waiver of costsharing for COVID–19 testing. Normal
TRICARE copayments and cost-sharing
apply to testing and related services
after May 11, 2023.
Additionally, for DoD beneficiaries
receiving telehealth from the Direct Care
component via Facetime, Google Duo/
Meet, Microsoft Skype or other similar
platforms, their telehealth services have
moved to an approved DHA Platform.
For DoD beneficiaries receiving Private
Sector telehealth, any platform used by
their provider must be HIPAAcompliant.
Appendix A
Certain TRICARE enrollee out-ofpocket costs (enrollment fees,
premiums, catastrophic caps,
deductibles, and copayments) are
adjusted annually by Federal law and
regulations based on the annual Cost of
Living Adjustment (COLA) applied to
Uniformed Service member retired pay.
A difference in copayments remains
between those who joined a Uniformed
Service before January 1, 2018, (Group
A), and those who joined on or after that
date (Group B).
The retiree COLA is typically
announced after the Federal fiscal year
begins in October. Beneficiary out-ofpocket expenses impacted by the 2024
COLA will be posted to the tricare.mil/
changes web page before the start of
TRICARE Open Season, November 13,
2023.
Pharmacy Out-of-Pocket Expenses for
CY 2024
TRICARE Pharmacy copayments will
increase on January 1, 2024:
E:\FR\FM\13OCN1.SGM
13OCN1
70961
Federal Register / Vol. 88, No. 197 / Friday, October 13, 2023 / Notices
PHARMACY COPAYMENTS FOR CALENDAR YEAR 2024 *
Year
Retail network
generic
formulary
30-day supply
Retail network
brand-name
formulary
30-day supply
Retail network
non-formulary
30-day supply
Mail order
generic
formulary
90-day supply
Mail order
brand-name
formulary
90-day supply
Mail order
non-formulary
90-day supply
2024 .....................
$16
$43
** $76
$13
$38
$76
* Active Duty Service Members enjoy a $0 copay for covered drugs at any pharmacy.
** For all beneficiaries except Active Duty Service Members, select brand-name maintenance medications (taken for long-term conditions) may
only be filled twice at retail and then must be filled through home delivery or military pharmacy.
Premium Based Plans
The CY 2024 monthly premiums for
TRICARE Reserve Select, TRICARE
Retired Reserve, and TRICARE Young
Adult and the quarterly premiums for
Continued Health Care Benefit Program
will be posted to the tricare.mil/changes
web page once announced.
Dated: October 11, 2023.
Natalie M. Ragland,
Alternate OSD Federal Register Liaison
Officer, Department of Defense.
[FR Doc. 2023–22790 Filed 10–11–23; 4:15 pm]
BILLING CODE 6001–FR–P
DEPARTMENT OF ENERGY
Environmental Management SiteSpecific Advisory Board, Savannah
River Site
Office of Environmental
Management, Department of Energy.
ACTION: Notice of open meeting.
AGENCY:
This notice announces a
meeting of the Environmental
Management Site-Specific Advisory
Board (EM SSAB), Savannah River Site.
The Federal Advisory Committee Act
requires that public notice of this
meeting be announced in the Federal
Register.
SUMMARY:
lotter on DSK11XQN23PROD with NOTICES1
DATES:
Monday, November 6, 2023; 1:00
p.m.–4:15 p.m. ET.
Tuesday, November 7, 2023; 9:00
a.m.–4:45 p.m. ET.
ADDRESSES: Sonesta Hilton Head, 130
Shipyard Drive, Hilton Head Island, SC
29928. The meeting will also be
streamed on YouTube, no registration is
necessary; links for the livestream can
be found on the following website:
https://cab.srs.gov/srs-cab.html.
FOR FURTHER INFORMATION CONTACT:
Amy Boyette, Office of External Affairs,
U.S. Department of Energy (DOE),
Savannah River Operations Office, P.O.
Box A, Aiken, SC 29802; Phone: (803)
952–6120; or Email: amy.boyette@
srs.gov.
