US (United States) Code. Title 10. Subtitle A. Part II. Chapter 55: Medical and dental care

Codificación normativa de EEUU (Estados Unidos). Legislación federal estadounidense # Armed Forces

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-CITE-

10 USC CHAPTER 55 - MEDICAL AND DENTAL CARE 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

.

-HEAD-

CHAPTER 55 - MEDICAL AND DENTAL CARE

-MISC1-

Sec.

1071. Purpose of this chapter.

1072. Definitions.

1073. Administration of this chapter.

1073a. Contracts for health care: best value contracting.

1074. Medical and dental care for members and certain former

members.

1074a. Medical and dental care: members on duty other than active

duty for a period of more than 30 days.

(1074b. Repealed.)

1074c. Medical care: authority to provide a wig.

1074d. Certain primary and preventive health care services.

1074e. Medical care: certain Reserves who served in Southwest Asia

during the Persian Gulf Conflict.

1074f. Medical tracking system for members deployed overseas.

1074g. Pharmacy benefits program.

1074h. Medical and dental care: medal of honor recipients;

dependents.

1074i. Reimbursement for certain travel expenses.

1074j. Sub-acute care program.

1074k. Long-term care insurance.

1075. Officers and certain enlisted members: subsistence charges.

1076. Medical and dental care for dependents: general rule.

1076a. TRICARE dental program.

(1076b. Repealed.)

1076c. Dental insurance plan: certain retirees and their surviving

spouses and other dependents.

1077. Medical care for dependents: authorized care in facilities of

uniformed services.

1078. Medical and dental care for dependents: charges.

1078a. Continued health benefits coverage.

1079. Contracts for medical care for spouses and children: plans.

1079a. CHAMPUS: treatment of refunds and other amounts collected.

1079b. Procedures for charging fees for care provided to civilians;

retention and use of fees collected.

1080. Contracts for medical care for spouses and children: election

of facilities.

1081. Contracts for medical care for spouses and children: review

and adjustment of payments.

1082. Contracts for health care: advisory committees.

1083. Contracts for medical care for spouses and children:

additional hospitalization.

1084. Determinations of dependency.

1085. Medical and dental care from another executive department:

reimbursement.

1086. Contracts for health benefits for certain members, former

members, and their dependents.

1086a. Certain former spouses: extension of period of eligibility

for health benefits.

1086b. Prohibition against requiring retired members to receive

health care solely through the Department of Defense.

1087. Programing facilities for certain members, former members,

and their dependents in construction projects of the uniformed

services.

1088. Air evacuation patients: furnished subsistence.

1089. Defense of certain suits arising out of medical malpractice.

1090. Identifying and treating drug and alcohol dependence.

1091. Personal services contracts.

1092. Studies and demonstration projects relating to delivery of

health and medical care.

1093. Performance of abortions: restrictions.

1094. Licensure requirement for health-care professionals.

1094a. Continuing medical education requirements: system for

monitoring physician compliance.

1095. Health care services incurred on behalf of covered

beneficiaries: collection from third-party payers.

1095a. Medical care: members held as captives and their dependents.

1095b. TRICARE program: contractor payment of certain claims.

1095c. TRICARE program: facilitation of processing of claims.

1095d. TRICARE program: waiver of certain deductibles.

1095e. TRICARE program: beneficiary counseling and assistance

coordinators.

1095f. TRICARE program: referrals for specialty health care.

1096. Military-civilian health services partnership program.

1097. Contracts for medical care for retirees, dependents, and

survivors: alternative delivery of health care.

1097a. TRICARE Prime: automatic enrollments; payment options.

1097b. TRICARE program: financial management.

1098. Incentives for participation in cost-effective health care

plans.

1099. Health care enrollment system.

1100. Defense Health Program Account.

1101. Resource allocation methods: capitation or diagnosis-related

groups.

1102. Confidentiality of medical quality assurance records:

qualified immunity for participants.

1103. Contracts for medical and dental care: State and local

preemption.

1104. Sharing of health-care resources with the Department of

Veterans Affairs.

1105. Specialized treatment facility program.

1106. Submittal of claims: standard form; time limits.

1107. Notice of use of an investigational new drug or a drug

unapproved for its applied use.

1108. Health care coverage through Federal Employees Health

Benefits program: demonstration project.

1109. Organ and tissue donor program.

1110. Anthrax vaccine immunization program; procedures for

exemptions and monitoring reactions.

AMENDMENTS

2001 - Pub. L. 107-107, div. A, title VII, Sec. 701(a)(2),

(f)(2), 731(b), 732(a)(2), 736(c)(2), title X, Sec. 1048(a)(10),

Dec. 28, 2001, 115 Stat. 1158, 1161, 1169, 1173, 1223, struck out

item 1074b ''Transitional medical and dental care: members on

active duty in support of contingency operations'', transferred

item 1074i to appear after item 1074h, and added items 1074j,

1074k, 1079b, and 1086b.

2000 - Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec.

706(a)(2), 728(a)(2), 751(b)(2), 758(b)), Oct. 30, 2000, 114 Stat.

1654, 1654A-175, 1654A-189, 1654A-194, 1654A-200, added items

1074h, 1074i, 1095f, and 1110.

1999 - Pub. L. 106-65, div. A, title VII, Sec. 701(a)(2),

711(b), 713(a)(2), 714(b), 715(a)(2), 716(a)(2), 722(b), Oct. 5,

1999, 113 Stat. 680, 687, 689-691, 695, added items 1073a, 1074g,

1076a, 1095c, 1095d, 1095e, and 1097b and struck out former items

1076a ''Dependents' dental program'' and 1076b ''Selected Reserve

dental insurance''.

1998 - Pub. L. 105-261, div. A, title VII, Sec. 711(b),

712(a)(2), 721(a)(2), 734(b)(2), 741(b)(2), Oct. 17, 1998, 112

Stat. 2058, 2059, 2065, 2073, 2074, added items 1094a, 1095b,

1097a, 1108, and 1109.

1997 - Pub. L. 105-85, div. A, title VII, Sec. 738(b), 764(b),

765(a)(2), 766(b), Nov. 18, 1997, 111 Stat. 1815, 1826-1828, added

items 1074e, 1074f, 1106, and 1107 and struck out former item 1106

''Submittal of claims under CHAMPUS''.

1996 - Pub. L. 104-201, div. A, title VII, Sec. 701(a)(2)(B),

703(a)(2), 733(a)(2), Sept. 23, 1996, 110 Stat. 2587, 2590, 2598,

substituted ''Certain primary and preventive health care services''

for ''Primary and preventive health care services for women'' in

item 1074d and added items 1076c and 1079a.

Pub. L. 104-106, div. A, title VII, Sec. 705(a)(2), 735(d)(2),

738(b)(2), Feb. 10, 1996, 110 Stat. 373, 383, added item 1076b and

substituted ''Performance of abortions: restrictions'' for

''Restriction on use of funds for abortions'' in item 1093 and

''Defense Health Program Account'' for ''Military Health Care

Account'' in item 1100.

1993 - Pub. L. 103-160, div. A, title VII, Sec. 701(a)(2),

712(a)(2), 714(b)(2), 716(a)(2), Nov. 30, 1993, 107 Stat. 1686,

1689, 1690, 1692, added item 1074d, substituted ''Personal services

contracts'' for ''Contracts for direct health care providers'' in

item 1091 and ''Resource allocation methods: capitation or

diagnosis-related groups'' for ''Diagnosis-related groups'' in item

1101, added item 1105, and struck out former item 1105 ''Issuance

of nonavailability of health care statements''.

1992 - Pub. L. 102-484, div. D, title XLIV, Sec. 4408(a)(2),

Oct. 23, 1992, 106 Stat. 2712, added item 1078a.

1991 - Pub. L. 102-190, div. A, title VI, Sec. 640(b), title

VII, Sec. 715(b), 716(a)(2), Dec. 5, 1991, 105 Stat. 1385, 1403,

1404, added item 1074b, redesignated former item 1074b as 1074c,

and added items 1105 and 1106.

1990 - Pub. L. 101-510, div. A, title VII, Sec. 713(d)(2)((3)),

Nov. 5, 1990, 104 Stat. 1584, substituted ''Health care services

incurred on behalf of covered beneficiaries: collection from

third-party payers'' for ''Collection from third-party payers of

reasonable inpatient hospital care costs incurred on behalf of

retirees and dependents'' in item 1095.

1989 - Pub. L. 101-189, div. A, title VII, Sec. 722(b),

731(b)(2), Nov. 29, 1989, 103 Stat. 1478, 1482, added items 1086a

and 1104.

1987 - Pub. L. 100-180, div. A, title VII, Sec. 725(a)(2), Dec.

4, 1987, 101 Stat. 1116, added item 1103.

Pub. L. 100-26, Sec. 7(e)(2), Apr. 21, 1987, 101 Stat. 281,

redesignated item 1095 ''Medical care: members held as captives and

their dependents'' as item 1095a.

1986 - Pub. L. 99-661, div. A, title VI, Sec. 604(a)(2), title

VII, Sec. 701(a)(2), 705(a)(2), Nov. 14, 1986, 100 Stat. 3875,

3897, 3904 substituted ''active duty for a period of more than 30

days'' for ''active duty; injuries, diseases, and illnesses

incident to duty'' in item 1074a and added items 1096 to 1102.

Pub. L. 99-399, title VIII, Sec. 801(c)(2), Aug. 27, 1986, 100

Stat. 886, added item 1095 ''Medical care: members held as captives

and their dependents''.

Pub. L. 99-272, title II, Sec. 2001(a)(2), Apr. 7, 1986, 100

Stat. 101, added item 1095 ''Collection from third-party payers of

reasonable inpatient hospital care costs incurred on behalf of

retirees and dependents''.

1985 - Pub. L. 99-145, title VI, Sec. 651(a)(2), 653(a)(2), Nov.

8, 1985, 99 Stat. 656, 658, added items 1076a and 1094.

1984 - Pub. L. 98-525, title VI, Sec. 631(a)(2), title XIV, Sec.

1401(e)(2)(B), (5)(B), Oct. 19, 1984, 98 Stat. 2543, 2616, 2618,

substituted in item 1074a ''Medical and dental care: members on

duty other than active duty; injuries, diseases, and illnesses

incident to duty'' for ''Medical and dental care for members of the

uniformed services for injuries incurred or aggravated while

traveling to and from inactive duty training'' and added items

1074b and 1093.

1983 - Pub. L. 98-94, title IX, Sec. 932(a)(2), 933(a)(2), title

X, Sec. 1012(a)(2), title XII, Sec. 1268(5)(B), Sept. 24, 1983, 97

Stat. 650, 651, 665, 706, added items 1074a, 1091, and 1092, and

struck out ''; reports'' at end of item 1081.

1982 - Pub. L. 97-295, Sec. 1(15)(B), Oct. 12, 1982, 96 Stat.

1290, added item 1090.

1980 - Pub. L. 96-513, title V, Sec. 511(34)(D), Dec. 12, 1980,

94 Stat. 2923, in items 1071 and 1073 substituted ''this chapter''

for ''sections 1071-1087 of this title'', and in item 1086

substituted ''benefits'' for ''care''.

1976 - Pub. L. 94-464, Sec. 1(b), Oct. 8, 1976, 90 Stat. 1986,

added item 1089.

1970 - Pub. L. 91-481, Sec. 2(2), Oct. 21, 1970, 84 Stat. 1082,

added item 1088.

1966 - Pub. L. 89-614, Sec. 2(9), Sept. 30, 1966, 80 Stat. 866,

substituted ''1087'' for ''1085'' in items 1071 and 1073, ''Medical

care'' and ''authorized care in facilities of uniformed services''

for ''Medical and dental care'' and ''specific inclusions and

exclusions'' in item 1077, ''Contracts for health care'' for

''Contracts for medical care for spouses and children'' in item

1082, and added items 1086 and 1087.

1965 - Pub. L. 89-264, Sec. 2, Oct. 19, 1965, 79 Stat. 989,

substituted ''executive department'' for ''uniformed service'' in

item 1085.

1958 - Pub. L. 85-861, Sec. 1(25)(A), (C), Sept. 2, 1958, 72

Stat. 1445, 1450, substituted ''Medical and Dental Care'' for

''Voting by Members of Armed Forces'' in heading of chapter, and

substituted items 1071 to 1085 for former items 1071 to 1086.

-SECREF-

CHAPTER REFERRED TO IN OTHER SECTIONS

This chapter is referred to in sections 129c, 1490 of this title;

title 14 sections 668, 705; title 26 sections 35, 9801, 9832; title

29 sections 1181, 1191b, 2918; title 38 sections 1781, 7423, 8111;

title 42 sections 300gg, 300gg-91, 1395w-21, 14402, 14405.

-CITE-

10 USC Sec. 1071 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1071. Purpose of this chapter

-STATUTE-

The purpose of this chapter is to create and maintain high morale

in the uniformed services by providing an improved and uniform

program of medical and dental care for members and certain former

members of those services, and for their dependents.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1445;

amended Pub. L. 89-614, Sec. 2(1), Sept. 30, 1966, 80 Stat. 862;

Pub. L. 96-513, title V, Sec. 511(34)(A), (B), Dec. 12, 1980, 94

Stat. 2922.)

-MISC1-

Historical and Revision Notes

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Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1071 37:401. June 7, 1956, ch.

374, Sec. 101, 70

Stat. 250.

-------------------------------

The words ''and certain former members'' are inserted to reflect

the fact that many of the persons entitled to retired pay are

former members only. The words ''and dental'' are inserted to

reflect the fact that members and, in certain limited situations,

dependents are entitled to dental care under sections 1071-1085 of

this title.

PRIOR PROVISIONS

A prior section 1071, act Aug. 10, 1956, ch. 1041, 70A Stat. 81,

which stated the purpose of former sections 1071 to 1086 of this

title, and provided for their construction, was repealed by Pub. L.

85-861, Sec. 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by

the Federal Voting Assistance Act of 1955 which is classified to

subchapter I-D (Sec. 1973cc et seq.) of chapter 20 of Title 42, The

Public Health and Welfare.

AMENDMENTS

1980 - Pub. L. 96-513 substituted ''Purpose of this chapter'' for

''Purpose of sections 1071-1087 of this title'' in section

catchline, and substituted reference to this chapter for reference

to sections 1071-1087 of this title in text.

1966 - Pub. L. 89-614 substituted ''1087'' for ''1085'' in

section catchline and text.

EFFECTIVE DATE OF 1980 AMENDMENT

Amendment by Pub. L. 96-513 effective Dec. 12, 1980, see section

701(b)(3) of Pub. L. 96-513, set out as a note under section 101 of

this title.

EFFECTIVE DATE OF 1966 AMENDMENT

Section 3 of Pub. L. 89-614 provided that: ''The amendments made

by this Act (see Short Title of 1966 Amendment note below) shall

become effective January 1, 1967, except that those amendments

relating to outpatient care in civilian facilities for spouses and

children of members of the uniformed services who are on active

duty for a period of more than 30 days shall become effective on

October 1, 1966.''

SHORT TITLE OF 1987 AMENDMENT

Pub. L. 100-180, div. A, title VII, Sec. 701, Dec. 4, 1987, 101

Stat. 1108, provided that: ''This title (enacting sections 1103,

2128 to 2130 (now 16201 to 16203), and 6392 of this title, amending

sections 533, 591, 1079, 1086, 1251, 2120, 2122, 2123, 2124, 2127,

2172 (now 16302), 3353, 3855, 5600, 8353, and 8855 of this title,

section 302 of Title 37, Pay and Allowances of the Uniformed

Services, and section 460 of Title 50, Appendix, War and National

Defense, enacting provisions set out as notes under sections 1073,

1074, 1079, 1092, 1103, 2121, 2124, 12201, and 16201 of this title,

amending provisions set out as notes under sections 1073 and 1101

of this title, and repealing provisions set out as notes under

sections 2121 and 2124 of this title) may be cited as the 'Military

Health Care Amendments of 1987'.''

SHORT TITLE OF 1966 AMENDMENT

Section 1 of Pub. L. 89-614 provided: ''That this Act (enacting

sections 1086 and 1087 of this title, amending this section and

sections 1072 to 1074, 1076 to 1079, 1082, and 1084 of this title,

and enacting provisions set out as a note under this section) may

be cited as the 'Military Medical Benefits Amendments of 1966'.''

ACCESS TO HEALTH CARE SERVICES FOR BENEFICIARIES ELIGIBLE FOR

TRICARE AND DEPARTMENT OF VETERANS AFFAIRS HEALTH CARE

Pub. L. 107-314, div. A, title VII, Sec. 708, Dec. 2, 2002, 116

Stat. 2585, provided that:

''(a) Requirement To Establish Process. - (1) The Secretary of

Defense shall prescribe in regulations a process for resolving

issues relating to patient safety and continuity of care for

covered beneficiaries who are concurrently entitled to health care

under the TRICARE program and eligible for health care services

provided by the Department of Veterans Affairs. The Secretary shall

-

''(A) ensure that the process provides for coordination of, and

access to, health care from the two sources in a manner that

prevents diminution of access to health care from either source;

and

''(B) in consultation with the Secretary of Veterans Affairs,

prescribe a clear definition of an 'episode of care' for use in

the resolution of patient safety and continuity of care issues

under such process.

''(2) Not later than May 1, 2003, the Secretary shall submit to

the Committees on Armed Services of the Senate and of the House of

Representatives a report describing the process prescribed under

paragraph (1).

''(3) While prescribing the process under paragraph (1) and upon

completion of the report under paragraph (2), the Secretary shall

provide to the Comptroller General information that would be

relevant in carrying out the study required by subsection (b).

''(b) Comptroller General Study and Report. - (1) The Comptroller

General shall conduct a study of the health care issues of covered

beneficiaries described in subsection (a). The study shall include

the following:

''(A) An analysis of whether covered beneficiaries who seek

services through the Department of Veterans Affairs are receiving

needed health care services in a timely manner from the

Department of Veterans Affairs, as compared to the timeliness of

the care available to covered beneficiaries under TRICARE Prime

(as set forth in access to care standards under TRICARE program

policy that are applicable to the care being sought).

''(B) An evaluation of the quality of care for covered

beneficiaries who do not receive needed services from the

Department of Veterans Affairs within a time period that is

comparable to the time period provided for under such access to

care standards and who then must seek alternative care under the

TRICARE program.

