H.R. 1699 — TOTAL Care Act

This section establishes a five-year pilot program, beginning not later than 180 days after the date of enactment, under which (1) the referral requirement under TRICARE Prime (10 U.S.C. 1095f(a)(1)) does not apply to obstetrical and gynecological care—including related items and services—for covered participants (i.e., female beneficiaries enrolled in TRICARE Prime who elect to participate); and (2) such participants may designate an obstetrical or gynecological provider as an additional primary care manager. (As background: TRICARE Prime is the managed care option of the TRICARE program for eligible beneficiaries of the uniformed services (i.e., armed forces and certain commissioned corps), which generally requires referrals from a primary care manager for specialty care.) The section further requires the Secretary of Defense to submit to the congressional defense committees, not later than four years after enactment, a report assessing changes in TRICARE Prime enrollment and costs of obstetrical and gynecological care during the pilot program, among other matters.