TRICARE Coverage of Certain Medical Benefits in Response to the COVID-19 Pandemic

The Assistant Secretary of Defense for Health Affairs (ASD(HA)) issues this interim final rule (IFR) with comment to temporarily modify the TRICARE regulation by: Waiving the three-day prior hospital qualifying stay requirement for coverage of skilled nursing facility (SNF) care; adding coverage for treatment use of investigational drugs under expanded access authorized by the United States (U.S.) Food and Drug Administration (FDA) when for the treatment of coronavirus disease 2019 (COVID-19); temporarily waiving certain provisions for acute care hospitals that will permit authorization of temporary hospital facilities and freestanding ambulatory surgical centers (ASCs) providing inpatient and outpatient hospital services; and, consistent with similar changes under the Centers for Medicaid and Medicare Services (CMS), revising diagnosis related group (DRG) reimbursement by temporarily reimbursing DRGs at a 20 percent higher rate for COVID-19 patients and temporarily waiving certain requirements for long term care hospitals (LTCHs). Finally, this IFR will also adopt Medicare's New Technology Add-On Payments (NTAPs) adjustment to DRGs for new medical services and technologies and adopt Medicare's Hospital Value Based Purchasing (HVBP) Program.