''(C) Recommendations to improve access to, and timeliness and

quality of, care for covered beneficiaries described in

subsection (a).

''(D) An evaluation of the feasibility and advisability of

making access to care standards applicable jointly under the

TRICARE program and the Department of Veterans Affairs health

care system.

''(E) A review of the process prescribed by the Secretary of

Defense under subsection (a) to determine whether the process

ensures the adequacy and quality of the health care services

provided to covered beneficiaries under the TRICARE program and

through the Department of Veterans Affairs, together with

timeliness of access to such services and patient safety.

''(2) Not later than 60 days after the congressional committees

specified in subsection (a)(2) receive the report required under

that subsection, the Comptroller General shall submit to those

committees a report on the study conducted under this subsection.

''(c) Definitions. - In this section:

''(1) The term 'covered beneficiary' has the meaning provided

by section 1072(5) of title 10, United States Code.

''(2) The term 'TRICARE program' has the meaning provided by

section 1072(7) of such title.

''(3) The term 'TRICARE Prime' has the meaning provided by

section 1097a(f) of such title.''

PILOT PROGRAM PROVIDING FOR DEPARTMENT OF VETERANS AFFAIRS SUPPORT

IN THE PERFORMANCE OF SEPARATION PHYSICAL EXAMINATIONS

Pub. L. 107-107, div. A, title VII, Sec. 734, Dec. 28, 2001, 115

Stat. 1170, provided that:

''(a) Authority. - The Secretary of Defense and the Secretary of

Veterans Affairs may jointly carry out a pilot program under which

the Secretary of Veterans Affairs may perform the physical

examinations required for members of the uniformed services

separating from the uniformed services who are in one or more

geographic areas designated for the pilot program by the

Secretaries.

''(b) Reimbursement. - The Secretary of Defense shall reimburse

the Secretary of Veterans Affairs for the cost incurred by the

Secretary of Veterans Affairs in performing, under the pilot

program, the elements of physical examination that are required by

the Secretary concerned in connection with the separation of a

member of a uniformed service. Reimbursements shall be paid out of

funds available for the performance of separation physical

examinations of members of that uniformed service in facilities of

the uniformed services.

''(c) Agreement. - (1) If the Secretary of Defense and the

Secretary of Veterans Affairs carry out the pilot program

authorized by this section, the Secretaries shall enter into an

agreement specifying the geographic areas in which the pilot

program is carried out and the means for making reimbursement

payments under subsection (b).

''(2) The other administering Secretaries shall also enter into

the agreement to the extent that the Secretary of Defense

determines necessary to apply the pilot program, including the

requirement for reimbursement, to the uniformed services not under

the jurisdiction of the Secretary of a military department.

''(d) Consultation Requirement. - In developing and carrying out

the pilot program, the Secretary of Defense shall consult with the

other administering Secretaries.

''(e) Period of Program. - The Secretary of Defense and the

Secretary of Veterans Affairs may carry out the pilot program under

this section beginning not later than July 1, 2002, and terminating

on December 31, 2005.

''(f) Reports. - (1) If the Secretary of Defense and the

Secretary of Veterans Affairs carry out the pilot program

authorized by this section -

''(A) not later than January 31, 2004, the Secretaries shall

jointly submit to Congress an interim report on the conduct of

the pilot program; and

''(B) not later than March 1, 2005, the Secretaries shall

jointly submit to Congress a final report on the conduct of the

pilot program.

''(2) Reports under this subsection shall include the

Secretaries' assessment, as of the date of the report, of the

efficacy of the performance of separation physical examinations as

provided for under the pilot program.

''(g) Definitions. - In this section:

''(1) The term 'administering Secretaries' has the meaning

given that term in section 1072(3) of title 10, United States

Code.

''(2) The term 'Secretary concerned' has the meaning given that

term in section 101(5) of title 37, United States Code.''

HEALTH CARE MANAGEMENT DEMONSTRATION PROGRAM

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 733), Oct. 30,

2000, 114 Stat. 1654, 1654A-191, as amended by Pub. L. 107-107,

div. A, title VII, Sec. 737, Dec. 28, 2001, 115 Stat. 1173,

provided that:

''(a) Establishment. - The Secretary of Defense shall carry out a

demonstration program on health care management to explore

opportunities for improving the planning, programming, budgeting

systems, and management of the Department of Defense health care

system.

''(b) Test Models. - Under the demonstration program, the

Secretary shall test the use of the following planning and

management models:

''(1) A health care simulation model for studying alternative

delivery policies, processes, organizations, and technologies.

''(2) A health care simulation model for studying long term

disease management.

''(c) Demonstration Sites. - The Secretary shall test each model

separately at one or more sites.

''(d) Period for Program. - The demonstration program shall begin

not later than 180 days after the date of the enactment of this Act

(Oct. 30, 2000) and shall terminate on December 31, 2003.

''(e) Report. - The Secretary of Defense shall submit a report on

the demonstration program to the Committees on Armed Services of

the Senate and the House of Representatives not later than March

15, 2004. The report shall include the Secretary's assessment of

the value of incorporating the use of the tested planning and

management models throughout the planning, programming, budgeting

systems, and management of the Department of Defense health care

system.

''(f) Funding. - Of the amount authorized to be appropriated

under section 301(22) (114 Stat. 1654A-52), $6,000,000 shall be

available for the demonstration program under this section.''

PROCESSES FOR PATIENT SAFETY IN MILITARY AND VETERANS HEALTH CARE

SYSTEMS

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 742), Oct. 30,

2000, 114 Stat. 1654, 1654A-192, provided that:

''(a) Error Tracking Process. - The Secretary of Defense shall

implement a centralized process for reporting, compilation, and

analysis of errors in the provision of health care under the

defense health program that endanger patients beyond the normal

risks associated with the care and treatment of such patients. To

the extent practicable, that process shall emulate the system

established by the Secretary of Veterans Affairs for reporting,

compilation, and analysis of errors in the provision of health care

under the Department of Veterans Affairs health care system that

endanger patients beyond such risks.

''(b) Sharing of Information. - The Secretary of Defense and the

Secretary of Veterans Affairs -

''(1) shall share information regarding the designs of systems

or protocols established to reduce errors in the provision of

health care described in subsection (a); and

''(2) shall develop such protocols as the Secretaries consider

necessary for the establishment and administration of effective

processes for the reporting, compilation, and analysis of such

errors.''

COOPERATION IN DEVELOPING PHARMACEUTICAL IDENTIFICATION TECHNOLOGY

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 743), Oct. 30,

2000, 114 Stat. 1654, 1654A-192, provided that: ''The Secretary of

Defense and the Secretary of Veterans Affairs shall cooperate in

developing systems for the use of bar codes for the identification

of pharmaceuticals in the health care programs of the Department of

Defense and the Department of Veterans Affairs. In any case in

which a common pharmaceutical is used in such programs, the bar

codes for those pharmaceuticals shall, to the maximum extent

practicable, be identical.''

PATIENT CARE REPORTING AND MANAGEMENT SYSTEM

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 754), Oct. 30,

2000, 114 Stat. 1654, 1654A-196, provided that:

''(a) Establishment. - The Secretary of Defense shall establish a

patient care error reporting and management system.

''(b) Purposes of System. - The purposes of the system are as

follows:

''(1) To study the occurrences of errors in the patient care

provided under chapter 55 of title 10, United States Code.

''(2) To identify the systemic factors that are associated with

such occurrences.

''(3) To provide for action to be taken to correct the

identified systemic factors.

''(c) Requirements for System. - The patient care error reporting

and management system shall include the following:

''(1) A hospital-level patient safety center, within the

quality assurance department of each health care organization of

the Department of Defense, to collect, assess, and report on the

nature and frequency of errors related to patient care.

''(2) For each health care organization of the Department of

Defense and for the entire Defense health program, patient safety

standards that are necessary for the development of a full

understanding of patient safety issues in each such organization

and the entire program, including the nature and types of errors

and the systemic causes of the errors.

''(3) Establishment of a Department of Defense Patient Safety

Center within the Armed Forces Institute of Pathology, which

shall have the following missions:

''(A) To analyze information on patient care errors that is

submitted to the Center by each military health care

organization.

''(B) To develop action plans for addressing patterns of

patient care errors.

''(C) To execute those action plans to mitigate and control

errors in patient care with a goal of ensuring that the health

care organizations of the Department of Defense provide highly

reliable patient care with virtually no error.

''(D) To provide, through the Assistant Secretary of Defense

for Health Affairs, to the Agency for Healthcare Research and

Quality of the Department of Health and Human Services any

reports that the Assistant Secretary determines appropriate.

''(E) To review and integrate processes for reducing errors

associated with patient care and for enhancing patient safety.

''(F) To contract with a qualified and objective external

organization to manage the national patient safety database of

the Department of Defense.

''(d) MedTeams Program. - The Secretary shall expand the health

care team coordination program to integrate that program into all

Department of Defense health care operations. In carrying out this

subsection, the Secretary shall take the following actions:

''(1) Establish not less than two Centers of Excellence for the

development, validation, proliferation, and sustainment of the

health care team coordination program, one of which shall support

all fixed military health care organizations, the other of which

shall support all combat casualty care organizations.

''(2) Deploy the program to all fixed and combat casualty care

organizations of each of the Armed Forces, at the rate of not

less than 10 organizations in each fiscal year.

''(3) Expand the scope of the health care team coordination

program from a focus on emergency department care to a coverage

that includes care in all major medical specialties, at the rate

of not less than one specialty in each fiscal year.

''(4) Continue research and development investments to improve

communication, coordination, and team work in the provision of

health care.

''(e) Consultation. - The Secretary shall consult with the other

administering Secretaries (as defined in section 1072(3) of title

10, United States Code) in carrying out this section.''

CONFIDENTIALITY OF COMMUNICATIONS WITH PROFESSIONALS PROVIDING

THERAPEUTIC OR RELATED SERVICES REGARDING SEXUAL OR DOMESTIC ABUSE

Pub. L. 106-65, div. A, title V, Sec. 585, Oct. 5, 1999, 113

Stat. 636, provided that:

''(a) Study and Report. - (1) The Comptroller General of the

United States shall study the policies, procedures, and practices

of the military departments for protecting the confidentiality of

communications between -

''(A) a dependent (as defined in section 1072(2) of title 10,

United States Code, with respect to a member of the Armed Forces)

of a member of the Armed Forces who -

''(i) is a victim of sexual harassment, sexual assault, or

intrafamily abuse; or

''(ii) has engaged in such misconduct; and

''(B) a therapist, counselor, advocate, or other professional

from whom the dependent seeks professional services in connection

with effects of such misconduct.

''(2) Not later than 180 days after the date of the enactment of

this Act (Oct. 5, 1999), the Comptroller General shall conclude the

study and submit a report on the results of the study to Congress

and the Secretary of Defense.

''(b) Regulations. - The Secretary of Defense shall prescribe in

regulations the policies and procedures that the Secretary

considers appropriate to provide the maximum protections for the

confidentiality of communications described in subsection (a)

relating to misconduct described in that subsection, taking into

consideration -

''(1) the findings of the Comptroller General;

''(2) the standards of confidentiality and ethical standards

issued by relevant professional organizations;

''(3) applicable requirements of Federal and State law;

''(4) the best interest of victims of sexual harassment, sexual

assault, or intrafamily abuse;

''(5) military necessity; and

''(6) such other factors as the Secretary, in consultation with

the Attorney General, may consider appropriate.

''(c) Report by Secretary of Defense. - Not later than January

21, 2000, the Secretary of Defense shall submit to Congress a

report on the actions taken under subsection (b) and any other

actions taken by the Secretary to provide the maximum possible

protections for confidentiality described in that subsection.''

HEALTH CARE QUALITY INFORMATION AND TECHNOLOGY ENHANCEMENT

Pub. L. 106-65, div. A, title VII, Sec. 723, Oct. 5, 1999, 113

Stat. 695, as amended by Pub. L. 106-398, Sec. 1 ((div. A), title

VII, Sec. 753(a)), Oct. 30, 2000, 114 Stat. 1654, 1654A-195,

provided that:

''(a) Purpose. - The purpose of this section is to ensure that

the Department of Defense addresses issues of medical quality

surveillance and implements solutions for those issues in a timely

manner that is consistent with national policy and industry

standards.

''(b) Department of Defense Program for Medical Informatics and

Data. - The Secretary of Defense shall establish a Department of

Defense program, the purposes of which shall be the following:

''(1) To develop parameters for assessing the quality of health

care information.

''(2) To develop the defense digital patient record.

''(3) To develop a repository for data on quality of health

care.

''(4) To develop capability for conducting research on quality

of health care.

''(5) To conduct research on matters of quality of health care.

''(6) To develop decision support tools for health care

providers.

''(7) To refine medical performance report cards.

''(8) To conduct educational programs on medical informatics to

meet identified needs.

''(c) Automation and Capture of Clinical Data. - (1) Through the

program established under subsection (b), the Secretary of Defense

shall accelerate the efforts of the Department of Defense to

automate, capture, and exchange controlled clinical data and

present providers with clinical guidance using a personal

information carrier, clinical lexicon, or digital patient record.

''(2) The program shall serve as a primary resource for the

Department of Defense for matters concerning the capture,

processing, and dissemination of data on health care quality.

''(d) Medical Informatics Advisory Committee. - (1) The Secretary

of Defense shall establish a Medical Informatics Advisory Committee

(hereinafter referred to as the 'Committee'), the members of which

shall be the following:

''(A) The Assistant Secretary of Defense for Health Affairs.

''(B) The Director of the TRICARE Management Activity of the

Department of Defense.

''(C) The Surgeon General of the Army.

''(D) The Surgeon General of the Navy.

''(E) The Surgeon General of the Air Force.

''(F) Representatives of the Department of Veterans Affairs,

designated by the Secretary of Veterans Affairs.

''(G) Representatives of the Department of Health and Human

Services, designated by the Secretary of Health and Human

Services.

''(H) Any additional members appointed by the Secretary of

Defense to represent health care insurers and managed care

organizations, academic health institutions, health care

providers (including representatives of physicians and

representatives of hospitals), and accreditors of health care

plans and organizations.

''(2) The primary mission of the Committee shall be to advise the

Secretary on the development, deployment, and maintenance of health

care informatics systems that allow for the collection, exchange,

and processing of health care quality information for the

Department of Defense in coordination with other Federal

departments and agencies and with the private sector.

''(3) Specific areas of responsibility of the Committee shall

include advising the Secretary on the following:

''(A) The ability of the medical informatics systems at the

Department of Defense and Department of Veterans Affairs to

monitor, evaluate, and improve the quality of care provided to

beneficiaries.

''(B) The coordination of key components of medical informatics

systems, including digital patient records, both within the

Federal Government and between the Federal Government and the

private sector.

''(C) The development of operational capabilities for executive

information systems and clinical decision support systems within

the Department of Defense and Department of Veterans Affairs.

''(D) Standardization of processes used to collect, evaluate,

and disseminate health care quality information.

''(E) Refinement of methodologies by which the quality of

health care provided within the Department of Defense and

Department of Veterans Affairs is evaluated.

''(F) Protecting the confidentiality of personal health

information.

''(4) The Assistant Secretary of Defense for Health Affairs shall

consult with the Committee on the issues described in paragraph

(3).

''(5) The Secretary of Defense shall submit to Congress an annual

report on medical informatics. The report shall include a

discussion of the following matters:

''(A) The activities of the Committee.

''(B) The coordination of development, deployment, and

maintenance of health care informatics systems within the Federal

Government, and between the Federal Government and the private

sector.

''(C) The progress or growth occurring in medical informatics.

''(D) How the TRICARE program and the Department of Veterans

Affairs health care system can use the advancement of knowledge

in medical informatics to raise the standards of health care and

treatment and the expectations for improving health care and

treatment.

''(6) Members of the Committee shall not be paid by reason of

their service on the Committee.

''(7) The Federal Advisory Committee Act (5 U.S.C. App.) shall

not apply to the Committee.

''(e) Annual Report. - The Assistant Secretary of Defense for

Health Affairs shall submit to Congress on an annual basis a report

on the quality of health care furnished under the health care

programs of the Department of Defense. The report shall cover the

most recent fiscal year ending before the date the report is

submitted and shall contain a discussion of the quality of the

health care measured on the basis of each statistical and customer

satisfaction factor that the Assistant Secretary determines

appropriate, including, at a minimum, a discussion of the

following:

''(1) Health outcomes.

''(2) The extent of use of health report cards.

''(3) The extent of use of standard clinical pathways.

''(4) The extent of use of innovative processes for

surveillance.''

JOINT DEPARTMENT OF DEFENSE AND DEPARTMENT OF VETERANS AFFAIRS

REPORTS RELATING TO INTERDEPARTMENTAL COOPERATION IN DELIVERY OF

MEDICAL CARE

Pub. L. 105-261, div. A, title VII, Sec. 745, Oct. 17, 1998, 112

Stat. 2075, as amended by Pub. L. 106-65, div. A, title X, Sec.

1067(3), Oct. 5, 1999, 113 Stat. 774, provided that:

''(a) Findings. - Congress makes the following findings:

''(1) The military health care system of the Department of

Defense and the Veterans Health Administration of the Department

of Veterans Affairs are national institutions that collectively

manage more than 1,500 hospitals, clinics, and health care

facilities worldwide to provide services to more than 11,000,000

beneficiaries.

''(2) In the post-Cold War era, these institutions are in a

profound transition that involves challenging opportunities.

''(3) During the period from 1988 to 1998, the number of

military medical personnel has declined by 15 percent and the

number of military hospitals has been reduced by one-third.

''(4) During the 2 years since 1996, the Department of Veterans

Affairs has revitalized its structure by decentralizing authority

into 22 Veterans Integrated Service Networks.

''(5) In the face of increasing costs of medical care,

increased demands for health care services, and increasing

budgetary constraints, the Department of Defense and the

Department of Veterans Affairs have embarked on a variety of

dynamic and innovative cooperative programs ranging from shared

services to joint venture operations of medical facilities.

''(6) In 1984, there was a combined total of 102 Department of

Veterans Affairs and Department of Defense facilities with

sharing agreements. By 1997, that number had grown to 420.

During the six years from fiscal year 1992 through fiscal year

1997, shared services increased from slightly over 3,000 services

to more than 6,000 services, ranging from major medical and

surgical services, laundry, blood, and laboratory services to

unusual speciality care services.

