S.Amdt. 3606

SA 3606, submitted by Mr. Hickenlooper, aims to add a new section to bill S. 2296 regarding payment adjustments for outpatient services for certain children's hospitals.

The amendment intends to change the law by requiring the Secretary to provide an annual payment adjustment to a children's hospital if it meets any of these criteria:

• 10 percent or more of the hospital's revenue comes from services provided to covered individuals under the TRICARE program.
• The hospital had at least 10,000 visits by covered individuals paid under paragraph (2).
• The Secretary determines the hospital is essential for TRICARE program operations.

The payment adjustment would be equal to 30 percent of the payments made to the children's hospital under the Outpatient Prospective Payment System (or a successor system) during that year for services provided to covered individuals.

The amendment defines a children's hospital as a provider of services under a plan covered by the section and a covered individual as a dependent of an active duty armed forces member or a member of the armed forces serving on active duty.

Additionally, the Secretary of Defense is required to create a payment methodology and prescribe joint regulations to handle these payments, keeping them separate from regulations for outpatient prospective payments.