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DOD/DODOASHA RIN: 0720-AB65 Publication ID: Fall 2016 
Title: TRICARE: Mental Health and Substance Use Disorder Treatment  

This final rule modifies the TRICARE regulation to reduce administrative barriers to access to mental health benefit coverage and to improve access to substance use disorder (SUD) treatment for TRICARE beneficiaries, consistent with earlier Department of Defense and Institute of Medicine recommendations, current standards of practice in mental health and addiction medicine, and governing laws. This rule has four main objectives: (1) To eliminate unnecessary quantitative and non-quantitative treatment limitations on SUD and mental health benefit coverage and align beneficiary cost-sharing for mental health and SUD benefits with those applicable to medical/surgical benefits; (2) to expand covered mental health and SUD treatment under TRICARE, to include coverage of intensive outpatient programs and treatment of opioid use disorder; (3) to streamline the requirements for mental health and SUD institutional providers to become TRICARE authorized providers; and (4) to develop TRICARE reimbursement methodologies for newly recognized mental health and SUD intensive outpatient programs and opioid treatment programs.



Agency: Department of Defense(DOD)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Final Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: 32 CFR 199   
Legal Authority: 5 U.S.C. 301    10 U.S.C. ch 55   
Legal Deadline:  None
Action Date FR Cite
NPRM  02/01/2016  81 FR 5061   
NPRM Comment Period End  04/01/2016 
Final Action  09/02/2016  81 fr 61068   
Correction  09/16/2016  81 FR 63695   
Final Action Effective  10/03/2016 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Small Entities Affected: No  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Patricia Moseley
Department of Defense
Office of Assistant Secretary for Health Affairs
Defense Pentagon,
Washington, DC 22301
Phone:703 681-0064