SUPPLEMENTARY INFORMATION:
VerDate Sep<11>2014
18:12 Oct 12, 2023
Jkt 262001
Purpose of the Board: The purpose of
the Board is to provide advice and
recommendations concerning the
following EM site-specific issues: cleanup activities and environmental
restoration; waste and nuclear materials
management and disposition; excess
facilities; future land use and long-term
stewardship. The Board may also be
asked to provide advice and
recommendations on any EM program
components.
Tentative Agenda:
Monday, November 6, 2023:
Chair Update
Agency Updates
Subcommittee Updates
Program Presentations
Board Business
Public Comments
Tuesday, November 7, 2023:
Program Presentations
Public Comments
Board Business, Voting
Public Participation: The meeting is
open to the public. To register for inperson attendance, please send an email
to srscitizensadvisoryboard@srs.gov no
later than 4:00 p.m. ET on Friday,
November 3, 2023. The EM SSAB,
Savannah River Site, welcomes the
attendance of the public at its advisory
committee meetings and will make
every effort to accommodate persons
with physical disabilities or special
needs. If you require special
accommodations due to a disability,
please contact Amy Boyette at least
seven days in advance of the meeting at
the telephone number listed above.
Written statements may be filed with
the Board via email either before or after
the meeting. Individuals who wish to
make oral statements pertaining to
agenda items should submit their
request to srscitizensadvisoryboard@
srs.gov. Requests must be received five
days prior to the meeting and reasonable
provision will be made to include the
presentation in the agenda. Comments
will be accepted after the meeting, by no
later than 4:00 p.m. ET on Tuesday,
November 14, 2023. Please submit
comments to srscitizensadvisoryboard@
srs.gov. The Deputy Designated Federal
Officer is empowered to conduct the
PO 00000
Frm 00042
Fmt 4703
Sfmt 4703
meeting in a fashion that will facilitate
the orderly conduct of business.
Individuals wishing to make oral public
comments will be provided a maximum
of five minutes to present their
comments. Individuals wishing to
submit written public comments should
email them as directed above.
Minutes: Minutes will be available by
emailing or calling Amy Boyette at the
email address or telephone number
listed above. Minutes will also be
available at the following website:
https://cab.srs.gov/srs-cab.html.
Signed in Washington, DC, on October 6,
2023.
LaTanya Butler,
Deputy Committee Management Officer.
[FR Doc. 2023–22550 Filed 10–12–23; 8:45 am]
BILLING CODE 6450–01–P
DEPARTMENT OF ENERGY
Environmental Management SiteSpecific Advisory Board, Portsmouth
Office of Environmental
Management, Department of Energy.
ACTION: Notice of open meeting.
AGENCY:
This notice announces a
meeting of the Environmental
Management Site-Specific Advisory
Board (EM SSAB), Portsmouth. The
Federal Advisory Committee Act
requires that public notice of this
meeting be announced in the Federal
Register.
DATES: Thursday, November 2, 2023;
6:00 p.m.–8:00 p.m. EDT.
ADDRESSES: The Ohio State University,
Endeavor Center, 1862 Shyville Road,
Room 165, Piketon, OH 45661.
FOR FURTHER INFORMATION CONTACT: Greg
Simonton, Federal Coordinator, by
Phone: (740) 897–3737 or Email:
greg.simonton@pppo.gov.
SUPPLEMENTARY INFORMATION:
Purpose of the Board: The purpose of
the Board is to provide advice and
recommendations concerning the
following EM site-specific issues: cleanup activities and environmental
restoration; waste and nuclear materials
management and disposition; excess
SUMMARY:
E:\FR\FM\13OCN1.SGM
13OCN1
]]>Agencies
[Federal Register Volume 88, Number 197 (Friday, October 13, 2023)]
[Notices]
[Pages 70959-70961]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-22790]
-----------------------------------------------------------------------
DEPARTMENT OF DEFENSE
Office of the Secretary
TRICARE; Notice of TRICARE Plan Program Changes for Calendar Year
(CY) 2024
AGENCY: Office of the Secretary of Defense, Department of Defense
(DoD).
