Improvement of provider directory accuracy for specialty care providers under the TRICARE program

(a) In general The Director of the Defense Health Agency shall— (1) ensure that each managed care contract under the TRICARE program entered into after the date of the enactment of this Act includes requirements that the managed care contractor— (A) conduct comprehensive outreach campaigns, to include electronic and non-electronic means, and mass email campaigns to network specialty care providers providing— (i) information relating to penalties associated with inaccurate provider directory information; (ii) resources for improving directory information; and (iii) direct links for providers to update their directory information; (B) make it a condition of joining the network managed by such contractor under the TRICARE program for specialty care providers to validate their provider directory information not less frequently than quarterly; (C) ensure that when specialty care providers file for reimbursement, such providers are prompted to review and verify their directory accuracy; (D) create a mechanism by which beneficiaries under the TRICARE program can report provider directory inaccuracy to the contractor; (E) conduct random tests (not less frequently than monthly) encompassing all specialty care provider types, of the accuracy of information maintained by the contractor relating to specialty care providers; and (F) not less frequently than monthly, submit to the Director the results of such random tests, disaggregated by each specialty care provider type, conducted during the month covered by the report; and (2) develop financial penalties or other contractual remedies for inaccurate provider directory information under such contracts in accordance with the penalties or remedies imposed as of the date of the enactment of this Act under the T–5 Contract. (b) Other methods The Director shall carry out any other methods that the Director finds useful for the improvement of provider directory accuracy under the TRICARE program. (c) Testing of directory information Not less frequently than twice each year during the three-year period following the date of the enactment of this Act, the Inspector General of the Defense Health Agency shall— (1) conduct random tests, encompassing and disaggregating by all specialty care provider types, of the accuracy of information relating to specialty care providers contained in the provider directory under the TRICARE program; and (2) submit to the Committees on Armed Services of the Senate and the House of Representatives a report containing the findings of each random test. (d) Briefings (1) In general Not later than one year after the date of the enactment of this Act, and annually thereafter for the following four years, the Director shall provide to the Committees on Armed Services of the Senate and the House of Representatives a briefing on progress in carrying out this section. (2) Elements Each briefing under paragraph (1) shall include, at a minimum, the following: (A) A description of the techniques that are most effective in improving accuracy of provider directories. (B) An identification of the authorities or tools that the Defense Health Agency lacks for improving such accuracy. (C) An identification of challenges specific to each specialty care provider type that limit such accuracy. (D) An assessment of the impact of efforts of the Defense Health Agency towards improving such accuracy on providers either leaving the TRICARE program or on the willingness of non-network providers to join the TRICARE program. (e) Comptroller General review Not later than one year after the date of the enactment of this Act, and annually thereafter for the following two years, the Comptroller General of the United States shall— (1) conduct a holistic review of provider directory accuracy under the TRICARE program, disaggregated by each specialty care provider type, to measure the progress of the Director towards meeting the existing requirements set forth by each managed care contractor under the TRICARE program, including by providing recommendations that would inform the development of the next managed care support contract competition; and (2) submit to the Committees on Armed Services of the Senate and the House of Representatives a report on the review conducted under paragraph (1). (f) Definitions In this section: (1) Random test (A) In general The term random test, with respect to specialty care providers, means conducting covert calls to offices of a random sample of such providers using phone numbers from the directory available under the TRICARE program with respect to such providers to confirm the accuracy of information contained in such directory. (B) Special rule A random test may not be conducted with respect to the same sample of providers in consecutive tests. (2) TRICARE program The term TRICARE program has the meaning given that term in section 1072 of title 10, United States Code.