''(7) The Department of Defense and the Department of Veterans

Affairs are conducting four health care joint ventures in New

Mexico, Nevada, Texas, and Oklahoma, and are planning to conduct

four more such ventures in Alaska, Florida, Hawaii, and

California.

''(b) Sense of Congress. - It is the sense of Congress that -

''(1) the Department of Defense and the Department of Veterans

Affairs should be commended for the cooperation between the two

departments in the delivery of medical care, of which the

cooperation involved in the establishment and operation of the

Department of Defense and the Department of Veterans Affairs

Executive Council is a praiseworthy example;

''(2) the Department of Defense and the Department of Veterans

Affairs are encouraged to continue to explore new opportunities

to enhance the availability and delivery of medical care to

beneficiaries by further enhancing the cooperative efforts of the

departments; and

''(3) enhanced cooperation between the Department of Defense

and the Department of Veterans Affairs is encouraged regarding -

''(A) the general areas of access to quality medical care,

identification and elimination of impediments to enhanced

cooperation, and joint research and program development; and

''(B) the specific areas in which there is significant

potential to achieve progress in cooperation in a short term,

including computerization of patient records systems,

participation of the Department of Veterans Affairs in the

TRICARE program, pharmaceutical programs, and joint physical

examinations.

''(c) Joint Survey of Populations Served. - (1) The Secretary of

Defense and the Secretary of Veterans Affairs shall jointly conduct

a survey of their respective medical care beneficiary populations

to identify, by category of beneficiary (defined as the Secretaries

consider appropriate), the expectations of, requirements for, and

behavior patterns of the beneficiaries with respect to medical

care. The two Secretaries shall develop the protocol for the

survey jointly, but shall obtain the services of an entity

independent of the Department of Defense and the Department of

Veterans Affairs to carry out the survey.

''(2) The survey shall include the following:

''(A) Demographic characteristics, economic characteristics,

and geographic location of beneficiary populations with regard to

catchment or service areas.

''(B) The types and frequency of care required by veterans,

retirees, and dependents within catchment or service areas of

Department of Defense and Department of Veterans Affairs medical

facilities and outside those areas.

''(C) The numbers of, characteristics of, and types of medical

care needed by the veterans, retirees, and dependents who, though

eligible for medical care in Department of Defense or Department

of Veterans Affairs treatment facilities or through other

federally funded medical programs, choose not to seek medical

care from those facilities or under those programs, and the

reasons for that choice.

''(D) The obstacles or disincentives for seeking medical care

from such facilities or under such programs that are perceived by

veterans, retirees, and dependents.

''(E) Any other matters that the Secretary of Defense and the

Secretary of Veterans Affairs consider appropriate for the

survey.

''(3) The Secretary of Defense or the Secretary of Veterans

Affairs may waive the survey requirements under this subsection

with respect to information that can be better obtained from a

source other than the survey.

''(4) The Secretary of Defense and the Secretary of Veterans

Affairs shall submit a report on the results of the survey to the

appropriate committees of Congress. The report shall contain the

matters described in paragraph (2) and any proposals for

legislation that the Secretaries recommend for enhancing Department

of Defense and Department of Veterans Affairs cooperative efforts

with respect to the delivery of medical care.

''(d) Review of Law and Policies. - (1) The Secretary of Defense

and the Secretary of Veterans Affairs shall jointly conduct a

review to identify impediments to cooperation between the

Department of Defense and the Department of Veterans Affairs

regarding the delivery of medical care. The matters reviewed shall

include the following:

''(A) All laws, policies, and regulations, and any attitudes of

beneficiaries of the health care systems of the two departments,

that have the effect of preventing the establishment, or limiting

the effectiveness, of cooperative health care programs of the

departments.

''(B) The requirements and practices involved in the

credentialling and licensure of health care providers.

''(C) The perceptions of beneficiaries in a variety of

categories (defined as the Secretaries consider appropriate)

regarding the various Federal health care systems available for

their use.

''(D) The types and frequency of medical services furnished by

the Department of Defense and the Department of Veterans Affairs

through cooperative arrangements to each category of beneficiary

(including active-duty members, retirees, dependents, veterans in

the health-care eligibility categories referred to as Category A

and Category C, and persons authorized to receive medical care

under section 1713 (1781) of title 38, United States Code) of the

other department.

''(E) The extent to which health care facilities of the

Department of Defense and Department of Veterans Affairs have

sufficient capacity, or could jointly or individually create

sufficient capacity, to provide services to beneficiaries of the

other department without diminution of access or services to

their primary beneficiaries.

''(F) The extent to which the recruitment of scarce medical

specialists and allied health personnel by the Department of

Defense and the Department of Veterans Affairs could be enhanced

through cooperative arrangements for providing health care

services.

''(G) The obstacles and disincentives to providing health care

services through cooperative arrangements between the Department

of Defense and the Department of Veterans Affairs.

''(2) The Secretaries shall jointly submit a report on the

results of the review to the appropriate committees of Congress.

The report shall include any proposals for legislation that the

Secretaries recommend for eliminating or reducing impediments to

interdepartmental cooperation that are identified during the

review.

''(e) Participation in TRICARE. - (1) The Secretary of Defense

shall review the TRICARE program to identify opportunities for

increased participation by the Department of Veterans Affairs in

that program. The ongoing collaboration between Department of

Defense officials and Department of Veterans Affairs officials

regarding increased participation shall be included among the

matters reviewed.

''(2) The Secretary of Defense and the Secretary of Veterans

Affairs shall jointly submit to the appropriate committees of

Congress a semiannual report on the status of the review under this

subsection and on efforts to increase the participation of the

Department of Veterans Affairs in the TRICARE program. No report

is required under this paragraph after the submission of a

semiannual report in which the Secretaries declare that the

Department of Veterans Affairs is participating in the TRICARE

program to the extent that can reasonably be expected to be

attained.

''(f) Pharmaceutical Benefits and Programs. - (1) The Department

of Defense-Department of Veterans Affairs Federal Pharmacy

Executive Steering Committee shall -

''(A) undertake a comprehensive examination of existing

pharmaceutical benefits and programs for beneficiaries of

Department of Defense medical care programs, including matters

relating to the purchasing, distribution, and dispensing of

pharmaceuticals and the management of mail order pharmaceuticals

programs; and

''(B) review the existing methods for contracting for and

distributing medical supplies and services.

''(2) The committee shall submit a report on the results of the

examination to the appropriate committees of Congress.

''(g) Standardization of Physical Examinations for Disability. -

The Secretary of Defense and the Secretary of Veterans Affairs

shall jointly submit to the appropriate committees of Congress a

report on the status of the efforts of the Department of Defense

and the Department of Veterans Affairs to standardize physical

examinations administered by the two departments for the purpose of

determining or rating disabilities.

''(h) Appropriate Committees of Congress Defined. - For the

purposes of this section, the appropriate committees of Congress

are as follows:

''(1) The Committee on Armed Services and the Committee on

Veterans' Affairs of the Senate.

''(2) The Committee on Armed Services and the Committee on

Veterans' Affairs of the House of Representatives.

''(i) Deadlines for Submission of Reports. - (1) The report

required by subsection (c)(3) (probably should be (c)(4)) shall be

submitted not later than January 1, 2000.

''(2) The report required by subsection (d)(2) shall be submitted

not later than March 1, 1999.

''(3) The semiannual report required by subsection (e)(2) shall

be submitted not later than March 1 and September 1 of each year.

''(4) The report on the examination required under subsection (f)

shall be submitted not later than 60 days after the completion of

the examination.

''(5) The report required by subsection (g) shall be submitted

not later than March 1, 1999.''

EXTERNAL PEER REVIEW FOR DEFENSE HEALTH PROGRAM EXTRAMURAL MEDICAL

RESEARCH INVOLVING HUMAN SUBJECTS

Pub. L. 104-201, div. A, title VII, Sec. 742, Sept. 23, 1996,

110 Stat. 2600, provided that:

''(a) Establishment of External Peer Review Process. - The

Secretary of Defense shall establish a peer review process that

will use persons who are not officers or employees of the

Government to review the research protocols of medical research

projects.

''(b) Peer Review Requirements. - Funds of the Department of

Defense may not be obligated or expended for any medical research

project unless the research protocol for the project has been

approved by the external peer review process established under

subsection (a).

''(c) Medical Research Project Defined. - For purposes of this

section, the term 'medical research project' means a research

project that -

''(1) involves the participation of human subjects;

''(2) is conducted solely by a non-Federal entity; and

''(3) is funded through the Defense Health Program account.

''(d) Effective Date. - The peer review requirements of

subsection (b) shall take effect on October 1, 1996, and, except as

provided in subsection (e), shall apply to all medical research

projects proposed funded on or after that date, including medical

research projects funded pursuant to any requirement of law enacted

before, on, or after that date.

''(e) Exceptions. - Only the following medical research projects

shall be exempt from the peer review requirements of subsection

(b):

''(1) A medical research project that the Secretary determines

has been substantially completed by October 1, 1996.

''(2) A medical research project funded pursuant to any

provision of law enacted on or after that date if the provision

of law specifically refers to this section and specifically

states that the peer review requirements do not apply.''

ANNUAL BENEFICIARY SURVEY

Pub. L. 102-484, div. A, title VII, Sec. 724, Oct. 23, 1992, 106

Stat. 2440, as amended by Pub. L. 103-337, div. A, title VII, Sec.

717, Oct. 5, 1994, 108 Stat. 2804, provided that:

''(a) Survey Required. - The administering Secretaries shall

conduct annually a formal survey of persons receiving health care

under chapter 55 of title 10, United States Code, in order to

determine the following:

''(1) The availability of health care services to such persons

through the health care system provided for under that chapter,

the types of services received, and the facilities in which the

services were provided.

''(2) The familiarity of such persons with the services

available under that system and with the facilities in which such

services are provided.

''(3) The health of such persons.

''(4) The level of satisfaction of such persons with that

system and the quality of the health care provided through that

system.

''(5) Such other matters as the administering Secretaries

determine appropriate.

''(b) Exemption. - An annual survey under subsection (a) shall be

treated as not a collection of information for the purposes for

which such term is defined in section 3502(4) of title 44, United

States Code.

''(c) Definition. - For purposes of this section, the term

'administering Secretaries' has the meaning given such term in

section 1072(3) of title 10, United States Code.''

COMPREHENSIVE STUDY OF MILITARY MEDICAL CARE SYSTEM

Pub. L. 102-190, div. A, title VII, Sec. 733, Dec. 5, 1991, 105

Stat. 1408, as amended by Pub. L. 102-484, div. A, title VII, Sec.

723, Oct. 23, 1992, 106 Stat. 2440, directed Secretary of Defense

to conduct a comprehensive study of the military medical care

system, not later than Dec. 15, 1992, to submit to congressional

defense committees a detailed accounting on progress of the study,

including preliminary results of the study, and not later than Dec.

15, 1993, submit to congressional defense committees a final report

on the study.

IDENTIFICATION AND TREATMENT OF DRUG AND ALCOHOL DEPENDENT PERSONS

IN THE ARMED FORCES

Pub. L. 92-129, title V, Sec. 501, Sept. 28, 1971, 85 Stat. 361,

which directed Secretary of Defense to devise ways to identify,

treat, and rehabilitate drug and alcohol dependent members of the

armed forces, to identify, refuse admission to, and refer to

civilian treatment facilities such persons seeking entrance to the

armed forces, and to report to Congress on and suggest additional

legislation concerning these matters, was repealed and restated as

sections 978 and 1090 of this title by Pub. L. 97-295, Sec.

1(14)(A), (15)(A), 6(b), Oct. 12, 1982, 96 Stat. 1289, 1290, 1314.

-CITE-

10 USC Sec. 1072 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1072. Definitions

-STATUTE-

In this chapter:

(1) The term ''uniformed services'' means the armed forces and

the Commissioned Corps of the National Oceanic and Atmospheric

Administration and of the Public Health Service.

(2) The term ''dependent'', with respect to a member or former

member of a uniformed service, means -

(A) the spouse;

(B) the unremarried widow;

(C) the unremarried widower;

(D) a child who -

(i) has not attained the age of 21;

(ii) has not attained the age of 23, is enrolled in a

full-time course of study at an institution of higher

learning approved by the administering Secretary and is, or

was at the time of the member's or former member's death, in

fact dependent on the member or former member for over

one-half of the child's support; or

(iii) is incapable of self-support because of a mental or

physical incapacity that occurs while a dependent of a member

or former member under clause (i) or (ii) and is, or was at

the time of the member's or former member's death, in fact

dependent on the member or former member for over one-half of

the child's support;

(E) a parent or parent-in-law who is, or was at the time of

the member's or former member's death, in fact dependent on him

for over one-half of his support and residing in his household;

(F) the unremarried former spouse of a member or former

member who (i) on the date of the final decree of divorce,

dissolution, or annulment, had been married to the member or

former member for a period of at least 20 years during which

period the member or former member performed at least 20 years

of service which is creditable in determining that member's or

former member's eligibility for retired or retainer pay, or

equivalent pay, and (ii) does not have medical coverage under

an employer-sponsored health plan;

(G) a person who (i) is the unremarried former spouse of a

member or former member who performed at least 20 years of

service which is creditable in determining the member or former

member's eligibility for retired or retainer pay, or equivalent

pay, and on the date of the final decree of divorce,

dissolution, or annulment before April 1, 1985, had been

married to the member or former member for a period of at least

20 years, at least 15 of which, but less than 20 of which, were

during the period the member or former member performed service

creditable in determining the member or former member's

eligibility for retired or retainer pay, and (ii) does not have

medical coverage under an employer-sponsored health plan;

(H) a person who would qualify as a dependent under clause

(G) but for the fact that the date of the final decree of

divorce, dissolution, or annulment of the person is on or after

April 1, 1985, except that the term does not include the person

after the end of the one-year period beginning on the date of

that final decree; and

(I) an unmarried person who -

(i) is placed in the legal custody of the member or former

member as a result of an order of a court of competent

jurisdiction in the United States (or a Territory or

possession of the United States) for a period of at least 12

consecutive months;

(ii) either -

(I) has not attained the age of 21;

(II) has not attained the age of 23 and is enrolled in a

full time course of study at an institution of higher

learning approved by the administering Secretary; or

(III) is incapable of self support because of a mental or

physical incapacity that occurred while the person was

considered a dependent of the member or former member under

this subparagraph pursuant to subclause (I) or (II);

(iii) is dependent on the member or former member for over

one-half of the person's support;

(iv) resides with the member or former member unless

separated by the necessity of military service or to receive

institutional care as a result of disability or

incapacitation or under such other circumstances as the

administering Secretary may by regulation prescribe; and

(v) is not a dependent of a member or a former member under

any other subparagraph.

(3) The term ''administering Secretaries'' means the

Secretaries of executive departments specified in section 1073 of

this title as having responsibility for administering this

chapter.

(4) The term ''Civilian Health and Medical Program of the

Uniformed Services'' means the program authorized under sections

1079 and 1086 of this title and includes contracts entered into

under section 1091 or 1097 of this title and demonstration

projects under section 1092 of this title.

(5) The term ''covered beneficiary'' means a beneficiary under

this chapter other than a beneficiary under section 1074(a) of

this title.

(6) The term ''child'', with respect to a member or former

member of a uniformed service, means the following:

(A) An unmarried legitimate child.

(B) An unmarried adopted child.

(C) An unmarried stepchild.

(D) An unmarried person -

(i) who is placed in the home of the member or former

member by a placement agency (recognized by the Secretary of

Defense) in anticipation of the legal adoption of the person

by the member or former member; and

(ii) who otherwise meets the requirements specified in

paragraph (2)(D).

(7) The term ''TRICARE program'' means the managed health care

program that is established by the Department of Defense under

the authority of this chapter, principally section 1097 of this

title, and includes the competitive selection of contractors to

financially underwrite the delivery of health care services under

the Civilian Health and Medical Program of the Uniformed

Services.

(8) The term ''custodial care'' means treatment or services,

regardless of who recommends such treatment or services or where

such treatment or services are provided, that -

(A) can be rendered safely and reasonably by a person who is

not medically skilled; or

(B) is or are designed mainly to help the patient with the

activities of daily living.

(9) The term ''domiciliary care'' means care provided to a

patient in an institution or homelike environment because -

(A) providing support for the activities of daily living in

the home is not available or is unsuitable; or

(B) members of the patient's family are unwilling to provide

the care.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1446;

amended Pub. L. 89-614, Sec. 2(1), Sept. 30, 1966, 80 Stat. 862;

Pub. L. 89-718, Sec. 8(a), Nov. 2, 1966, 80 Stat. 1117; Pub. L.

96-513, title I, Sec. 115(b), title V, Sec. 511(34)(A), (35), (36),

Dec. 12, 1980, 94 Stat. 2877, 2922, 2923; Pub. L. 97-252, title X,

Sec. 1004(a), Sept. 8, 1982, 96 Stat. 737; Pub. L. 98-525, title

VI, Sec. 645(a), Oct. 19, 1984, 98 Stat. 2548; Pub. L. 98-557, Sec.

19(1), Oct. 30, 1984, 98 Stat. 2869; Pub. L. 99-661, div. A, title

VII, Sec. 701(b), Nov. 14, 1986, 100 Stat. 3898; Pub. L. 101-189,

div. A, title VII, Sec. 731(a), Nov. 29, 1989, 103 Stat. 1481;

Pub. L. 102-484, div. A, title VII, Sec. 706, Oct. 23, 1992, 106

Stat. 2433; Pub. L. 103-160, div. A, title VII, Sec. 702(a), Nov.

30, 1993, 107 Stat. 1686; Pub. L. 103-337, div. A, title VII, Sec.

701(a), Oct. 5, 1994, 108 Stat. 2797; Pub. L. 105-85, div. A,

title VII, Sec. 711, Nov. 18, 1997, 111 Stat. 1808; Pub. L.

107-107, div. A, title VII, Sec. 701(c), Dec. 28, 2001, 115 Stat.

1160.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1072(1) 1072(2) 37:402(a)(1). June 7, 1956, ch.

37:402(a)(4). 374, Sec.

102(a)(1), (4), 70

Stat. 250.

-------------------------------

In clause (1), the words ''the armed forces'' are substituted for

the words ''the Army, the Navy, the Air Force, the Marine Corps,

the Coast Guard'' to reflect section 101(4) of this title.

