10 U.S.C. § 1095b — TRICARE program: contractor payment of certain claims

submitted 28 years ago by Pub. L. 105-261 to r/title-10-ARMED-FORCES · 181 words · no verdicts yet

in plain englishAI-generated · not legal advice

The Secretary may let TRICARE contractors pay certain covered claims first and recover the cost from a responsible third-party payer.

(a)(1) The Secretary of Defense may authorize a TRICARE contractor to pay a claim before seeking reimbursement from a third-party payer. (2) The claim must be submitted by a TRICARE provider for care given to a covered beneficiary and identified as one for which a third-party payer may be liable. (b) The United States has the same right to collect charges for these claims as it has under section 1095. (c) “Third-party payer” has the meaning in section 1095(h), except that it does not include a primary medical insurer.

the actual law source: uscode.house.gov ↗public domain

(a)Payment of Claims.—

(1)

The Secretary of Defense may authorize a contractor under the TRICARE program to pay a claim described in paragraph (2) before seeking to recover from a third-party payer the costs incurred by the contractor to provide health care services that are the basis of the claim to a beneficiary under such program.

(2)

A claim under this paragraph is a claim—

(A)

that is submitted to the contractor by a provider under the TRICARE program for payment for services for health care provided to a covered beneficiary; and

(B)

that is identified by the contractor as a claim for which a third-party payer may be liable.

(b)Recovery From Third-Party Payers.—

The United States shall have the same right to collect charges related to claims described in subsection (a) as charges for claims under section 1095 of this title.

(c)Definition of Third-Party Payer.—

In this section, the term “third-party payer” has the meaning given that term in section 1095(h) of this title, except that such term excludes primary medical insurers.

Source credit: (Added Pub. L. 105–261, div. A, title VII, § 711(a)(1), Oct. 17, 1998, 112 Stat. 2058; amended Pub. L. 106–65, div. A, title VII, § 716(c)(2), Oct. 5, 1999, 113 Stat. 692.)

history & why it existsrecord from the source credit

1998Enacted · Pub. L. 105-261 · 112 Stat. 2058
1999Amended · Pub. L. 106-65 · 113 Stat. 692

A history note hasn’t been published yet. The record shows enactment by Pub. L. 105-261 on 1998-10-17.

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