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DOD/DODOASHA RIN: 0720-AB75 Publication ID: Fall 2019 
Title: TRICARE Pharmacy Benefits Program Reforms 
Abstract:

DoD will finalize the provisions of the published interim final rule. Section 702 of the National Defense Authorization Act for Fiscal Year 2018 (NDAA FY18) makes significant changes to the TRICARE Pharmacy Benefits Program. Specifically, it updates co-payment requirements; authorizes a new process for encouraging use of pharmaceutical agents that provide the best clinical effectiveness by excluding coverage for particular pharmaceutical agents that provide very little or no clinical effectiveness relative to similar agents and for giving preferential status to agents that provide enhanced clinical effectiveness; and authorizes special reimbursement methods, amounts, and procedures to encourage use or high-value products and discourage use of low-value products with respect to pharmaceutical agents provided as part of medical services from authorized providers. This rule was issued as an interim final rule in order to implement expeditiously the reforms authorized by section 702, as specifically authorized by subsection (b)(3) of that section. 

 
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 
EO 13771 Designation: Other 
CFR Citation: 32 CFR 199   
Legal Authority: 5 U.S.C. 301    10 U.S.C. ch. 55   
Legal Deadline:  None
Timetable:
Action Date FR Cite
Interim Final Rule  12/11/2018  83 FR 63574   
Interim Final Rule Effective  12/11/2018 
Interim Final Rule Comment Period End  02/11/2019 
Final Action  12/00/2019 
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:
David Bobb
Chief Pharmacy Operations
Department of Defense
Office of Assistant Secretary for Health Affairs
7700 Arlington Boulevard,
Falls Church, VA 22042
Phone:703 681-2890
Email: david.w.bobb.civ@mail.mil