In clause (2), the words ''or to a person who died while a member

or retired member of a uniformed service'' and ''lawful'' are

omitted as surplusage. The word ''former'' is substituted for the

word ''retired'', since a retired member or a member of the Fleet

Reserve or the Fleet Marine Corps Reserve is already included as a

''member'' of an armed force.

Clause (2)(E) combines 37:402(a)(4)(E) and (G).

PRIOR PROVISIONS

A prior section 1072, act Aug. 10, 1956, ch. 1041, 70A Stat. 81,

defined terms used in former sections 1071 to 1086 of this title,

prior to repeal by Pub. L. 85-861, Sec. 36B(5), Sept. 2, 1958, 72

Stat. 1570, as superseded by the Federal Voting Assistance Act of

1955 which is classified to subchapter I-D (Sec. 1973cc et seq.) of

chapter 20 of Title 42, The Public Health and Welfare.

AMENDMENTS

2001 - Pars. (8), (9). Pub. L. 107-107 added pars. (8) and (9).

1997 - Par. (7). Pub. L. 105-85 added par. (7).

1994 - Par. (2)(D). Pub. L. 103-337, Sec. 701(a)(1), substituted

''a child who'' for ''an unmarried legitimate child, including an

adopted child or stepchild, who'' in introductory provisions.

Par. (6). Pub. L. 103-337, Sec. 701(a)(2), added par. (6).

1993 - Par. (2)(I). Pub. L. 103-160 added subpar. (I).

1992 - Par. (2)(D). Pub. L. 102-484 added subpar. (D) and struck

out former subpar. (D) which read as follows: ''an unmarried

legitimate child, including an adopted child or a stepchild, who

either -

''(i) has not passed his twenty-first birthday;

''(ii) is incapable of self-support because of a mental or

physical incapacity that existed before that birthday and is, or

was at the time of the member's or former member's death, in fact

dependent on him for over one-half of his support; or

''(iii) has not passed his twenty-third birthday, is enrolled

in a full-time course of study in an institution of higher

learning approved by the administering Secretary and is, or was

at the time of the member's or former member's death, in fact

dependent on him for over one-half of his support;''.

1989 - Par. (2)(H). Pub. L. 101-189 added subpar. (H).

1986 - Par. (1). Pub. L. 99-661, Sec. 701(b)(1), substituted

''The term 'uniformed services' means'' for '' 'Uniformed services'

means''.

Par. (2). Pub. L. 99-661, Sec. 701(b)(2), substituted ''The term

'dependent', with respect to'' for '' 'Dependent', with respect

to''.

Par. (3). Pub. L. 99-661, Sec. 701(b)(3), substituted ''The term

'administering Secretaries' means'' for '' 'Administering

Secretaries' means''.

Pars. (4), (5). Pub. L. 99-661, Sec. 701(b)(4), added pars. (4)

and (5).

1984 - Par. (2)(D)(iii). Pub. L. 98-557, Sec. 19(1)(A),

substituted reference to the administering Secretary for reference

to the Secretary of Defense or the Secretary of Health and Human

Services.

Par. (2)(G). Pub. L. 98-525 added subpar. (G).

Par. (3). Pub. L. 98-557, Sec. 19(1)(B), added par. (3).

1982 - Par. (2)(F). Pub. L. 97-252 added cl. (F).

1980 - Pub. L. 96-513, Sec. 511(34)(A), substituted in

introductory material reference to this chapter for reference to

sections 1071-1087 of this title.

Par. (1). Pub. L. 96-513, Sec. 511(35), substituted ''National

Oceanic and Atmospheric Administration'' for ''Environmental

Science Services Administration''.

Par. (2). Pub. L. 96-513, Sec. 115(b), 511(36), substituted

''spouse'' for ''wife'' in cl. (A), struck out cl. (C) ''the

husband, if he is in fact dependent on the member or former member

for over one-half of his support;'', redesignated cls. (D), (E),

and (F) as (C), (D), and (E), respectively, in cl. (C) as so

redesignated, struck out '', if, because of mental or physical

incapacity he was in fact dependent on the member or former member

at the time of her death for over one-half of his support'' after

''the unremarried widower'', and in cl. (D)(iii) as so

redesignated, substituted ''Health and Human Services'' for

''Health, Education, and Welfare''.

1966 - Pub. L. 89-718 substituted ''Environmental Science

Services Administration'' for ''Coast and Geodetic Survey'' in

clause (1).

Pub. L. 89-614 substituted ''1087'' for ''1085'' in introductory

phrase.

EFFECTIVE DATE OF 1993 AMENDMENT

Section 702(b) of Pub. L. 103-160 provided that: ''Section

1072(2)(I) of title 10, United States Code, as added by subsection

(a), shall apply with respect to determinations of dependency made

on or after July 1, 1994.''

EFFECTIVE DATE OF 1989 AMENDMENT

Section 731(d) of Pub. L. 101-189 provided that:

''(1) The amendments made by this section (enacting section 1086a

of this title and amending this section and sections 1076 and 1086

of this title) apply to a person referred to in section 1072(2)(H)

of title 10, United States Code (as added by subsection (a)), whose

decree of divorce, dissolution, or annulment becomes final on or

after the date of the enactment of this Act (Nov. 29, 1989).

''(2) The amendments made by this section shall also apply to a

person referred to in such section whose decree of divorce,

dissolution, or annulment became final during the period beginning

on September 29, 1988, and ending on the day before the date of the

enactment of this Act, as if the amendments had become effective on

September 29, 1988.''

EFFECTIVE DATE OF 1984 AMENDMENT

Section 645(d) of Pub. L. 98-525 provided that: ''The amendments

made by subsections (a), (b), and (c) (amending this section and

provisions set out as a note under section 1408 of this title and

enacting provisions set out as a note under this section) shall be

effective on January 1, 1985, and shall apply with respect to

health care furnished on or after that date.''

EFFECTIVE DATE OF 1982 AMENDMENT; TRANSITION PROVISIONS

Amendment by Pub. L. 97-252 effective Feb. 1, 1983, and

applicable in the case of any former spouse of a member or former

member of the uniformed services whether final decree of divorce,

dissolution, or annulment of marriage of former spouse and such

member or former member is dated before, on, or after Feb. 1, 1983,

see section 1006 of Pub. L. 97-252, set out as an Effective Date;

Transition Provisions note under section 1408 of this title.

EFFECTIVE DATE OF 1980 AMENDMENT

Amendment by section 115(b) of Pub. L. 96-513 effective Sept. 15,

1981, but the authority to prescribe regulations under the

amendment by Pub. L. 96-513 effective on Dec. 12, 1980, and

amendment by section 511(34)(A), (35), (36) of Pub. L. 96-513

effective Dec. 12, 1980, see section 701 of Pub. L. 96-513, set out

as a note under section 101 of this title.

EFFECTIVE DATE OF 1966 AMENDMENT

For effective date of amendment by Pub. L. 89-614, see section 3

of Pub. L. 89-614, set out as a note under section 1071 of this

title.

REPEALS

The directory language of, but not the amendment made by, Pub. L.

89-718, Sec. 8(a), Nov. 2, 1966, 80 Stat. 1117, cited as a credit

to this section, was repealed by Pub. L. 97-295, Sec. 6(b), Oct.

12, 1982, 96 Stat. 1314.

CONTINUATION OF INDIVIDUAL CASE MANAGEMENT SERVICES FOR CERTAIN

ELIGIBLE BENEFICIARIES

Pub. L. 107-107, div. A, title VII, Sec. 701(d), Dec. 28, 2001,

115 Stat. 1160, provided that:

''(1) Notwithstanding the termination of the Individual Case

Management Program by subsection (g) (amending section 1079 of this

title and repealing provisions set out as a note under section 1077

of this title), the Secretary of Defense shall, in any case in

which the Secretary makes the determination described in paragraph

(2), continue to provide payment as if such program were in effect

for home health care or custodial care services provided to an

eligible beneficiary that would otherwise be excluded from coverage

under regulations implementing chapter 55 of title 10, United

States Code.

''(2) The determination referred to in paragraph (1) is a

determination that discontinuation of payment for services not

otherwise provided under such chapter would result in the provision

of services inadequate to meet the needs of the eligible

beneficiary and would be unjust to such beneficiary.

''(3) For purposes of this subsection, 'eligible beneficiary'

means a covered beneficiary (as that term is defined in section

1072 of title 10, United States Code) who, before the effective

date of this section (Dec. 28, 2001), was provided custodial care

services under the Individual Case Management Program for which the

Secretary provided payment.''

IMPROVEMENTS IN ADMINISTRATION OF THE TRICARE PROGRAM; FLEXIBILITY

OF CONTRACTING

Pub. L. 107-107, div. A, title VII, Sec. 708(a), Dec. 28, 2001,

115 Stat. 1164, provided that:

''(1) During the one-year period following the date of the

enactment of this Act (Dec. 28, 2001), section 1072(7) of title 10,

United States Code, shall be deemed to be amended by striking 'the

competitive selection of contractors to financially underwrite'.

''(2) The terms and conditions of any contract to provide health

care services under the TRICARE program entered into during the

period described in paragraph (1) shall not be considered to be

modified or terminated as a result of the termination of such

period.''

TRANSITIONAL PROVISIONS FOR QUALIFICATION FOR CONVERSION HEALTH

POLICIES; PREEXISTING CONDITIONS

Section 731(e) of Pub. L. 101-189 provided that:

''(1) In the case of a person who qualified as a dependent under

section 645(c) of the Department of Defense Authorization Act, 1985

(Public Law 98-525; 98 Stat. 2549) (set out below), on September

28, 1988, the Secretary of Defense shall make a conversion health

policy available for purchase by the person during the remaining

period the person is considered to be a dependent under that

section (or within a reasonable time after that period as

prescribed by the Secretary of Defense).

''(2) Purchase of a conversion health policy under paragraph (1)

by a person shall entitle the person to health care for preexisting

conditions in the same manner and to the same extent as provided by

section 1086a(b) of title 10, United States Code (as added by

subsection (b)), until the end of the one-year period beginning on

the later of -

''(A) the date the person is no longer qualified as a dependent

under section 645(c) of the Department of Defense Authorization

Act, 1985; and

''(B) the date of the purchase of the policy.

''(3) For purposes of this subsection, the term 'conversion

health policy' has the meaning given that term in section 1086a(c)

of title 10, United States Code (as added by subsection (b)).''

DEPENDENT; QUALIFICATION AS; EFFECTIVE DATE

Section 645(c) of Pub. L. 98-525, as amended by Pub. L. 99-661,

div. A, title VI, Sec. 646, Nov. 14, 1986, 100 Stat. 3887; Pub. L.

100-271, Sec. 1, Mar. 29, 1988, 102 Stat. 45; Pub. L. 100-271, Sec.

1, Mar. 29, 1988, 102 Stat. 45, provided that a person who would

qualify as a dependent under section 1072(2)(G) of title 10 but for

the fact that the person's final decree of divorce, dissolution, or

annulment was dated on or after Apr. 1, 1985, would be considered

to be a dependent under such section until the later of (1) Dec.

31, 1988, and (2) the last day of the two-year period beginning on

the date of such final decree, prior to repeal by Pub. L. 100-456,

div. A, title VI, Sec. 651(b), Sept. 29, 1988, 102 Stat. 1990,

effective Sept. 29, 1988, or 30 days after the Secretary of Defense

first makes available a conversion health policy (as defined in

section 1076(f) of title 10), whichever is later.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1040, 1060a, 1062, 1074h,

1076a, 1076c, 1078a, 1079, 1086, 1086a, 1095d, 1097a, 1108, 1111,

1481, 1490, 2114, 2147 of this title; title 42 section 1320d.

-CITE-

10 USC Sec. 1073 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1073. Administration of this chapter

-STATUTE-

(a) Responsible Officials. - Except as otherwise provided in this

chapter, the Secretary of Defense shall administer this chapter,

for the armed forces under his jurisdiction, the Secretary of

Homeland Security shall administer this chapter for the Coast Guard

when the Coast Guard is not operating as a service in the Navy, and

the Secretary of Health and Human Services shall administer this

chapter and for the National Oceanic and Atmospheric Administration

and the Public Health Service. This chapter shall be administered

consistent with the Assisted Suicide Funding Restriction Act of

1997 (42 U.S.C. 14401 et seq.).

(b) Stability in Program of Benefits. - The Secretary of Defense

shall, to the maximum extent practicable, provide a stable program

of benefits under this chapter throughout each fiscal year. To

achieve the stability in the case of managed care support contracts

entered into under this chapter, the contracts shall be

administered so as to implement all changes in benefits and

administration on a quarterly basis. However, the Secretary of

Defense may implement any such change prior to the next fiscal

quarter if the Secretary determines that the change would

significantly improve the provision of care to eligible

beneficiaries under this chapter.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1446;

amended Pub. L. 89-614, Sec. 2(1), Sept. 30, 1966, 80 Stat. 862;

Pub. L. 89-718, Sec. 8(a), Nov. 2, 1966, 80 Stat. 1117; Pub. L.

96-513, title V, Sec. 511(34)(A), (C), (35), (36), Dec. 12, 1980,

94 Stat. 2922, 2923; Pub. L. 98-557, Sec. 19(2), Oct. 30, 1984, 98

Stat. 2869; Pub. L. 105-12, Sec. 9(h), Apr. 30, 1997, 111 Stat. 27;

Pub. L. 106-65, div. A, title VII, Sec. 725, title X, Sec.

1066(a)(7), Oct. 5, 1999, 113 Stat. 698, 770; Pub. L. 107-296,

title XVII, Sec. 1704(b)(1), Nov. 25, 2002, 116 Stat. 2314.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1073 37:402(b). June 7, 1956, ch.

374, Sec. 102(b),

70 Stat. 251.

-------------------------------

The words ''armed forces under his jurisdiction'' are substituted

for the words ''Army, Navy, Air Force, and Marine Corps and for the

Coast Guard when it is operating as a service in the Navy'' to

reflect section 101(4) of this title.

-REFTEXT-

REFERENCES IN TEXT

The Assisted Suicide Funding Restriction Act of 1997, referred to

in subsec. (a), is Pub. L. 105-12, Apr. 30, 1997, 111 Stat. 23,

which is classified principally to chapter 138 (Sec. 14401 et seq.)

of Title 42, The Public Health and Welfare. For complete

classification of this Act to the Code, see Short Title note set

out under section 14401 of Title 42 and Tables.

-MISC2-

PRIOR PROVISIONS

A prior section 1073, act Aug. 10, 1956, ch. 1041, 70A Stat. 82,

related to right to vote in war-time presidential and congressional

election, prior to repeal by Pub. L. 85-861, Sec. 36B(5), Sept. 2,

1958, 72 Stat. 1570, as superseded by the Federal Voting Assistance

Act of 1955 which is classified to subchapter I-D (Sec. 1973cc et

seq.) of chapter 20 of Title 42, The Public Health and Welfare.

AMENDMENTS

2002 - Subsec. (a). Pub. L. 107-296 substituted ''of Homeland

Security'' for ''of Transportation''.

1999 - Pub. L. 106-65, Sec. 725, designated existing provisions,

as amended by Pub. L. 106-65, Sec. 1066(a)(7), as subsec. (a),

inserted heading, and added subsec. (b).

Pub. L. 106-65, Sec. 1066(a)(7), inserted ''(42 U.S.C. 14401 et

seq.)'' after ''Act of 1997''.

1997 - Pub. L. 105-12 inserted at end ''This chapter shall be

administered consistent with the Assisted Suicide Funding

Restriction Act of 1997.''

1984 - Pub. L. 98-557 inserted provisions which transferred

authority to administer chapter for the Coast Guard when the Coast

Guard is not operating as a service in the Navy from the Secretary

of Health and Human Services to the Secretary of Transportation.

1980 - Pub. L. 96-513 substituted in section catchline ''of this

chapter'' for ''of sections 1071-1087 of this title'', and

substituted in text ''this chapter'' for ''sections 1071-1087 of

this title'', ''those sections'', and ''them'', ''Secretary of

Health and Human Services'' for ''Secretary of Health, Education,

and Welfare'', and ''National Oceanic and Atmospheric

Administration'' for ''Environmental Science Services

Administration''.

1966 - Pub. L. 89-718 substituted ''Environmental Science

Services Administration'' for ''Coast and Geodetic Survey''.

Pub. L. 89-614 substituted ''1087'' for ''1085'' in section

catchline and text.

EFFECTIVE DATE OF 2002 AMENDMENT

Amendment by Pub. L. 107-296 effective on the date of transfer of

the Coast Guard to the Department of Homeland Security, see section

1704(g) of Pub. L. 107-296, set out as a note under section 101 of

this title.

EFFECTIVE DATE OF 1997 AMENDMENT

Amendment by Pub. L. 105-12 effective Apr. 30, 1997, and

applicable to Federal payments made pursuant to obligations

incurred after Apr. 30, 1997, for items and services provided on or

after such date, subject to also being applicable with respect to

contracts entered into, renewed, or extended after Apr. 30, 1997,

as well as contracts entered into before Apr. 30, 1997, to the

extent permitted under such contracts, see section 11 of Pub. L.

105-12, set out as an Effective Date note under section 14401 of

Title 42, The Public Health and Welfare.

EFFECTIVE DATE OF 1980 AMENDMENT

Amendment by Pub. L. 96-513 effective Dec. 12, 1980, see section

701(b)(3) of Pub. L. 96-513, set out as a note under section 101 of

this title.

EFFECTIVE DATE OF 1966 AMENDMENT

For effective date of amendment by Pub. L. 89-614, see section 3

of Pub. L. 89-614, set out as a note under section 1071 of this

title.

REPEALS

The directory language of, but not the amendment made by, Pub. L.

89-718, Sec. 8(a), Nov. 2, 1966, 80 Stat. 1117, cited as a credit

to this section, was repealed by Pub. L. 97-295, Sec. 6(b), Oct.

12, 1982, 96 Stat. 1314.

MODERNIZATION OF TRICARE BUSINESS PRACTICES AND INCREASE OF USE OF

MILITARY TREATMENT FACILITIES

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 723), Oct. 30,

2000, 114 Stat. 1654, 1654A-186, provided that:

''(a) Requirement To Implement Internet-Based System. - Not later

than October 1, 2001, the Secretary of Defense shall implement a

system to simplify and make accessible through the use of the

Internet, through commercially available systems and products,

critical administrative processes within the military health care

system and the TRICARE program. The purposes of the system shall

be to enhance efficiency, improve service, and achieve commercially

recognized standards of performance.