ACTION: Notice; TRICARE plan program changes for CY 2024.
-----------------------------------------------------------------------
SUMMARY: This notice provides information regarding TRICARE Plan
Program Changes for CY 2024.
DATES: TRICARE health plan information in this notice is valid for
services during CY 2024 (January 1, 2024-December 31, 2024).
ADDRESSES: Defense Health Agency, TRICARE Health Plan Division, 7700
Arlington Boulevard, Suite 5101, Falls Church, Virginia 22042-5101.
FOR FURTHER INFORMATION CONTACT: Ms. Debra Fisher, phone: (703) 275-
6224.
SUPPLEMENTARY INFORMATION: A final rule published in the Federal
Register (FR) on February 15, 2019, (84 FR 4326-4333) that established
the requirement for the Director, Defense Health Agency (DHA), to
provide public notice to Military Health System (MHS) beneficiaries
each calendar year in connection with the annual open season enrollment
period with a summary of changes to the TRICARE program. The following
changes or improvements to the TRICARE program benefits apply for CY
2024.
Announcement of Open Season
Open Season is an annual period when beneficiaries can enroll in or
make changes to their healthcare, dental, and vision coverage for the
next calendar year.
During the TRICARE Open Season that runs from November 13, 2023,
through December 12, 2023, qualified MHS beneficiaries may enroll in or
change their TRICARE Prime or TRICARE Select plan.
During the Federal Employee Dental and Vision Insurance Program
(FEDVIP) Open Season that runs from November 13, 2023, through December
11, 2023, qualified MHS beneficiaries, including TRICARE for Life
beneficiaries, may enroll in or make changes to their dental and vision
plans. FEDVIP is operated by the U.S. Office of Personnel Management.
Any changes MHS beneficiaries make during Open Season will take
effect on January 1, 2024. If a beneficiary remains eligible and does
not make any changes during Open Season, then their coverage will stay
the same for 2024. TRICARE enrollees can ensure they receive important
health plan information by promptly listing any change in address and
other information in the Defense Enrollment Eligibility Reporting
System (DEERS).
Annual Announcements
The following TRICARE program features are subject to a year-to-
year determination and are announced each year prior to the annual
TRICARE Open Season.
Urgent Care Visits: There continues to be no limit to the number of
urgent care visits a covered beneficiary enrolled in TRICARE Prime may
receive without a referral for Plan Year 2024. They may receive urgent
care from any TRICARE-authorized urgent care center (UCC), either
network or non-network, without a referral. They may also receive
urgent care from any TRICARE network provider. If the TRICARE Prime
enrollee seeks care from a non-network TRICARE authorized provider
(outside of a TRICARE-authorized UCC), the usual TRICARE Prime Point of
Service (POS) deductible and cost-shares shall apply. Private Sector
care for Active Duty Service Members is subject to different rules.
Covered beneficiaries who want assistance on decisions to seek urgent
care in the United States (U.S.), except those enrolled in the
Uniformed Services Family Health Plan (USFHP), may call the MHS Nurse
Advice Line (NAL) for health care guidance from a specially trained
registered nurse. The NAL is available 24/7 to all non-USFHP TRICARE
beneficiaries. Beneficiaries who live overseas can call the NAL for
health care advice when traveling in the U.S. but must coordinate care
with their Overseas Regional Call Center. For additional information,
call the servicing TRICARE contractor or visit https://www.tricare.mil/ContactUs and click on ``MHS Nurse Advice Line.''
Prime Service Area Changes: Prime Service Areas (PSAs) are
geographic areas around military medical treatment facilities and Base
Realignment and Closure sites. PSAs support the medical readiness of
active duty members of the Uniformed Services by adding to the
capability and capacity of military hospitals and clinics. There are no
changes to the existing PSAs for CY 2024.
