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DOD/DODOASHA RIN: 0720-AB81 Publication ID: Spring 2022 
Title: TRICARE Coverage and Reimbursement of Certain Services Resulting From Temporary Program Changes in Response to the COVID-19 Pandemic 
Abstract:

This final rule finalizes certain provisions of three TRICARE interim final rules with request for comments issued in 2020 in response to the novel coronavirus disease 2019 (COVID-19) national emergency. The rules are as follows:

1. Interim final rule titled TRICARE Coverage and Reimbursement of Certain Services Resulting from Temporary Program Changes in Response to the COVID-19 Pandemic” (RIN 0720-AB81, published May 12, 2020 (85 FR 27921-27927)). The subject of the final rule has been changed to read as set forth in the title field above.

2. Interim final rule titled TRICARE Coverage of Certain Medical Benefits in Response to the COVID-19 Pandemic” (RIN 0720-AB82, published September 3, 2020 (85 FR 54914-54924)).

3. Interim final rule titled TRICARE Coverage of National Institute of Allergy and Infectious Disease Coronavirus Disease 2019 Clinical Trials” (RIN 0720-AB83, published October 30, 2020 (85 FR 68753-68758)).

The following provisions are finalized in a consolidated final rule, with modifications: (1) temporary waiver of the exclusion of audio-only telehealth services during the COVID-19 national emergency; (2) temporary waiver of telehealth cost-sharing during the COVID-19 national emergency; (3) temporary waiver of certain provider licensing requirements during the COVID-19 national emergency; (4) temporary waiver of the three-day prior hospital qualifying stay requirements for skilled nursing facilities during the COVID-19 national emergency; (5) temporary waiver of certain acute care hospital requirements for temporary hospitals and freestanding ambulatory surgery centers during the COVID-19 national emergency; (6) temporary revision of diagnosis related group (DRG) reimbursement at a 20 percent higher rate for COVID-19 patients during the COVID-19 Health and Human Services (HHS) Public Health Emergency (PHE); (7) temporary waiver of certain requirements for Long Term Care Hospitals (LTCHs) during the HHS PHE; (8) the permanent adoption of Medicare’s New Technology Add-On Payments (NTAPs) for new medical items and services; and (9) TRICARE’s enactment of the Medicare Hospital Value Based Purchasing (HVBP) Program.  Two provisions of the TRICARE COVID-19 interim final rules are being addressed in a separate final rule: treatment use of investigational drugs under expanded access; and National Institute for Allergy and Infectious Disease (NIAID) sponsored clinical trials.

 
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
Timetable:
Action Date FR Cite
Interim Final Rule  05/12/2020  85 FR 27921   
Interim Final Rule Effective  05/12/2020 
Interim Final Rule Comment Period End  06/11/2020 
Final Action  06/01/2022  87 FR 33001   
Final Action; Correction  06/08/2022  87 FR 34779   
Final Action Effective  07/01/2022 
Final Action; Correction Effective  07/01/2022 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Federalism: No 
Included in the Regulatory Plan: Yes 
RIN Data Printed in the FR: No 
Related RINs: Related to 0720-AB82, Related to 0720-AB83 
Agency Contact:
Erica Ferron
Defense Health Agency, Medical Benefits and Reimbursement Division
Department of Defense
Office of Assistant Secretary for Health Affairs
16401 E Centretech Parkway,
Aurora, CO 80011-9066
Phone:303 676-3626
Email: erica.c.ferron.civ@mail.mil