''(b) Elements of System. - The system required by subsection (a)

-

''(1) shall comply with patient confidentiality and security

requirements, and incorporate data requirements, that are

currently widely used by insurers under medicare and commercial

insurers;

''(2) shall be designed to achieve improvements with respect to

-

''(A) the availability and scheduling of appointments;

''(B) the filing, processing, and payment of claims;

''(C) marketing and information initiatives;

''(D) the continuation of enrollments without expiration;

''(E) the portability of enrollments nationwide;

''(F) education of beneficiaries regarding the military

health care system and the TRICARE program; and

''(G) education of health care providers regarding such

system and program; and

''(3) may be implemented through a contractor under TRICARE

Prime.

''(c) Areas of Implementation. - The Secretary shall implement

the system required by subsection (a) in at least one region under

the TRICARE program.

''(d) Plan for Improved Portability of Benefits. - Not later than

March 15, 2001, the Secretary of Defense shall submit to the

Committees on Armed Services of the Senate and the House of

Representatives a plan to provide portability and reciprocity of

benefits for all enrollees under the TRICARE program throughout all

TRICARE regions.

''(e) Increase of Use of Military Medical Treatment Facilities. -

The Secretary shall initiate a program to maximize the use of

military medical treatment facilities by improving the efficiency

of health care operations in such facilities.

''(f) Definition. - In this section the term 'TRICARE program'

has the meaning given such term in section 1072 of title 10, United

States Code.''

IMPROVEMENT OF ACCESS TO HEALTH CARE UNDER THE TRICARE PROGRAM

Pub. L. 107-107, div. A, title VII, Sec. 735(e), Dec. 28, 2001,

115 Stat. 1172, provided that: ''Not later than March 1, 2002, the

Secretary of Defense shall submit to the Committees on Armed

Services of the House of Representatives and the Senate a report on

the Secretary's plans for implementing section 721 of the Floyd D.

Spence National Defense Authorization Act for Fiscal Year 2001

(Pub. L. 106-398, set out below), as amended by this section.''

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 721), Oct. 30,

2000, 114 Stat. 1654, 1654A-184, as amended by Pub. L. 107-107,

div. A, title VII, Sec. 735(a)-(d), Dec. 28, 2001, 115 Stat. 1171,

1172, provided that:

''(a) Waiver of Nonavailability Statement or Preauthorization. -

In the case of a covered beneficiary under TRICARE Standard

pursuant to chapter 55 of title 10, United States Code, the

Secretary of Defense may not require with regard to authorized

health care services (other than mental health services) under such

chapter that the beneficiary -

''(1) obtain a nonavailability statement or preauthorization

from a military medical treatment facility in order to receive

the services from a civilian provider; or

''(2) obtain a nonavailability statement for care in

specialized treatment facilities outside the 200-mile radius of a

military medical treatment facility.

''(b) Waiver Authority. - The Secretary may waive the prohibition

in subsection (a) if -

''(1) the Secretary -

''(A) demonstrates that significant costs would be avoided by

performing specific procedures at the affected military medical

treatment facility or facilities;

''(B) determines that a specific procedure must be provided

at the affected military medical treatment facility or

facilities to ensure the proficiency levels of the

practitioners at the facility or facilities; or

''(C) determines that the lack of nonavailability statement

data would significantly interfere with TRICARE contract

administration;

''(2) the Secretary provides notification of the Secretary's

intent to grant a waiver under this subsection to covered

beneficiaries who receive care at the military medical treatment

facility or facilities that will be affected by the decision to

grant a waiver under this subsection;

''(3) the Secretary notifies the Committees on Armed Services

of the House of Representatives and the Senate of the Secretary's

intent to grant a waiver under this subsection, the reason for

the waiver, and the date that a nonavailability statement will be

required; and

''(4) 60 days have elapsed since the date of the notification

described in paragraph (3).

''(c) Waiver Exception for Maternity Care. - Subsection (b) shall

not apply with respect to maternity care.

''(d) Effective Date. - This section shall take effect on the

earlier of the following:

''(1) The date that a new contract entered into by the

Secretary to provide health care services under TRICARE Standard

takes effect.

''(2) The date that is two years after the date of the

enactment of the National Defense Authorization Act for Fiscal

Year 2002 (Dec. 28, 2001).''.

Pub. L. 106-65, div. A, title VII, Sec. 712(a), (b), Oct. 5,

1999, 113 Stat. 687, provided that:

''(a) Access. - The Secretary of Defense shall, to the maximum

extent practicable, minimize the authorization and certification

requirements imposed on covered beneficiaries under the TRICARE

program as a condition of access to benefits under that program.

''(b) Report on Initiatives To Improve Access. - Not later than

March 31, 2000, the Secretary of Defense shall submit to the

Committees on Armed Services of the Senate and the House of

Representatives a report on specific actions taken to -

''(1) reduce the requirements for preauthorization for care

under the TRICARE program;

''(2) reduce the requirements for beneficiaries to obtain

preventive services, such as obstetric or gynecologic

examinations, mammograms for females over 35 years of age, and

urological examinations for males over the age of 60 without

preauthorization; and

''(3) reduce the requirements for statements of nonavailability

of services.''

TRICARE MANAGED CARE SUPPORT CONTRACTS

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 724), Oct. 30,

2000, 114 Stat. 1654, 1654A-187, provided that:

''(a) Authority. - Notwithstanding any other provision of law and

subject to subsection (b), any TRICARE managed care support

contract in effect, or in the final stages of acquisition, on

September 30, 1999, may be extended for four years.

''(b) Conditions. - Any extension of a contract under subsection

(a) -

''(1) may be made only if the Secretary of Defense determines

that it is in the best interest of the United States to do so;

and

''(2) shall be based on the price in the final best and final

offer for the last year of the existing contract as adjusted for

inflation and other factors mutually agreed to by the contractor

and the Federal Government.''

Pub. L. 106-259, title VIII, Sec. 8090, Aug. 9, 2000, 114 Stat.

694, provided that: ''Notwithstanding any other provision of law,

the TRICARE managed care support contracts in effect, or in final

stages of acquisition as of September 30, 2000, may be extended for

2 years: Provided, That any such extension may only take place if

the Secretary of Defense determines that it is in the best interest

of the Government: Provided further, That any contract extension

shall be based on the price in the final best and final offer for

the last year of the existing contract as adjusted for inflation

and other factors mutually agreed to by the contractor and the

Government: Provided further, That notwithstanding any other

provision of law, all future TRICARE managed care support contracts

replacing contracts in effect, or in the final stages of

acquisition as of September 30, 2000, may include a base contract

period for transition and up to seven 1-year option periods.''

Similar provisions were contained in the following prior

appropriation act:

Pub. L. 106-79, title VIII, Sec. 8095, Oct. 25, 1999, 113 Stat.

1254.

Pub. L. 105-262, title VIII, Sec. 8107, Oct. 17, 1998, 112 Stat.

2321.

REDESIGN OF MILITARY PHARMACY SYSTEM

Pub. L. 105-261, div. A, title VII, Sec. 703, Oct. 17, 1998, 112

Stat. 2057, provided that:

''(a) Plan Required. - The Secretary of Defense shall submit to

Congress a plan that would provide for a system-wide redesign of

the military and contractor retail and mail-order pharmacy system

of the Department of Defense by incorporating 'best business

practices' of the private sector. The Secretary shall work with

contractors of TRICARE retail pharmacy and national mail-order

pharmacy programs to develop a plan for the redesign of the

pharmacy system that -

''(1) may include a plan for an incentive-based formulary for

military medical treatment facilities and contractors of TRICARE

retail pharmacies and the national mail-order pharmacy; and

''(2) shall include a plan for each of the following:

''(A) A uniform formulary for such facilities and

contractors.

''(B) A centralized database that integrates the patient

databases of pharmacies of military medical treatment

facilities and contractor retail and mail-order programs to

implement automated prospective drug utilization review

systems.

''(C) A system-wide drug benefit for covered beneficiaries

under chapter 55 of title 10, United States Code, who are

entitled to hospital insurance benefits under part A of title

XVIII of the Social Security Act (42 U.S.C. 1395c et seq.).

''(b) Submission of Plan. - The Secretary shall submit the plan

required under subsection (a) not later than March 1, 1999.

''(c) Suspension of Implementation of Program. - The Secretary

shall suspend any plan to establish a national retail pharmacy

program for the Department of Defense until -

''(1) the plan required under subsection (a) is submitted; and

''(2) the Secretary implements cost-saving reforms with respect

to the military and contractor retail and mail order pharmacy

system.''

Pub. L. 105-261, div. A, title VII, Sec. 723, Oct. 17, 1998, 112

Stat. 2068, as amended by Pub. L. 106-65, div. A, title X, Sec.

1067(3), Oct. 5, 1999, 113 Stat. 774; Pub. L. 106-398, Sec. 1

((div. A), title VII, Sec. 711(a)), Oct. 30, 2000, 114 Stat. 1654,

1654A-175, provided that:

''(a) In General. - Not later than April 1, 2001, the Secretary

of Defense shall implement, with respect to eligible individuals

described in subsection (e), the redesign of the pharmacy system

under TRICARE (including the mail-order and retail pharmacy benefit

under TRICARE) to incorporate 'best business practices' of the

private sector in providing pharmaceuticals, as developed under the

plan described in section 703 (set out as a note above).

''(b) Program Requirements. - The same coverage for pharmacy

services and the same requirements for cost sharing and

reimbursement as are applicable under section 1086 of title 10,

United States Code, shall apply with respect to the program

required by subsection (a).

''(c) Evaluation. - The Secretary shall provide for an evaluation

of the implementation of the redesign of the pharmacy system under

TRICARE under this section by an appropriate person or entity that

is independent of the Department of Defense. The evaluation shall

include the following:

''(1) An analysis of the costs of the implementation of the

redesign of the pharmacy system under TRICARE and to the eligible

individuals who participate in the system.

''(2) An assessment of the extent to which the implementation

of such system satisfies the requirements of the eligible

individuals for the health care services available under TRICARE.

''(3) An assessment of the effect, if any, of the

implementation of the system on military medical readiness.

''(4) A description of the rate of the participation in the

system of the individuals who were eligible to participate.

''(5) An evaluation of any other matters that the Secretary

considers appropriate.

''(d) Reports. - The Secretary shall submit two reports on the

results of the evaluation under subsection (c), together with the

evaluation, to the Committee on Armed Services of the Senate and

the Committee on Armed Services of the House of Representatives.

The first report shall be submitted not later than December 31,

2001, and the second report shall be submitted not later than

December 31, 2003.

''(e) Eligible Individuals. - (1) An individual is eligible to

participate under this section if the individual is a member or

former member of the uniformed services described in section

1074(b) of title 10, United States Code, a dependent of the member

described in section 1076(a)(2)(B) or 1076(b) of that title, or a

dependent of a member of the uniformed services who died while on

active duty for a period of more than 30 days, who -

''(A) is 65 years of age or older;

''(B) is entitled to hospital insurance benefits under part A

of title XVIII of the Social Security Act (42 U.S.C. 1395c et

seq.); and

''(C) except as provided in paragraph (2), is enrolled in the

supplemental medical insurance program under part B of such title

XVIII (42 U.S.C. 1395j et seq.).

''(2) Paragraph (1)(C) shall not apply in the case of an

individual who, before April 1, 2001, has attained the age of 65

and did not enroll in the program described in such paragraph.''

SYSTEM FOR TRACKING DATA AND MEASURING PERFORMANCE IN MEETING

TRICARE ACCESS STANDARDS

Pub. L. 105-261, div. A, title VII, Sec. 713, Oct. 17, 1998, 112

Stat. 2060, provided that:

''(a) Requirement To Establish System. - (1) The Secretary of

Defense shall establish a system -

''(A) to track data regarding access of covered beneficiaries

under chapter 55 of title 10, United States Code, to primary

health care under the TRICARE program; and

''(B) to measure performance in increasing such access against

the primary care access standards established by the Secretary

under the TRICARE program.

''(2) In implementing the system described in paragraph (1), the

Secretary shall collect data on the timeliness of appointments and

precise waiting times for appointments in order to measure

performance in meeting the primary care access standards

established under the TRICARE program.

''(b) Deadline for Establishment. - The Secretary shall establish

the system described in subsection (a) not later than April 1,

1999.''

TRICARE AS SUPPLEMENT TO MEDICARE DEMONSTRATION

Pub. L. 105-261, div. A, title VII, Sec. 722, Oct. 17, 1998, 112

Stat. 2065, as amended by Pub. L. 106-65, div. A, title X, Sec.

1066(b)(6), 1067(3), Oct. 5, 1999, 113 Stat. 773, 774, provided

that:

''(a) In General. - (1) The Secretary of Defense shall, after

consultation with the other administering Secretaries, carry out a

demonstration project in order to assess the feasibility and

advisability of providing medical care coverage under the TRICARE

program to the individuals described in subsection (c). The

demonstration project shall be known as the 'TRICARE Senior

Supplement'.

''(2) The Secretary shall commence the demonstration project not

later than January 1, 2000, and shall terminate the demonstration

project not later than December 31, 2002.

''(3) Under the demonstration project, the Secretary shall permit

eligible individuals described in subsection (c) to enroll in the

TRICARE program.

''(4) Payment for care and services received by eligible

individuals who enroll in the TRICARE program under the

demonstration project shall be made as follows:

''(A) First, under title XVIII of the Social Security Act (42

U.S.C. 1395 et seq.), but only to the extent that payment for

such care and services is provided for under that title.

''(B) Second, under the TRICARE program, but only to the extent

that payment for such care and services is provided under that

program and is not provided for under subparagraph (A).

''(C) Third, by the eligible individual concerned, but only to

the extent that payment for such care and services is not

provided for under subparagraph (A) or (B).

''(5)(A) The Secretary shall require each eligible individual who

enrolls in the TRICARE program under the demonstration project to

pay an enrollment fee. The Secretary shall provide, to the extent

feasible, the option of payment of the enrollment fee through

electronic transfers of funds and through withholding of such

payment from the pay of a member or former member of the Armed

Forces, and shall provide the option that payment of the enrollment

fee be made in full at the beginning of the enrollment period or

that payments be made on a monthly or quarterly basis.

''(B) The amount of the enrollment fee charged an eligible

individual under subparagraph (A) for self-only or family

enrollment in any year may not exceed the amount equal to 75

percent of the total subscription charges in that year for

self-only or family, respectively, fee-for-service coverage under

the health benefits plan under the Federal Employees Health

Benefits program under chapter 89 of title 5, United States Code,

that is most similar in coverage to the TRICARE program.

''(6) A covered beneficiary who enrolls in TRICARE Senior

Supplement under this subsection shall not be eligible to receive

health care at a facility of the uniformed services during the

period such enrollment is in effect.

''(b) Evaluation; Review. - (1) The Secretary shall provide for

an evaluation of the demonstration project conducted under this

subsection by an appropriate person or entity that is independent

of the Department of Defense. The evaluation shall include the

following:

''(A) An analysis of the costs of the demonstration project to

the United States and to the eligible individuals who participate

in such demonstration project.

''(B) An assessment of the extent to which the demonstration

project satisfies the requirements of such eligible individuals

for the health care services available under the demonstration

project.

''(C) An assessment of the effect, if any, of the demonstration

project on military medical readiness.

''(D) A description of the rate of the enrollment in the

demonstration project of the individuals who were eligible to

enroll in the demonstration project.

''(E) An assessment of whether the demonstration project

provides the most suitable model for a program to provide

adequate health care services to the population of individuals

consisting of the eligible individuals.

''(F) An evaluation of any other matters that the Secretary

considers appropriate.

''(2) The Comptroller General shall review the evaluation

conducted under paragraph (1). In carrying out the review, the

Comptroller General shall -

''(A) assess the validity of the processes used in the

evaluation; and

''(B) assess the validity of any findings under the evaluation,

including any limitations with respect to the data contained in

the evaluation as a result of the size and design of the

demonstration project.

''(3)(A) The Secretary shall submit a report on the results of

the evaluation under paragraph (1), together with the evaluation,

to the Committee on Armed Services of the Senate and the Committee

on Armed Services of the House of Representatives not later than

December 31, 2002.

''(B) The Comptroller General shall submit a report on the

results of the review under paragraph (2) to the committees

referred to in subparagraph (A) not later than February 15, 2003.

''(c) Eligible Individuals. - An individual is eligible to

participate under this section if the individual is a member or

former member of the uniformed services described in section

1074(b) of title 10, United States Code, a dependent of the member

described in section 1076(a)(2)(B) or 1076(b) of that title, or a

dependent of a member of the uniformed services who died while on

active duty for a period of more than 30 days, who -

''(1) is 65 years of age or older;

''(2) is entitled to hospital insurance benefits under part A

of title XVIII of the Social Security Act (42 U.S.C. 1395c et

seq.);

''(3) is enrolled in the supplemental medical insurance program

under part B of such title XVIII (42 U.S.C. 1395j et seq.); and

''(4) resides in an area selected by the Secretary under

subsection (d).

''(d) Areas of Implementation. - (1) The Secretary shall carry

out the demonstration project under this section in two separate

areas selected by the Secretary.

''(2) The areas selected by the Secretary under paragraph (1)

shall be as follows:

''(A) One area shall be an area outside the catchment area of a

military medical treatment facility in which -

''(i) no eligible organization has a contract in effect under

section 1876 of the Social Security Act (42 U.S.C. 1395mm) and

no Medicare+Choice organization has a contract in effect under

part C of title XVIII of that Act (42 U.S.C. 1395w-21 (et

seq.)); or

''(ii) the aggregate number of enrollees with an eligible

organization with a contract in effect under section 1876 of

that Act or with a Medicare+Choice organization with a contract

in effect under part C of title XVIII of that Act is less than

2.5 percent of the total number of individuals in the area who

are entitled to hospital insurance benefits under part A of

title XVIII of that Act.

''(B) The other area shall be an area outside the catchment

area of a military medical treatment facility in which -

''(i) at least one eligible organization has a contract in

effect under section 1876 of that Act or one Medicare+Choice

organization has a contract in effect under part C of title

XVIII of that Act; and

''(ii) the aggregate number of enrollees with an eligible

organization with a contract in effect under section 1876 of

that Act or with a Medicare+Choice organization with a contract

in effect under part C of title XVIII of that Act exceeds 10

percent of the total number of individuals in the area who are

entitled to hospital insurance benefits under part A of title

XVIII of that Act.

