TRICARE ECHO Improvement Act
This bill expands benefits available under the TRICARE Extended Health Care Option program for beneficiaries with special needs, including by expanding coverage of respite care and durable medical equipment.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6148 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 6148
To amend title 10, United States Code, to expand benefits available
under the TRICARE Extended Health Care Option program, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 9, 2020
Mr. Cole (for himself and Mrs. Luria) introduced the following bill;
which was referred to the Committee on Armed Services
_______________________________________________________________________
A BILL
To amend title 10, United States Code, to expand benefits available
under the TRICARE Extended Health Care Option program, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``TRICARE ECHO Improvement Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Active duty members of the uniformed services encounter
difficulties accessing Home and Community-Based Services (HCBS)
waivers under Medicaid for the dependents of such members who
have intellectual or developmental disabilities.
(2) State residency requirements create barriers to
accessing such benefits for military families who move across
State lines and are required to reenroll with each permanent
change of station.
(3) Enrollment caps for such waivers create additional
barriers, and often result in waiting lists due to the demand
for such waivers, including, in 2017, an average 30-month wait
time.
(4) The Military Compensation and Retirement Modernization
Commission concluded that ``access to HCBS waiver benefits is a
substantial issue for military families . . . Service members
are required to re-apply for benefits each time they move to a
new state. Many Service members encounter waiting lists that
exceed their time assigned to a location.''.
(5) In 2001, the TRICARE Extended Care Health Option
program (``ECHO program'') was established as an alternative to
HCBS waivers for military families. The ECHO program provides
additional medical and non-medical services not covered by
TRICARE to eligible military dependents with special needs, for
the purpose of assisting in the reduction of the disabling
effects of the qualifying condition of the dependent.
(6) The Military Compensation and Retirement Modernization
Commission concluded that, although ECHO was created as an
alternative to HCBS waiver benefits, ``ECHO benefits, as
currently implemented, are not robust enough to replace state
waiver programs when those programs are inaccessible.''
(7) Although the purpose of the ECHO program is to provide
supplemental services to dependents with special needs, a 2014
study conducted by the Manpower Data Center of the Department
of Defense found that only 37 percent of military families that
have a child with special needs were aware of the program.
(8) The Conference Report accompanying the National Defense
Authorization Act for Fiscal Year 2010 stated that ``expanding
support for families with special needs is a critical
requirement for the all-volunteer force.''.
SEC. 3. SENSE OF CONGRESS.
It is the sense of Congress that military families deserve--
(1) equitable access to critical services that minimize the
debilitating effects of a disabling condition; and
(2) an evaluation of the effectiveness of current services
under the ECHO program.
SEC. 4. EXPANSION OF BENEFITS AVAILABLE UNDER TRICARE EXTENDED HEALTH
CARE OPTION PROGRAM.
(a) Extended Benefits for Eligible Dependents.--Subsection (e) of
section 1079 of title 10, United States Code, is amended to read as
follows:
``(e)(1) Extended benefits for eligible dependents under subsection
(d) may include comprehensive health care services (including services
necessary to maintain, or minimize or prevent deterioration of,
function of the patient) and case management services with respect to
the qualifying condition of such a dependent, and include, to the
extent such benefits are not provided under provisions of this chapter
other than under this section, the following:
``(A) Diagnosis and screening.
``(B) Inpatient, outpatient, and comprehensive home health
care supplies and services which may include cost effective and
medically appropriate services other than part-time or
intermittent services (within the meaning of such terms as used
in the second sentence of section 1861(m) of the Social
Security Act).
``(C) Rehabilitation and habilitation services and devices.
``(D) Institutional care in private nonprofit, public, and
State institutions and facilities and, if appropriate,
transportation to and from such institutions and facilities.
``(E) Custodial care, notwithstanding the prohibition in
section 1077(b)(1) of this title.
``(F) In accordance with paragraph (2), respite care for
the primary caregiver of the eligible dependent.
``(G) In accordance with paragraph (3), service and
modification of durable equipment and assistive technology
devices.
``(H) Special education.
``(I) Vocational training, which may be furnished to an
eligible dependent in the residence of the eligible dependent
or at a facility in which such training is provided.
``(J) In accordance with paragraph (4), adaptations to the
private residence and vehicle of the eligible dependent.
``(K) Such other services and supplies as determined
appropriate by the Secretary, notwithstanding the limitations
in subsection (a)(12).
``(2) Respite care under paragraph (1)(F) shall be provided subject
to the following conditions:
``(A) Such respite care shall be limited to 50 hours in
each month.
``(B) Unused hours of respite care may not be carried over
to another month.
``(C) Such respite care may be provided to an eligible
beneficiary regardless of whether the eligible beneficiary is
receiving another benefit under this subsection.
``(3)(A) Service and modification of durable equipment and
assistive technology devices under paragraph (1)(G) may be provided
only upon determination by the Secretary that the service or
modification is necessary for the use of such equipment or device by
the eligible dependent.
``(B) Service and modification of durable equipment and assistive
technology devices under such paragraph may not be provided--
``(i) in the case of misuse, loss, or theft of the
equipment or device; or
``(ii) for a deluxe, luxury, or immaterial feature of the
equipment or device, as determined by the Secretary.
``(C) Service and modification of durable equipment and assistive
technology devices under such paragraph may include training of the
eligible dependent and immediate family members of the eligible
dependent on the use of the equipment or device.
``(4)(A) Adaptations to the private residence and vehicle of the
eligible dependent under paragraph (1)(J) may be provided if such
adaptations--
``(i) are determined to be medically necessary by the
provider responsible for the care of the eligible dependent
with respect to the qualifying condition; and
``(ii) are necessary to assist in--
``(I) the reduction of the disabling effects of the
qualifying condition; or
``(II) maintenance of the present functionality of
the eligible dependent.
``(B) With respect to a vehicle, adaptations may be provided under
such paragraph if the vehicle is the primary means of transportation of
the eligible dependent.''.
SEC. 5. ADDITIONAL REQUIREMENTS IN OFFICE OF SPECIAL NEEDS ANNUAL
REPORT.
Section 1781c(g)(2) of title 10, United States Code, is amended--
(1) by redesignating subparagraph (C) as subparagraph (D);
and
(2) by inserting after subparagraph (B) the following new
subparagraph (C):
``(C) With respect to the Extended Care Health Option
program under section 1079(d) of this title--
``(i) the utilization rates of services under such
program by eligible dependents (as such term is defined
in such section) during the prior year;
``(ii) a description of gaps in such services, as
ascertained by the Secretary from information provided
by families of eligible dependents;
``(iii) an assessment of factors that prevent
knowledge of and access to such program, including a
discussion of actions the Secretary may take to address
these factors; and
``(iv) an assessment of the average wait time for
an eligible dependent enrolled in the program to access
alternative health coverage for a qualifying condition
(as such term is defined in such section), including a
discussion of any adverse health outcomes associated
with such wait.''.
SEC. 6. EFFECTIVE DATE.
The amendments made by this Act shall take effect October 1, 2020.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Armed Services.
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