Enterprise Revenue Cycle Improvement Initiative

(a) In general Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense, acting through the Assistant Secretary of Defense for Health Affairs and the Director of the Defense Health Agency, shall implement an enterprise-wide revenue cycle improvement initiative (in this section referred to as the Initiative) to standardize revenue cycle management processes, strengthen governance and accountability, improve workforce capability, and increase the accuracy, timeliness, and yield of third-party collections and claims management across the military health system. (b) Objectives The objectives of the Initiative are the following: (1) To establish and implement standardized revenue cycle management processes, defined stage-by-stage accountability, and enterprise performance standards across all military medical treatment facilities. (2) To improve the accuracy, timeliness, and completeness of clinical documentation, medical coding, charge capture, claims submission, and denial management, including through the use of advanced analytics, automation, and robotic process automation technologies as appropriate. (3) To increase third-party collections yield and reduce preventable claim denials across the military health system. (4) To strengthen the accuracy of medical readiness documentation, including documentation supporting deployment eligibility determinations, disability evaluation processing, and military provider clinical currency sustainment. (5) To ensure interoperability with the GENESIS electronic health record platform of the military health system to support end-to-end revenue cycle operations and performance visibility. (6) To establish enterprise workforce training and certification programs to improve revenue cycle competency across military medical treatment facilities. (7) To provide actionable performance data and operational feedback to markets, networks, and military medical treatment facilities of the Defense Health Agency to improve accountability and outcomes. (c) Elements In carrying out the Initiative, the Secretary shall— (1) designate a senior official within the Defense Health Agency to serve as the enterprise revenue cycle improvement lead, with responsibility for implementation, performance oversight, and reporting; (2) establish enterprise-wide revenue cycle performance standards and defined accountability for each stage of the revenue cycle, from patient scheduling through final collections; (3) develop and implement enterprise performance metrics, including leading and lagging indicators, with escalation thresholds and corrective action requirements; (4) implement workforce training and proficiency assessment programs for personnel performing revenue cycle functions across military medical treatment facilities; (5) leverage existing investments in the GENESIS electronic health record platform of the military health system, existing analytics capabilities, and enterprise financial systems to support standardized revenue cycle operations; and (6) incorporate advanced analytics, automation, and artificial intelligence capabilities, consistent with policies of the Department of Defense for responsible use of artificial intelligence, to support coding accuracy, denial prevention, charge capture, and revenue integrity. (d) Implementation (1) Application The Initiative shall apply to all military medical treatment facilities within the Defense Health Agency. (2) Priority The Secretary shall prioritize initial implementation of the Initiative at facilities with the greatest opportunity for improvement in revenue cycle performance and third-party collections yield. (3) Contracts and support The Secretary may enter into contracts or other agreements using available acquisition methods and competitive procedures, as appropriate, to obtain specialized expertise, technology capabilities, or implementation support necessary to carry out the Initiative. (4) Rule of construction Nothing in this section shall be construed to require the establishment of a new acquisition program or program management office for the purpose of revenue cycle management. (e) Reporting (1) Initial report Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report describing— (A) the baseline performance of military medical treatment facilities across key revenue cycle metrics, including days to final bill, clean claim submission rate, preventable denial rate, coding accuracy rate, and third-party collections yield; (B) the enterprise revenue cycle governance structure established under the Initiative, including stage-by-stage accountability designations; (C) implementation milestones and target dates for enterprise-wide deployment; and (D) the allocation of funds authorized for the Initiative. (2) Quarterly reports Not later than 90 days after the submission of the initial report under paragraph (1), and quarterly thereafter for a period of not less than two years, the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report describing— (A) progress in implementing the Initiative as compared to implementation milestones; (B) performance improvements in the metrics identified under paragraph (1)(A) compared to the established baseline; (C) the status of workforce training and certification programs; (D) the impact of revenue cycle accuracy improvements on medical readiness documentation, including any identified effects on deployment eligibility determinations or disability evaluation processing; and (E) challenges, risks, and recommendations for sustainment or expansion of the Initiative. (f) Sunset This section shall terminate on the date that is three years after the date of the enactment of this Act.