''(e) Definitions. - In this section:

''(1) The term 'administering Secretaries' has the meaning

given that term in section 1072(3) of title 10, United States

Code.

''(2) The term 'TRICARE program' has the meaning given that

term in section 1072(7) of title 10, United States Code.''

STUDY CONCERNING PROVISION OF COMPARATIVE INFORMATION

Pub. L. 105-85, div. A, title VII, Sec. 703, Nov. 18, 1997, 111

Stat. 1807, provided that:

''(a) Study. - The Secretary of Defense shall conduct a study

concerning the provision of the information described in subsection

(b) to beneficiaries under the TRICARE program established under

the authority of chapter 55 of title 10, United States Code, and

prepare and submit to Congress a report concerning such study.

''(b) Provision of Comparative Information. - Information

described in this subsection, with respect to a managed care entity

that contracts with the Secretary of Defense to provide medical

assistance under the program described in subsection (a), shall

include the following:

''(1) The benefits covered by the entity involved, including -

''(A) covered items and services beyond those provided under

a traditional fee-for-service program;

''(B) any beneficiary cost sharing; and

''(C) any maximum limitations on out-of-pocket expenses.

''(2) The net monthly premium, if any, under the entity.

''(3) The service area of the entity.

''(4) To the extent available, quality and performance

indicators for the benefits under the entity (and how they

compare to such indicators under the traditional fee-for-service

programs in the area involved), including -

''(A) disenrollment rates for enrollees electing to receive

benefits through the entity for the previous two years

(excluding disenrollment due to death or moving outside the

service area of the entity);

''(B) information on enrollee satisfaction;

''(C) information on health process and outcomes;

''(D) grievance procedures;

''(E) the extent to which an enrollee may select the health

care provider of their (sic) choice, including health care

providers within the network of the entity and out-of-network

health care providers (if the entity covers out-of-network

items and services); and

''(F) an indication of enrollee exposure to balance billing

and the restrictions on coverage of items and services provided

to such enrollee by an out-of-network health care provider.

''(5) Whether the entity offers optional supplemental benefits

and the terms and conditions (including premiums) for such

coverage.

''(6) An overall summary description as to the method of

compensation of participating physicians.''

DISCLOSURE OF CAUTIONARY INFORMATION ON PRESCRIPTION MEDICATIONS

Pub. L. 105-85, div. A, title VII, Sec. 744, Nov. 18, 1997, 111

Stat. 1820, provided that:

''(a) Regulations Required. - Not later than 180 days after the

date of the enactment of this Act (Nov. 18, 1997), the Secretary of

Defense, in consultation with the administering Secretaries

referred to in section 1073 of title 10, United States Code, shall

prescribe regulations to require each source described in

subsection (d) that dispenses a prescription medication to a

beneficiary under chapter 55 of such title to include with the

medication the written cautionary information required by

subsection (b).

''(b) Information To Be Disclosed. - Information required to be

disclosed about a medication under the regulations shall include

appropriate cautions about usage of the medication, including

possible side effects and potentially hazardous interactions with

foods.

''(c) Form of Information. - The regulations shall require that

information be furnished in a form that, to the maximum extent

practicable, is easily read and understood.

''(d) Covered Sources. - The regulations shall apply to the

following:

''(1) Pharmacies and any other dispensers of prescription

medications in medical facilities of the uniformed services.

''(2) Sources of prescription medications under any mail order

pharmaceuticals program provided by any of the administering

Secretaries under chapter 55 of title 10, United States Code.

''(3) Pharmacies paid under the Civilian Health and Medical

Program of the Uniformed Services (including the TRICARE

program).

''(4) Pharmacies, and any other pharmaceutical dispensers, of

designated providers referred to in section 721(5) of the

National Defense Authorization Act for Fiscal Year 1997 (Public

Law 104-201; 110 Stat. 2593; 10 U.S.C. 1073 note).''

COMPETITIVE PROCUREMENT OF OPHTHALMIC SERVICES

Pub. L. 105-85, div. A, title VII, Sec. 745, Nov. 18, 1997, 111

Stat. 1820, provided that:

''(a) Competitive Procurement Required. - Beginning not later

than October 1, 1998, the Secretary of Defense shall competitively

procure from private-sector sources, or other sources outside of

the Department of Defense, all ophthalmic services related to the

provision of single vision and multivision eyeware for members of

the Armed Forces, retired members, and certain covered

beneficiaries under chapter 55 of title 10, United States Code, who

would otherwise receive such ophthalmic services through the

Department of Defense.

''(b) Exception. - Subsection (a) shall not apply to the extent

that the Secretary of Defense determines that the use of sources

within the Department of Defense to provide such ophthalmic

services -

''(1) is necessary to meet the readiness requirements of the

Armed Forces; or

''(2) is more cost effective.

''(c) Completion of Existing Orders. - Subsection (a) shall not

apply to orders for ophthalmic services received on or before

September 30, 1998.''

INCLUSION OF CERTAIN DESIGNATED PROVIDERS IN UNIFORMED SERVICES

HEALTH CARE DELIVERY SYSTEM

Pub. L. 104-201, div. A, title VII, subtitle C, Sept. 23, 1996,

110 Stat. 2592, as amended by Pub. L. 104-208, div. A, title I,

Sec. 101(b) (title VIII, Sec. 8131(a)), Sept. 30, 1996, 110 Stat.

3009-71, 3009-117; Pub. L. 105-85, div. A, title VII, Sec.

721-723, Nov. 18, 1997, 111 Stat. 1809, 1810; Pub. L. 106-65, div.

A, title VII, Sec. 707, Oct. 5, 1999, 113 Stat. 684; Pub. L.

107-296, title XVII, Sec. 1704(e)(2), Nov. 25, 2002, 116 Stat.

2315, provided that:

''SEC. 721. DEFINITIONS.

''In this subtitle:

''(1) The term 'administering Secretaries' means the Secretary

of Defense, the Secretary of Homeland Security, and the Secretary

of Health and Human Services.

''(2) The term 'agreement' means the agreement required under

section 722(b) between the Secretary of Defense and a designated

provider.

''(3) The term 'capitation payment' means an actuarially sound

payment for a defined set of health care services that is

established on a per enrollee per month basis.

''(4) The term 'covered beneficiary' means a beneficiary under

chapter 55 of title 10, United States Code, other than a

beneficiary under section 1074(a) of such title.

''(5) The term 'designated provider' means a public or

nonprofit private entity that was a transferee of a Public Health

Service hospital or other station under section 987 of the

Omnibus Budget Reconciliation Act of 1981 (Public Law 97-35; 42

U.S.C. 248b) and that, before the date of the enactment of this

Act (Sept. 23, 1996), was deemed to be a facility of the

uniformed services for the purposes of chapter 55 of title 10,

United States Code. The term includes any legal successor in

interest of the transferee.

''(6) The term 'enrollee' means a covered beneficiary who

enrolls with a designated provider.

''(7) The term 'health care services' means the health care

services provided under the health plan known as the 'TRICARE

PRIME' option under the TRICARE program.

''(8) The term 'Secretary' means the Secretary of Defense.

''(9) The term 'TRICARE program' means the managed health care

program that is established by the Secretary of Defense under the

authority of chapter 55 of title 10, United States Code,

principally section 1097 of such title, and includes the

competitive selection of contractors to financially underwrite

the delivery of health care services under the Civilian Health

and Medical Program of the Uniformed Services.

''SEC. 722. INCLUSION OF DESIGNATED PROVIDERS IN UNIFORMED SERVICES

HEALTH CARE DELIVERY SYSTEM.

''(a) Inclusion in System. - The health care delivery system of

the uniformed services shall include the designated providers.

''(b) Agreements to Provide Managed Health Care Services. - (1)

After consultation with the other administering Secretaries, the

Secretary of Defense shall negotiate and enter into an agreement

with each designated provider under which the designated provider

will provide health care services in or through managed care plans

to covered beneficiaries who enroll with the designated provider.

''(2) The agreement shall be entered into on a sole source

basis. The Federal Acquisition Regulation, except for those

requirements regarding competition, issued pursuant to section

25(c) of the Office of Federal Procurement Policy Act (41 U.S.C.

421(c)) shall apply to the agreements as acquisitions of commercial

items.

''(3) The implementation of an agreement is subject to

availability of funds for such purpose.

''(c) Effective Date of Agreements. - (1) Unless an earlier

effective date is agreed upon by the Secretary and the designated

provider, the agreement shall take effect upon the later of the

following:

''(A) The date on which a managed care support contract under

the TRICARE program is implemented in the service area of the

designated provider.

''(B) October 1, 1997.

''(2) The Secretary may modify the effective date established

under paragraph (1) for an agreement to permit a transition period

of not more than six months between the date on which the agreement

is executed by the parties and the date on which the designated

provider commences the delivery of health care services under the

agreement.

''(d) Temporary Continuation of Existing Participation

Agreements. - The Secretary shall extend the participation

agreement of a designated provider in effect immediately before the

date of the enactment of this Act (Sept. 23, 1996) under section

718(c) of the National Defense Authorization Act for Fiscal Year

1991 (Public Law 101-510; (former) 42 U.S.C. 248c (note)) until the

agreement required by this section takes effect under subsection

(c), including any transitional period provided by the Secretary

under paragraph (2) of such subsection.

''(e) Service Area. - The Secretary may not reduce the size of

the service area of a designated provider below the size of the

service area in effect as of September 30, 1996.

''(f) Compliance With Administrative Requirements. - (1) Unless

otherwise agreed upon by the Secretary and a designated provider,

the designated provider shall comply with necessary and appropriate

administrative requirements established by the Secretary for other

providers of health care services and requirements established by

the Secretary of Health and Human Services for risk-sharing

contractors under section 1876 of the Social Security Act (42

U.S.C. 1395mm). The Secretary and the designated provider shall

determine and apply only such administrative requirements as are

minimally necessary and appropriate. A designated provider shall

not be required to comply with a law or regulation of a State

government requiring licensure as a health insurer or health

maintenance organization.

''(2) A designated provider may not contract out more than five

percent of its primary care enrollment without the approval of the

Secretary, except in the case of primary care contracts between a

designated provider and a primary care contractor in force on the

date of the enactment of this Act (Sept. 23, 1996).

''(g) Continued Acquisition of Reduced-Cost Drugs. - A designated

provider shall be treated as part of the Department of Defense for

purposes of section 8126 of title 38, United States Code, in

connection with the provision by the designated provider of health

care services to covered beneficiaries pursuant to the

participation agreement of the designated provider under section

718(c) of the National Defense Authorization Act for Fiscal Year

1991 (Public Law 101-510; (former) 42 U.S.C. 248c note) or pursuant

to the agreement entered into under subsection (b).

''SEC. 723. PROVISION OF UNIFORM BENEFIT BY DESIGNATED PROVIDERS.

''(a) Uniform Benefit Required. - A designated provider shall

offer to enrollees the health benefit option prescribed and

implemented by the Secretary under section 731 of the National

Defense Authorization Act for Fiscal Year 1994 (Public Law 103-160;

10 U.S.C. 1073 note), including accompanying cost-sharing

requirements.

''(b) Time for Implementation of Benefit. - A designated provider

shall offer the health benefit option described in subsection (a)

to enrollees upon the later of the following:

''(1) The date on which health care services within the health

care delivery system of the uniformed services are rendered

through the TRICARE program in the region in which the designated

provider operates.

''(2) October 1, 1997.

''(c) Adjustments. - The Secretary may establish a later date

under subsection (b)(2) or prescribe reduced cost-sharing

requirements for enrollees.

''SEC. 724. ENROLLMENT OF COVERED BENEFICIARIES.

''(a) Fiscal Year 1997 Limitation. - (1) During fiscal year 1997,

the number of covered beneficiaries who are enrolled in managed

care plans offered by designated providers may not exceed the

number of such enrollees as of October 1, 1995.

''(2) The Secretary may waive the limitation under paragraph (1)

if the Secretary determines that additional enrollment authority

for a designated provider is required to accommodate covered

beneficiaries who are dependents of members of the uniformed

services entitled to health care under section 1074(a) of title 10,

United States Code.

''(b) Permanent Limitation. - For each fiscal year beginning

after September 30, 1997, the number of enrollees in managed care

plans offered by designated providers may not exceed 110 percent of

the number of such enrollees as of the first day of the immediately

preceding fiscal year. The Secretary may waive this limitation as

provided in subsection (a)(2).

''(c) Retention of Current Enrollees. - An enrollee in the

managed care plan of a designated provider as of September 30,

1997, or such earlier date as the designated provider and the

Secretary may agree upon, shall continue receiving services from

the designated provider pursuant to the agreement entered into

under section 722 unless the enrollee disenrolls from the

designated provider. Except as provided in subsection (e), the

administering Secretaries may not disenroll such an enrollee unless

the disenrollment is agreed to by the Secretary and the designated

provider.

''(d) Additional Enrollment Authority. - Other covered

beneficiaries may also receive health care services from a

designated provider, except that the designated provider may market

such services to, and enroll, only those covered beneficiaries who

-

''(1) do not have other primary health insurance coverage

(other than Medicare coverage) covering basic primary care and

inpatient and outpatient services; or

''(2) are enrolled in the direct care system under the TRICARE

program, regardless of whether the covered beneficiaries were

users of the health care delivery system of the uniformed

services in prior years.

''(e) Special Rule for Medicare-Eligible Beneficiaries. - If a

covered beneficiary who desires to enroll in the managed care

program of a designated provider is also entitled to hospital

insurance benefits under part A of title XVIII of the Social

Security Act (42 U.S.C. 1395c et seq.), the covered beneficiary

shall elect whether to receive health care services as an enrollee

or under part A of title XVIII of the Social Security Act. The

Secretary may disenroll an enrollee who subsequently violates the

election made under this subsection and receives benefits under

part A of title XVIII of the Social Security Act.

''(f) Information Regarding Eligible Covered Beneficiaries. - The

Secretary shall provide, in a timely manner, a designated provider

with an accurate list of covered beneficiaries within the marketing

area of the designated provider to whom the designated provider may

offer enrollment.

''(g) Open Enrollment Demonstration Program. - (1) The Secretary

of Defense shall conduct a demonstration program under which

covered beneficiaries shall be permitted to enroll at any time in a

managed care plan offered by a designated provider consistent with

the enrollment requirements for the TRICARE Prime option under the

TRICARE program, but without regard to the limitation in subsection

(b). The demonstration program under this subsection shall cover

designated providers, selected by the Secretary of Defense, and the

service areas of the designated providers.

''(2) The demonstration program carried out under this section

shall commence on October 1, 1999, and end on September 30, 2001.

''(3) Not later than March 15, 2001, the Secretary of Defense

shall submit to the Committees on Armed Services of the Senate and

the House of Representatives a report on the demonstration program

carried out under this subsection. The report shall include, at a

minimum, an evaluation of the benefits of the open enrollment

opportunity to covered beneficiaries and a recommendation on

whether to authorize open enrollments in the managed care plans of

designated providers permanently.

''SEC. 725. APPLICATION OF CHAMPUS PAYMENT RULES.

''(a) Application of Payment Rules. - Subject to subsection (b),

the Secretary shall require a private facility or health care

provider that is a health care provider under the Civilian Health

and Medical Program of the Uniformed Services to apply the payment

rules described in section 1074(c) of title 10, United States Code,

in imposing charges for health care that the private facility or

provider provides to enrollees of a designated provider.

''(b) Authorized Adjustments. - The payment rules imposed under

subsection (a) shall be subject to such modifications as the

Secretary considers appropriate. The Secretary may authorize a

lower rate than the maximum rate that would otherwise apply under

subsection (a) if the lower rate is agreed to by the designated

provider and the private facility or health care provider.

''(c) Regulations. - The Secretary shall prescribe regulations to

implement this section after consultation with the other

administering Secretaries.

''(d) Conforming Amendment. - (Amended section 1074 of this

title.)

''SEC. 726. PAYMENTS FOR SERVICES.

''(a) Form of Payment. - Unless otherwise agreed to by the

Secretary and a designated provider, the form of payment for health

care services provided by a designated provider shall be on a full

risk capitation payment basis. The capitation payments shall be

negotiated and agreed upon by the Secretary and the designated

provider. In addition to such other factors as the parties may

agree to apply, the capitation payments shall be based on the

utilization experience of enrollees and competitive market rates

for equivalent health care services for a comparable population to

such enrollees in the area in which the designated provider is

located.

''(b) Limitation on Total Payments. - Total capitation payments

for health care services to a designated provider shall not exceed

an amount equal to the cost that would have been incurred by the

Government if the enrollees had received such health care services

through a military treatment facility, the TRICARE program, or the

Medicare program, as the case may be. In establishing the ceiling

rate for enrollees with the designated providers who are also

eligible for the Civilian Health and Medical Program of the

Uniformed Services, the Secretary of Defense shall take into

account the health status of the enrollees.

''(c) Establishment of Payment Rates on Annual Basis. - The

Secretary and a designated provider shall establish capitation

payments on an annual basis, subject to periodic review for

actuarial soundness and to adjustment for any adverse or favorable

selection reasonably anticipated to result from the design of the

program under this subtitle.

''(d) Alternative Basis for Calculating Payments. - After

September 30, 1999, the Secretary and a designated provider may

mutually agree upon a new basis for calculating capitation

payments.

''SEC. 727. REPEAL OF SUPERSEDED AUTHORITIES.

''(a) Repeals. - (Repealed sections 248c and 248d of Title 42,

The Public Health and Welfare, and section 718(c) of Pub. L.

101-510 and section 726 of Pub. L. 104-106, set out as notes under

section 248c of Title 42.)

''(b) Effective Date. - The amendments made by paragraphs (1),

(2), and (3) of subsection (a) shall take effect on October 1,

1997.''

(Pub. L. 104-208, div. A, title I, Sec. 101(b) (title VIII, Sec.

8131(b)), Sept. 30, 1996, 110 Stat. 3009-71, 3009-117, provided

that: ''The amendments made by subsection (a) (amending section 722

of Pub. L. 104-201, set out above) shall take effect as of the date

of the enactment of the National Defense Authorization Act for

Fiscal Year 1997 (Sept. 23, 1996) as if section 722 of such Act had

been enacted as so amended.'')

