10 U.S.C. § 1095f
Title 10
Chapter 55
Current through PL 116-220
~1 min read
Last updated: March 30, 2026
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- § 1071
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- § 1073
- § 1073a
- § 1073b
- § 1073c
- § 1073d
- § 1074
- § 1074a
- § 1074b
- § 1074c
- § 1074d
- § 1074e
- § 1074f
- § 1074g
- § 1074h
- § 1074i
- § 1074j
- § 1074k
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- § 1074n
- § 1074o
- § 1075
- § 1075a
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- § 1076a
- § 1076b
- § 1076c
- § 1076d
- § 1076e
- § 1076f
- § 1077
- § 1077a
- § 1078
- § 1078a
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- § 1079a
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- § 1086a
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- § 1090
- § 1090a
- § 1091
- § 1092
- § 1092a
- § 1093
- § 1094
- § 1094a
- § 1095
- § 1095a
- § 1095b
- § 1095c
- § 1095d
- § 1095e
- § 1095f
- § 1095g
- § 1096
- § 1097
- § 1097a
- § 1097b
- § 1097c
- § 1097d
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- § 1110a
- § 1110b
§ 1095f. TRICARE program: referrals and preauthorizations under TRICARE Prime
- (a)
- (1) Except as provided by paragraph (2), a beneficiary enrolled in TRICARE Prime shall be required to obtain a referral for care through a designated primary care manager (or other care coordinator) prior to obtaining care under the TRICARE program.
- (2) The Secretary may waive the referral requirement in paragraph (1) in such circumstances as the Secretary may establish for purposes of this subsection.
- (3) The cost-sharing amounts for a beneficiary enrolled in TRICARE Prime who does not obtain a referral for care under paragraph (1) (or a waiver pursuant to paragraph (2) for such care) shall be determined under section 1075a(c) of this title .
- (b) A beneficiary enrolled in TRICARE Prime shall be required to obtain preauthorization only with respect to a referral for the following:
- (1) Inpatient hospitalization.
- (2) Inpatient care at a skilled nursing facility.
- (3) Inpatient care at a rehabilitation facility.
- (4) Inpatient care at a residential treatment center.
- (c) The Secretary of Defense shall ensure that no contract for managed care support under the TRICARE program includes any requirement that a managed care support contractor require a primary care or specialty care provider to obtain prior authorization before referring a patient to a specialty care provider that is part of the network of health care providers or institutions of the contractor.
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