[[Page 70960]]
What's New
The following changes or improvements to the TRICARE program
benefits apply to CY 2024 (although some changes were implemented in
2023):
Elimination of Cost-Sharing for Female Tubal Sterilization as
Preventive Care: Effective January 1, 2023, TRICARE eliminated cost-
sharing for female tubal sterilization as a preventive service when it
is performed by in-network TRICARE-authorized providers.
Preconception and Prenatal Carrier Screening: TRICARE covers
preconception and prenatal carrier screening tests for cystic fibrosis,
spinal muscular atrophy, fragile X syndrome, Tay-Sachs Disease,
hemoglobinopathies, and conditions linked with Ashkenazi Jewish descent
for beneficiaries with a limit of one test per condition per lifetime.
Breastfeeding Supplies: Effective January 25, 2023, in keeping with
industry norms of shipping packages of 100 versus the earlier-covered
90 breast milk bags, TRICARE began cost-sharing for 100 breast milk
bags every thirty days following the birth event for breastfeeding
TRICARE Prime and TRICARE Select enrollees.
USFHP: USFHP is an additional TRICARE Prime option available
through networks of community-based, not-for-profit health care systems
(designated providers) in six geographic areas of the U.S.
Beneficiaries are encouraged to review the information at https://www.tricare.mil/Plans/Enroll/USFHP and other available resources to
determine whether they are in a USFHP eligible ZIP Code.
TRICARE Prime enrollees who reside in a ZIP Code where a USFHP
service area and a PSA served by a TRICARE regional contractor overlap
may change between the two at any time. This will be considered a
Primary Care Manager (PCM) change and can be changed by phone, online,
or by mail. Beneficiaries who are not enrolled in TRICARE Prime but
wish to enroll in USFHP can contact the USFHP in their area to make
enrollment changes during Open Season or as a result of a Qualifying
Life Event (QLE). A QLE is a certain change in the beneficiary's life,
such as marriage, birth of a child, or retirement from active duty,
which may mean different TRICARE health plan options are available. A
QLE opens a 90-day period for beneficiaries to make eligible enrollment
changes.
TRICARE Managed Care Support Contracts for East and West Regions
Change: A set of new TRICARE Managed Care Support contracts that
facilitate health care in the private sector will serve beneficiaries
in the East and West regions. Under the new contracts, beneficiaries
residing in Arkansas, Illinois, Louisiana, Oklahoma, Texas, and
Wisconsin will shift from the East to the West region. Beneficiaries
with questions about this transition can seek more information at
https://newsroom.tricare.mil/News/TRICARE-News/Article/3254092/changes-to-tricare-expected-in-2024.
Reimbursement and Coverage of Services Provided by Freestanding
End-Stage Renal Disease (ESRD) Facilities: Effective January 12, 2023,
TRICARE now recognizes freestanding end-stage renal disease facilities
as authorized institutional providers, with an accompanying
reimbursement methodology.
Planned Changes
Low Back Pain Physical Therapy Demonstration Ends: This three-year
demonstration operating in ten states ends on December 31, 2023. The
demonstration addresses the ongoing issue of low back pain among
TRICARE enrollees and was designed to test the impact of waiving cost-
shares associated with the first three physical therapy visits for low
back pain. Information can be found at https://www.tricare.mil/Plans/SpecialPrograms/LowBackPain.
Laboratory Developed Test Demonstration Extended: The Laboratory
Developed Test (LDT) Demonstration to assess whether submitted LDTs
without United States Food and Drug Administration approval or
clearance otherwise meet TRICARE coverage criteria, i.e., proven safety
and effectiveness for its intended use, was slated to terminate on July
18, 2023. However, DHA has opted to extend the LDT Demonstration
through July 18, 2028, to allow the Agency additional time to determine
how to address LDT coverage long-term and allow continued coverage of
these tests for TRICARE beneficiaries in the interim.