DEFINITION OF TRICARE PROGRAM

Pub. L. 104-106, div. A, title VII, Sec. 711, Feb. 10, 1996, 110

Stat. 374, provided that: ''For purposes of this subtitle (subtitle

B (Sec. 711-718) of title VII of div. A of Pub. L. 104-106,

amending section 1097 of this title, enacting provisions set out as

notes below, and amending provisions set out as a note below), the

term 'TRICARE program' means the managed health care program that

is established by the Secretary of Defense under the authority of

chapter 55 of title 10, United States Code, principally section

1097 of such title, and includes the competitive selection of

contractors to financially underwrite the delivery of health care

services under the Civilian Health and Medical Program of the

Uniformed Services.''

TRAINING IN HEALTH CARE MANAGEMENT AND ADMINISTRATION FOR TRICARE

LEAD AGENTS

Pub. L. 104-106, div. A, title VII, Sec. 715, Feb. 10, 1996, 110

Stat. 375, as amended by Pub. L. 106-398, Sec. 1 ((div. A), title

VII, Sec. 760(a)), Oct. 30, 2000, 114 Stat. 1654, 1654A-200,

provided that:

''(a) Provision of Training. - The Secretary of Defense shall

implement a professional educational program to provide appropriate

training in health care management and administration -

''(1) to each commander, deputy commander, and managed care

coordinator of a military medical treatment facility of the

Department of Defense, and any other person, who is selected to

serve as a lead agent to coordinate the delivery of health care

by military and civilian providers under the TRICARE program; and

''(2) to appropriate members of the support staff of the

treatment facility who will be responsible for daily operation of

the TRICARE program.

''(b) Limitation on Assignment Until Completion of Training. - No

person may be assigned as the commander, deputy commander, or

managed care coordinator of a military medical treatment facility

or as a TRICARE lead agent or senior member of the staff of a

TRICARE lead agent office until the Secretary of the military

department concerned submits a certification to the Secretary of

Defense that such person has completed the training described in

subsection (a).''

(Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 760(c)), Oct.

30, 2000, 114 Stat. 1654, 1654A-200, provided that: ''The

amendments made by subsection (a) to section 715 of such Act

(section 715 of Pub. L. 104-106, set out above) -

(''(1) shall apply to a deputy commander, a managed care

coordinator of a military medical treatment facility, or a lead

agent for coordinating the delivery of health care by military

and civilian providers under the TRICARE program, who is assigned

to such position on or after the date that is one year after the

date of the enactment of this Act (Oct. 30, 2000); and

(''(2) may apply, in the discretion of the Secretary of

Defense, to a deputy commander, a managed care coordinator of

such a facility, or a lead agent for coordinating the delivery of

such health care, who is assigned to such position before the

date that is one year after the date of the enactment of this

Act.'')

PILOT PROGRAM OF INDIVIDUALIZED RESIDENTIAL MENTAL HEALTH SERVICES

Pub. L. 104-106, div. A, title VII, Sec. 716, Feb. 10, 1996, 110

Stat. 375, provided that:

''(a) Program Required. - (1) During fiscal year 1996, the

Secretary of Defense, in consultation with the other administering

Secretaries under chapter 55 of title 10, United States Code, shall

implement a pilot program to provide residential and wraparound

services to children described in paragraph (2) who are in need of

mental health services. The Secretary shall implement the pilot

program for an initial period of at least two years in a military

health care region in which the TRICARE program has been

implemented.

''(2) A child shall be eligible for selection to participate in

the pilot program if the child is a dependent (as described in

subparagraph (D) or (I) of section 1072(2) of title 10, United

States Code) who -

''(A) is eligible for health care under section 1079 or 1086 of

such title; and

''(B) has a serious emotional disturbance that is generally

regarded as amenable to treatment.

''(b) Wraparound Services Defined. - For purposes of this

section, the term 'wraparound services' means individualized mental

health services that are provided principally to allow a child to

remain in the family home or other least-restrictive and

least-costly setting, but also are provided as an aftercare

planning service for children who have received acute or

residential care. Such term includes nontraditional mental health

services that will assist the child to be maintained in the

least-restrictive and least-costly setting.

''(c) Pilot Program Agreement. - Under the pilot program the

Secretary of Defense shall enter into one or more agreements that

require a mental health services provider under the agreement -

''(1) to provide wraparound services to a child described in

subsection (a)(2);

''(2) to continue to provide such services as needed during the

period of the agreement even if the child moves to another

location within the same TRICARE program region during that

period; and

''(3) to share financial risk by accepting as a maximum annual

payment for such services a case-rate reimbursement not in excess

of the amount of the annual standard CHAMPUS residential

treatment benefit payable (as determined in accordance with

section 8.1 of chapter 3 of volume II of the CHAMPUS policy

manual).

''(d) Report. - Not later than March 1, 1998, the Secretary of

Defense shall submit to the Committee on Armed Services of the

Senate and the Committee on National Security of the House of

Representatives a report on the program carried out under this

section. The report shall contain -

''(1) an assessment of the effectiveness of the program; and

''(2) the Secretary's views regarding whether the program

should be implemented throughout the military health care

system.''

EVALUATION AND REPORT ON TRICARE PROGRAM EFFECTIVENESS

Pub. L. 104-106, div. A, title VII, Sec. 717, Feb. 10, 1996, 110

Stat. 376, provided that:

''(a) Evaluation Required. - The Secretary of Defense shall

arrange for an on-going evaluation of the effectiveness of the

TRICARE program in meeting the goals of increasing the access of

covered beneficiaries under chapter 55 of title 10, United States

Code, to health care and improving the quality of health care

provided to covered beneficiaries, without increasing the costs

incurred by the Government or covered beneficiaries. The

evaluation shall specifically address -

''(1) the impact of the TRICARE program on military retirees

with regard to access, costs, and quality of health care

services; and

''(2) identify noncatchment areas in which the health

maintenance organization option of the TRICARE program is

available or is proposed to become available.

''(b) Entity To Conduct Evaluation. - The Secretary may use a

federally funded research and development center to conduct the

evaluation required by subsection (a).

''(c) Annual Report. - Not later than March 1, 1997, and each

March 1 thereafter, the Secretary shall submit to Congress a report

describing the results of the evaluation under subsection (a)

during the preceding year.''

USE OF HEALTH MAINTENANCE ORGANIZATION MODEL AS OPTION FOR MILITARY

HEALTH CARE

Pub. L. 103-160, div. A, title VII, Sec. 731, Nov. 30, 1993, 107

Stat. 1696, as amended by Pub. L. 103-337, div. A, title VII, Sec.

715, Oct. 5, 1994, 108 Stat. 2803; Pub. L. 104-106, div. A, title

VII, Sec. 714, Feb. 10, 1996, 110 Stat. 374, provided that:

''(a) Use of Model. - The Secretary of Defense shall prescribe

and implement a health benefit option (and accompanying

cost-sharing requirements) for covered beneficiaries eligible for

health care under chapter 55 of title 10, United States Code, that

is modelled on health maintenance organization plans offered in the

private sector and other similar Government health insurance

programs. The Secretary shall include, to the maximum extent

practicable, the health benefit option required under this

subsection as one of the options available to covered beneficiaries

in all managed health care initiatives undertaken by the Secretary

after December 31, 1994.

''(b) Elements of Option. - The Secretary shall offer covered

beneficiaries who enroll in the health benefit option required

under subsection (a) reduced out-of-pocket costs and a benefit

structure that is as uniform as possible throughout the United

States. The Secretary shall allow enrollees to seek health care

outside of the option, except that the Secretary may prescribe

higher out-of-pocket costs than are provided under section 1079 or

1086 of title 10, United States Code, for enrollees who obtain

health care outside of the option.

''(c) Government Costs. - The health benefit option required

under subsection (a) shall be administered so that the costs

incurred by the Secretary under the TRICARE program are no greater

than the costs that would otherwise be incurred to provide health

care to the members of the uniformed services and covered

beneficiaries who participate in the TRICARE program.

''(d) Definitions. - For purposes of this section:

''(1) The term 'covered beneficiary' means a beneficiary under

chapter 55 of title 10, United States Code, other than a

beneficiary under section 1074(a) of such title.

''(2) The term 'TRICARE program' means the managed health care

program that is established by the Secretary of Defense under the

authority of chapter 55 of title 10, United States Code,

principally section 1097 of such title, and includes the

competitive selection of contractors to financially underwrite

the delivery of health care services under the Civilian Health

and Medical Program of the Uniformed Services.

''(e) Regulations. - Not later than December 31, 1994, the

Secretary shall prescribe final regulations to implement the health

benefit option required by subsection (a).

''(f) Modification of Existing Contracts. - In the case of

managed health care contracts in effect or in final stages of

acquisition as of December 31, 1994, the Secretary may modify such

contracts to incorporate the health benefit option required under

subsection (a).''

MANAGED HEALTH CARE PROGRAM AND CONTRACTS FOR MILITARY HEALTH

SERVICES SYSTEM

Pub. L. 104-61, title VI, Dec. 1, 1995, 109 Stat. 649, provided

in part: ''That the date for implementation of the nation-wide

managed care military health services system shall be extended to

September 30, 1997''.

Pub. L. 103-139, title VIII, Sec. 8025, Nov. 11, 1993, 107 Stat.

1443, provided that: ''Notwithstanding any other provision of law,

to establish region-wide, at-risk, fixed price managed care

contracts possessing features similar to those of the CHAMPUS

Reform Initiative, the Secretary of Defense shall submit to the

Congress a plan to implement a nation-wide managed health care

program for the military health services system not later than

December 31, 1993: Provided, That the program shall include, but

not be limited to: (1) a uniform, stabilized benefit structure

characterized by a triple option health benefit feature; (2) a

regionally-based health care management system; (3) cost

minimization incentives including 'gatekeeping' and annual

enrollment procedures, capitation budgeting, and at-risk managed

care support contracts; and (4) full and open competition for all

managed care support contracts: Provided further, That the

implementation of the nation-wide managed care military health

services system shall be completed by September 30, 1996: Provided

further, That the Department shall competitively award contracts in

fiscal year 1994 for at least four new region-wide, at-risk, fixed

price managed care support contracts consistent with the

nation-wide plan, that one such contract shall include the State of

Florida (which may include Department of Veterans Affairs' medical

facilities with the concurrence of the Secretary of Veterans

Affairs), one such contract shall include the States of Washington

and Oregon, and one such contract shall include the State of Texas:

Provided further, That any law or regulation of a State or local

government relating to health insurance, prepaid health plans, or

other health care delivery, administration, and financing methods

shall be preempted and shall not apply to any region-wide, at-risk,

fixed price managed care contract entered into pursuant to chapter

55 of title 10, United States Code: Provided further, That the

Department shall competitively award within 13 months after the

date of enactment of this Act (Nov. 11, 1993) two contracts for

stand-alone, at-risk managed mental health services in high

utilization, high-cost areas, consistent with the management and

service delivery features in operation in Department of Defense

managed mental health care contracts: Provided further, That the

Assistant Secretary of Defense for Health Affairs shall, during the

current fiscal year, initiate through competitive procedures a

managed health care program for eligible beneficiaries in the area

of Homestead Air Force Base with benefits and services

substantially identical to those established to serve beneficiary

populations in areas where military medical facilities have been

terminated, to include retail pharmacy networks available to

Medicare-eligible beneficiaries, and shall present a plan to

implement this program to the House and Senate Committees on

Appropriations not later than January 15, 1994.''

CONDITION ON EXPANSION OF CHAMPUS REFORM INITIATIVE TO OTHER

LOCATIONS

Pub. L. 102-484, div. A, title VII, Sec. 712, Oct. 23, 1992, 106

Stat. 2435, as amended by Pub. L. 103-160, div. A, title VII, Sec.

720, Nov. 30, 1993, 107 Stat. 1695; Pub. L. 103-337, div. A, title

VII, Sec. 714(c), Oct. 5, 1994, 108 Stat. 2803, provided that:

''(a) Condition. - (1) Except as provided in subsection (b), the

Secretary of Defense may not expand the CHAMPUS reform initiative

underway in the States of California and Hawaii to another location

until not less than 90 days after the date on which the Secretary

certifies to Congress that expansion of the initiative to that

location is the most efficient method of providing health care to

covered beneficiaries in that location. In determining whether the

expansion of the CHAMPUS reform initiative to a location is the

most efficient method of providing health care to covered

beneficiaries in that location, the Secretary shall consider the

cost-effectiveness of the initiative (while assuring that the

combined cost of care in military treatment facilities and under

the Civilian Health and Medical Program of the Uniformed Services

will not be increased as a result of the expansion) and the effect

of the expansion of the initiative on the access of covered

beneficiaries to health care and on the quality of health care

received by covered beneficiaries.

''(2) To the extent any revision of the CHAMPUS reform initiative

is necessary in order to make the certification required by this

subsection, the Secretary shall assure that enrolled covered

beneficiaries may obtain health care services with reduced

out-of-pocket costs, as compared to standard CHAMPUS.

''(b) Exception. - The Secretary of Defense may waive the

operation of the condition on the expansion of the CHAMPUS reform

initiative specified in subsection (a) in order to expand the

initiative to a location adversely affected by the closure or

realignment of a military installation in that location, as

determined by the Secretary.

''(c) Evaluation of Certification. - The Comptroller General of

the United States and the Director of the Congressional Budget

Office shall evaluate each certification made by the Secretary of

Defense under subsection (a) that expansion of the CHAMPUS reform

initiative to another location is the most efficient method of

providing health care to covered beneficiaries in that location.

They shall submit their findings to Congress if these findings

differ substantially from the findings upon which the Secretary

made the decision to expand the CHAMPUS reform initiative.

''(d) Definitions. - For purposes of this section:

''(1) The terms 'CHAMPUS reform initiative' and 'initiative'

mean the health care delivery project required by section 702 of

the National Defense Authorization Act for Fiscal Year 1987

(Public Law 99-661; 10 U.S.C. 1073 note).

''(2) The term 'covered beneficiary' has the meaning given that

term in section 1072(5) of title 10, United States Code.

''(3) The terms 'Civilian Health and Medical Program of the

Uniformed Services' and 'CHAMPUS' have the meaning given the term

'Civilian Health and Medical Program of the Uniformed Services'

in section 1072(4) of title 10, United States Code.''

ALTERNATIVE HEALTH CARE DELIVERY METHODOLOGIES

Pub. L. 102-484, div. A, title VII, Sec. 713, Oct. 23, 1992, 106

Stat. 2435, as amended by Pub. L. 103-160, div. A, title VII, Sec.

719, Nov. 30, 1993, 107 Stat. 1694, provided that:

''(a) Continuation of Health Care Reform Initiatives. - (1)

During fiscal years 1993 through 1996, the Secretary of Defense

shall continue to conduct a broad array of reform initiatives for

furnishing health care to persons who are eligible to receive

health care under chapter 55 of title 10, United States Code.

''(2) The health care reform initiatives conducted in accordance

with paragraph (1) shall include CHAMPUS alternatives, the CHAMPUS

reform initiative, catchment area management, coordinated care, and

such other reform initiatives as the Secretary of Defense considers

to be appropriate.

''(3) Not later than September 30, 1994, the Secretary shall

submit to Congress a report regarding the health care reform

initiatives conducted during fiscal years 1993 and 1994. The report

shall include a discussion of the cost effectiveness of the

initiatives and the extent to which the persons who received health

care under such initiatives are satisfied with that health care.

''(b) Continuation of CHAMPUS Reform Initiative in Hawaii and

California. - (1) The Secretary of Defense shall ensure that a

replacement or successor contract for the CHAMPUS reform initiative

contract applicable to the States of California and Hawaii is

awarded in sufficient time for the contractor to begin to provide

health care in those States under the replacement or successor

contract as soon as practicable after the date of the enactment of

the National Defense Authorization Act for Fiscal Year 1994 (Nov.

30, 1993).

''(2) The Secretary shall use competitive procedures for awarding

a replacement or successor contract under paragraph (1).

''(c) Evaluation of CHAMPUS Reform Initiative. - (1) Not later

than June 1, 1994, the Secretary of Defense shall enter into a

contract with a non-Federal entity under which the entity will

perform an evaluation of the performance of the CHAMPUS reform

initiative in the States of California and Hawaii. The evaluation

shall cover each of the fiscal years during which the initiative is

carried out in those States under the replacement or successor

contract referred to in subsection (b) and under the predecessor

contracts. The evaluation shall include a comparison of the cost

savings and claims experience resulting in each such fiscal year

from carrying out the CHAMPUS reform initiative in those States.

''(2) Not later than one year after the date on which the

contract for evaluation is entered into under paragraph (1), the

non-Federal entity making the evaluation shall submit to the

Secretary and to Congress a report on the results of the

evaluation.

''(d) Definitions. - For purposes of this section:

''(1) The term 'CHAMPUS' means the Civilian Health and Medical

Program of the Uniformed Services, as defined in paragraph (4) of

section 1072 of title 10, United States Code.

''(2) The term 'covered beneficiary' has the meaning given that

term in paragraph (5) of such section.

''(3) The term 'CHAMPUS reform initiative' means the health

care delivery project required by section 702 of the National

Defense Authorization Act for Fiscal Year 1987 (Public Law

99-661; 10 U.S.C. 1073 note).

''(4) The term 'catchment area management' means the

methodology provided for demonstration in accordance with section

731 of the National Defense Authorization Act for Fiscal Years

1988 and 1989 (Public Law 100-180; 10 U.S.C. 1092 note).''

MILITARY HEALTH CARE FOR PERSONS RELIANT ON HEALTH CARE FACILITIES

AT BASES BEING CLOSED OR REALIGNED

Pub. L. 102-484, div. A, title VII, Sec. 722, Oct. 23, 1992, 106

Stat. 2439, provided that:

''(a) Establishment. - The Secretary of Defense shall establish a

joint services working group on the provision of military health

care to persons who rely for health care on health care facilities

at military installations being closed or realigned.

''(b) Membership. - The members of the working group shall

include the Assistant Secretary of Defense for Health Affairs, the

Surgeon General of the Army, the Surgeon General of the Navy, the

Surgeon General of the Air Force, or a designee of each such

person, and one independent member appointed by the Secretary of

Defense from among private citizens whose interest in matters

within the responsibility of the working group qualify that person

to represent all personnel entitled to health care under chapter 55

of title 10, United States Code.