Coronavirus Disease (COVID-19) Response Changes: The U.S. National
Emergency responding to the COVID-19 pandemic, originally declared in
March 2020, ended on April 10, 2023. The Secretary of Health and Human
Services (HHS) then ended the corresponding Public Health Emergency
(PHE) on May 11, 2023. DoD had implemented certain flexibility for the
MHS for the pendency of the National Emergency and HHS PHE that were to
sunset with the termination of such emergency statuses.
On termination of the National Emergency, DoD resumed requiring a
three-day acute care hospital stay prior to admission to a skilled
nursing facility and requiring TRICARE Prime enrollees seek referrals
to acquire COVID-19 vaccines from non-network, authorized providers
without incurring point-of-services charges; and discontinued coverage
of National Institute of Allergy and Infectious Disease (NIAID)-
sponsored clinical trials (note: eligible beneficiaries who enrolled in
a covered trial on or before April 10, 2023 will continue to have their
care covered through the end of the trial). DoD also discontinued
coverage of the treatment use of investigational drugs under expanded
access for all new episodes of treatment and eliminated the temporary
waiver of certain interstate and international licensing requirements
for providers practicing both in person and via telehealth.
On termination of the HHS PHE, DoD discontinued its temporary
coverage of facilities registered with Medicare Hospitals Without Walls
initiative. DoD also discontinued its waiver of cost-sharing for COVID-
19 testing. Normal TRICARE copayments and cost-sharing apply to testing
and related services after May 11, 2023.
Additionally, for DoD beneficiaries receiving telehealth from the
Direct Care component via Facetime, Google Duo/Meet, Microsoft Skype or
other similar platforms, their telehealth services have moved to an
approved DHA Platform. For DoD beneficiaries receiving Private Sector
telehealth, any platform used by their provider must be HIPAA-
compliant.
Appendix A
Certain TRICARE enrollee out-of-pocket costs (enrollment fees,
premiums, catastrophic caps, deductibles, and copayments) are adjusted
annually by Federal law and regulations based on the annual Cost of
Living Adjustment (COLA) applied to Uniformed Service member retired
pay. A difference in copayments remains between those who joined a
Uniformed Service before January 1, 2018, (Group A), and those who
joined on or after that date (Group B).
The retiree COLA is typically announced after the Federal fiscal
year begins in October. Beneficiary out-of-pocket expenses impacted by
the 2024 COLA will be posted to the tricare.mil/changes web page before
the start of TRICARE Open Season, November 13, 2023.
Pharmacy Out-of-Pocket Expenses for CY 2024
TRICARE Pharmacy copayments will increase on January 1, 2024:
[[Page 70961]]
Pharmacy Copayments for Calendar Year 2024 *
--------------------------------------------------------------------------------------------------------------------------------------------------------
Retail network
Retail network brand-name Retail network non- Mail order generic Mail order brand- Mail order non-
Year generic formulary formulary 30-day formulary 30-day formulary 90-day name formulary 90- formulary 90-day
30-day supply supply supply supply day supply supply
--------------------------------------------------------------------------------------------------------------------------------------------------------
2024............................ $16 $43 ** $76 $13 $38 $76
--------------------------------------------------------------------------------------------------------------------------------------------------------
* Active Duty Service Members enjoy a $0 copay for covered drugs at any pharmacy.
** For all beneficiaries except Active Duty Service Members, select brand-name maintenance medications (taken for long-term conditions) may only be
filled twice at retail and then must be filled through home delivery or military pharmacy.
Premium Based Plans
The CY 2024 monthly premiums for TRICARE Reserve Select, TRICARE
Retired Reserve, and TRICARE Young Adult and the quarterly premiums for
Continued Health Care Benefit Program will be posted to the
tricare.mil/changes web page once announced.
Dated: October 11, 2023.
Natalie M. Ragland,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2023-22790 Filed 10-11-23; 4:15 pm]
BILLING CODE 6001-FR-P