''(c) Duties. - (1) In the case of each closure or realignment of

a military installation that will adversely affect the

accessibility of health care in a facility of the uniformed

services for persons entitled to such health care under chapter 55

of title 10, United States Code, the working group shall solicit

the views of such persons regarding suitable substitutes for the

furnishing of health care to those persons under that chapter.

''(2) In carrying out paragraph (1), the working group -

''(A) shall conduct meetings with persons referred to in that

paragraph, or representatives of such persons;

''(B) may use reliable sampling techniques;

''(C) shall visit the areas where closures or realignments of

military installations will adversely affect the accessibility of

health care in a facility of the uniformed services for persons

referred to in paragraph (1) and shall conduct public meetings;

and

''(D) shall ensure that members of the uniformed services on

active duty, members and former members of the uniformed services

entitled to retired or retainer pay, and dependents and survivors

of such members and retired personnel are afforded the

opportunity to express views.

''(d) Recommendations. - With respect to each closure and

realignment of a military installation referred to in subsection

(c), the working group shall submit to the Congress and the

Secretary of Defense the working group's recommendations regarding

the alternative means for continuing to provide accessible health

care under chapter 55 of title 10, United States Code, to persons

referred to in that subsection.

''(e) Application of Advisory Committee Act. - The provisions of

the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply

to the joint services working group established pursuant to this

section.''

AUTHORIZATION FOR EXTENSION OF CHAMPUS REFORM INITIATIVE

Pub. L. 102-190, div. A, title VII, Sec. 722, Dec. 5, 1991, 105

Stat. 1406, provided that:

''(a) Authority. - Upon the termination (for any reason) of the

contract of the Department of Defense in effect on the date of the

enactment of this Act (Dec. 5, 1991) under the CHAMPUS reform

initiative established under section 702 of the National Defense

Authorization Act for Fiscal Year 1987 (Pub. L. 99-661) (10 U.S.C.

1073 note), the Secretary of Defense may enter into a replacement

or successor contract with the same or a different contractor and

for such amount as may be determined in accordance with applicable

procurement laws and regulations and without regard to any

limitation (enacted before, on, or after the date of the enactment

of this Act) on the availability of funds for that purpose.

''(b) Treatment of Limitation on Funds for Program. - No

provision of law stated as a limitation on the availability of

funds may be treated as constituting the extension of, or as

requiring the extension of, any contract under the CHAMPUS reform

initiative that would otherwise expire in accordance with its

terms.''

EXTENSION OF CHAMPUS REFORM INITIATIVE FOR CERTAIN STATES

Pub. L. 102-172, title VIII, Sec. 8032, Nov. 26, 1991, 105 Stat.

1178, provided: ''That notwithstanding any other provision of law,

the CHAMPUS Reform Initiative contract for California and Hawaii

shall be extended until February 1, 1994, within the limits and

rates specified in the contract: Provided further, That the

Department shall competitively award contracts for the geographic

expansion of the CHAMPUS Reform Initiative in Florida (which may

include Department of Veterans Affairs medical facilities with the

concurrence of the Secretary of Veterans Affairs), Washington,

Oregon, and the Tidewater region of Virginia: Provided further,

That competitive expansion of the CHAMPUS Reform Initiative may

occur in any other regions that the Assistant Secretary of Defense

for Health Affairs deems appropriate.''

CONDITIONS ON EXPANSION OF CHAMPUS REFORM INITIATIVE

Pub. L. 101-510, div. A, title VII, Sec. 715, Nov. 5, 1990, 104

Stat. 1584, provided that:

''(a) Certification of Cost-Effectiveness. - The Secretary of

Defense may not proceed with the proposed expansion of the CHAMPUS

reform initiative underway in the States of California and Hawaii

until not less than 90 days after the date on which the Secretary

certifies to the Congress that -

''(1) such CHAMPUS reform initiative has been demonstrated to

be more cost-effective than the Civilian Health and Medical

Program of the Uniformed Services or any other health care

demonstration program being conducted by the Secretary;

''(2) the contractor selected to underwrite the delivery of

health care under the CHAMPUS reform initiative will accomplish

the expansion without the disruption of services to beneficiaries

under the Civilian Health and Medical Program of the Uniformed

Services or delays in the processing of claims; and

''(3) such contractor is currently, and projected to remain,

financially able to underwrite the CHAMPUS reform initiative.

''(b) Report on Certification. - Not later than 30 days after the

date on which the Secretary of Defense submits the certification

required by subsection (a), the Comptroller General of the United

States and the Director of the Congressional Budget Office shall

jointly submit to Congress a report evaluating such certification.

''(c) CHAMPUS Reform Initiative Defined. - For purposes of this

section, the term 'CHAMPUS reform initiative' has the meaning given

that term in section 702(d)(1) of the Department of Defense

Authorization Act for Fiscal Year 1987 (Pub. L. 99-661) (10 U.S.C.

1073 note).''

REQUIREMENTS PRIOR TO TERMINATION OF MEDICAL SERVICES AT MILITARY

MEDICAL TREATMENT FACILITIES

Pub. L. 101-510, div. A, title VII, Sec. 716, Nov. 5, 1990, 104

Stat. 1585, provided that:

''(a) Prohibition. - During the period beginning on the date of

the enactment of this Act (Nov. 5, 1990) and ending on September

30, 1995, the Secretary of a military department may not take any

action to close a military medical facility under the jurisdiction

of that Secretary or reduce the level of care provided at such a

medical facility until 90 days after the date on which the

Secretary submits to Congress a report described in subsection (b).

''(b) Elements of Report. - A report referred to in subsection

(a) shall include the following:

''(1) The reason for the action.

''(2) The projected savings to the Government from the action.

''(3) The impact on CHAMPUS and MEDICARE costs in the catchment

area of the facility.

''(4) The impact on beneficiary cost-sharing.

''(5) An examination of alternative ways to provide care to the

persons served by the facility that the Secretary determines

would not result in adverse consequences to such persons.

''(6) An explanation of how care will be provided for and the

cost, if any, to those persons to receive such care.

''(c) Exception. - Subsection (a) shall not apply with respect to

the closing of a military medical facility (or the reduction of the

level of care provided at a military medical facility) as a result

of a base closure or an operational deployment.''

REQUIREMENT FOR AVAILABILITY OF ADDITIONAL INSURANCE COVERAGE;

FUNDING LIMITATIONS; DEFINITION

Pub. L. 100-180, div. A, title VII, Sec. 732(e)-(g), Dec. 4,

1987, 101 Stat. 1120, 1121, provided that:

''(e) Requirement for Availability of Additional Insurance

Coverage. - (1) The Secretary of Defense shall make every effort to

enter into an agreement, similar to the one being negotiated with a

private insurer on the date of the enactment of this Act (Dec. 4,

1987), that would provide an insurance plan that meets the

requirements described in paragraph (3).

''(2) If an agreement referred to in paragraph (1) is not entered

into before a request for proposals with respect to the second

phase of the CHAMPUS reform initiative is issued, the Secretary

shall provide for an insurance plan which meets the requirements

described in paragraph (3) through either of the following means:

''(A) By including, in any request for proposals with respect

to the second (and any subsequent) phase of the CHAMPUS reform

initiative, a requirement for the contractor to offer an option

to elect an insurance plan which meets the requirements described

in paragraph (3).

''(B) By including, in any request for proposals for a contract

to process claims for CHAMPUS, a requirement for the contractor

(known as a fiscal intermediary) to offer an option to elect an

insurance plan which meets the requirements described in

paragraph (3).

''(3) The insurance plan requirements referred to in paragraphs

(1) and (2) are the following:

''(A) At the election of the individual, the plan shall be

available to an individual losing eligibility (by reason of

discharge, release from active duty, a change in family status

(including divorce or annulment, or, in the case of a child,

reaching age 22), or other similar reason) to be a covered

beneficiary under chapter 55 of title 10, United States Code.

''(B) The plan shall provide for coverage of benefits similar

to the coverage of benefits available to the individual under

CHAMPUS, regardless of any pre-existing condition.

''(C) The plan shall provide that enrollees in the plan shall

pay the full periodic charges for the benefit coverage.

''(f) Funding Limitations. - (1) None of the funds appropriated

or otherwise made available to the Department of Defense may be

obligated or expended for the purpose of entering into a contract

for the demonstration phase of the CHAMPUS reform initiative

required by section 702(a)(1) of the National Defense Authorization

Act for Fiscal Year 1987 (section 702(a)(1) of Pub. L. 99-661, set

out as a note below) until the requirements of section 702(a)(4) of

such Act (as added by subsection (a)) are met.

''(2) None of the funds appropriated or otherwise made available

to the Department of Defense may be obligated or expended for the

purpose of requesting a proposal for the second (or any subsequent)

phase of the CHAMPUS reform initiative as described in section

702(c) of the National Defense Authorization Act for Fiscal Year

1987 until the requirements of paragraph (2) of section 702(c) of

such Act (as added by subsection (c)) are met.

''(g) CHAMPUS Defined. - In this section, the term 'CHAMPUS' has

the meaning given such term by section 1072(4) of title 10, United

States Code.''

CHAMPUS REFORM INITIATIVE

Pub. L. 99-661, div. A, title VII, Sec. 702, Nov. 14, 1986, 100

Stat. 3899, as amended by Pub. L. 100-180, div. A, title VII, Sec.

732(a), (c), Dec. 4, 1987, 101 Stat. 1119, provided that:

''(a) Demonstration Project. - (1) The Secretary of Defense shall

conduct a project designed to demonstrate the feasibility of

improving the effectiveness of the Civilian Health and Medical

Program of the Uniformed Services (CHAMPUS) through the competitive

selection of contractors to financially underwrite the delivery of

health care services under the program.

''(2) The demonstration project required by paragraph (1) -

''(A) shall begin not later than September 30, 1988, and

continue for not less than one year;

''(B) shall include not more than one-third of covered

beneficiaries; and

''(C) shall include a health care enrollment system that meets

the requirements specified in section 1099 of title 10, United

States Code (as added by section 701(a)(1)).

''(3)(A) The Secretary shall submit to the Committees on Armed

Services of the Senate and House of Representatives a report on the

development of the demonstration project required by paragraph (1).

Such report shall include -

''(i) a description of the scope and structure of the project;

''(ii) an estimate of the costs of the care to be provided

under the project; and

''(iii) a description of the health care enrollment system

included in the project.

''(B) The report required by subparagraph (A) shall be submitted

-

''(i) not later than 60 days before the initiation of the

project, if the project is to be restricted to a contiguous area

of the United States; or

''(ii) not later than 60 days before a solicitation for bids or

proposals with respect to such project is issued, if the project

will not be restricted to a contiguous area of the United States.

''(4) The Secretary of Defense shall develop a methodology to be

used in evaluating the results of the demonstration project

required by paragraph (1) and shall submit to the Committees on

Armed Services of the Senate and the House of Representatives a

report on such methodology.

''(b) Study of Health Care Alternatives. - (1) The demonstration

project required by subsection (a)(1) shall include a study of -

''(A) methods to guarantee the maintenance of competition among

providers of health care to persons under the jurisdiction of the

Secretary;

''(B) the merits of the use of a voucher system or a fee

schedule for provision of health care to such persons; and

''(C) methods to guarantee that community hospitals are given

equal consideration with other health care providers for

provision of health care services under contracts with the

Department of Defense.

''(2) The Secretary shall submit to Congress a report discussing

the matters evaluated in the study required by paragraph (1) before

the end of the 90-day period beginning on the date of the enactment

of this Act (Nov. 14, 1986).

''(c) Phased Implementation of CHAMPUS Reform Initiative. - (1)

The Secretary of Defense may proceed with implementation of the

CHAMPUS reform initiative, to be carried out in two phases during a

period of not less than two years, if -

''(A) the Secretary determines, based on the results of the

demonstration project required by subsection (a)(1), that such

initiative should be implemented;

''(B) not less than one year elapses after the date on which

the demonstration project required by subsection (a)(1) is

initiated; and

''(C) 90 days elapse after the date on which the Secretary

submits to the Committees on Armed Services of the Senate and

House of Representatives a report that includes -

''(i) a description of the results of the demonstration

project, evaluated in accordance with the methodology developed

under subsection (a)(4);

''(ii) a description of any changes the Secretary intends to

make in the initiative during the proposed implementation; and

''(iii) a comparison of the costs of providing health care

under CHAMPUS with the costs of providing health care under the

demonstration project and the estimated costs of providing

health care under the CHAMPUS reform initiative if fully

implemented.

''(2) The Secretary may not issue a request for proposals with

respect to the second (or any subsequent) phase of the CHAMPUS

reform initiative until -

''(A) all principal features of the demonstration project,

including networks of providers of health care, have been in

operation for not less than one year; and

''(B) the expiration of 60 days after the date on which the

report described in paragraph (1)(C) has been received by the

committees referred to in such paragraph.

''(d) Definitions. - In this section:

''(1) The term 'CHAMPUS reform initiative' means the

competitive selection of contractors to financially underwrite

the delivery of health care services under the Civilian Health

and Medical Program of the Uniformed Services.

''(2) The term 'Civilian Health and Medical Program of the

Uniformed Services' has the meaning given such term in section

1072(4) of title 10, United States Code (as added by section

701(b)).

''(3) The term 'covered beneficiary' has the meaning given such

term in section 1072(5) of title 10, United States Code (as added

by section 701(b)).''

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 1072 of this title.

-CITE-

10 USC Sec. 1073a 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1073a. Contracts for health care: best value contracting

-STATUTE-

(a) Authority. - Under regulations prescribed by the

administering Secretaries, health care contracts shall be awarded

in the administration of this chapter to the offeror or offerors

that will provide the best value to the United States to the

maximum extent consistent with furnishing high-quality health care

in a manner that protects the fiscal and other interests of the

United States.

(b) Factors Considered. - In the determination of best value

under subsection (a) -

(1) consideration shall be given to the factors specified in

the regulations; and

(2) greater weight shall be accorded to technical and

performance-related factors than to cost and price-related

factors.

(c) Applicability. - The authority under the regulations

prescribed under subsection (a) shall apply to any contract in

excess of $5,000,000.

-SOURCE-

(Added Pub. L. 106-65, div. A, title VII, Sec. 722(a), Oct. 5,

1999, 113 Stat. 695.)

-CITE-

10 USC Sec. 1074 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074. Medical and dental care for members and certain former

members

-STATUTE-

(a) Under joint regulations to be prescribed by the administering

Secretaries, a member of a uniformed service who is on active duty

is entitled to medical and dental care in any facility of any

uniformed service.

(b) Under joint regulations to be prescribed by the administering

Secretaries, a member or former member of a uniformed service who

is entitled to retired or retainer pay, or equivalent pay may, upon

request, be given medical and dental care in any facility of any

uniformed service, subject to the availability of space and

facilities and the capabilities of the medical and dental staff.

The administering Secretaries may, with the agreement of the

Secretary of Veterans Affairs, provide care to persons covered by

this subsection in facilities operated by the Secretary of Veterans

Affairs and determined by him to be available for this purpose on a

reimbursable basis at rates approved by the President.

(c)(1) Funds appropriated to a military department, the

Department of Homeland Security (with respect to the Coast Guard

when it is not operating as a service in the Navy), or the

Department of Health and Human Services (with respect to the

National Oceanic and Atmospheric Administration and the Public

Health Service) may be used to provide medical and dental care to

persons entitled to such care by law or regulations, including the

provision of such care (other than elective private treatment) in

private facilities for members of the uniformed services. If a

private facility or health care provider providing care under this

subsection is a health care provider under the Civilian Health and

Medical Program of the Uniformed Services, the Secretary of

Defense, after consultation with the other administering

Secretaries, may by regulation require the private facility or

health care provider to provide such care in accordance with the

same payment rules (subject to any modifications considered

appropriate by the Secretary) as apply under that program.

(2)(A) Subject to such exceptions as the Secretary of Defense

considers necessary, coverage for medical care for members of the

uniformed services under this subsection, and standards with

respect to timely access to such care, shall be comparable to

coverage for medical care and standards for timely access to such

care under the managed care option of the TRICARE program known as

TRICARE Prime.

(B) The Secretary of Defense shall enter into arrangements with

contractors under the TRICARE program or with other appropriate

contractors for the timely and efficient processing of claims under

this subsection.

(C) The Secretary of Defense shall consult with the other

administering Secretaries in the administration of this paragraph.

(3)(A) A member of the uniformed services described in

subparagraph (B) may not be required to receive routine primary

medical care at a military medical treatment facility.

(B) A member referred to in subparagraph (A) is a member of the

uniformed services on active duty who is entitled to medical care

under this subsection and who -

(i) receives a duty assignment described in subparagraph (C);

and

(ii) pursuant to the assignment of such duty, resides at a

location that is more than 50 miles, or approximately one hour of

driving time, from the nearest military medical treatment

facility adequate to provide the needed care.

(C) A duty assignment referred to in subparagraph (B) means any

of the following:

(i) Permanent duty as a recruiter.

(ii) Permanent duty at an educational institution to instruct,

administer a program of instruction, or provide administrative

services in support of a program of instruction for the Reserve

Officers' Training Corps.

(iii) Permanent duty as a full-time adviser to a unit of a

reserve component.

(iv) Any other permanent duty designated by the Secretary

concerned for purposes of this paragraph.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1446;

amended Pub. L. 89-614, Sec. 2(2), Sept. 30, 1966, 80 Stat. 862;

Pub. L. 96-513, title V, Sec. 511(36), (37), Dec. 12, 1980, 94

Stat. 2923; Pub. L. 98-525, title XIV, Sec. 1401(e)(1), Oct. 19,

1984, 98 Stat. 2616; Pub. L. 98-557, Sec. 19(3), Oct. 30, 1984, 98

Stat. 2869; Pub. L. 101-189, div. A, title VII, Sec. 729, title

XVI, Sec. 1621(a)(2), Nov. 29, 1989, 103 Stat. 1481, 1603; Pub. L.

101-510, div. A, title XIV, Sec. 1484(j)(1), Nov. 5, 1990, 104

Stat. 1718; Pub. L. 104-106, div. A, title VII, Sec. 723, Feb. 10,

1996, 110 Stat. 377; Pub. L. 104-201, div. A, title VII, Sec.

725(d), Sept. 23, 1996, 110 Stat. 2596; Pub. L. 105-85, div. A,

title VII, Sec. 731(a)(1), Nov. 18, 1997, 111 Stat. 1810; Pub. L.

106-398, Sec. 1 ((div. A), title VII, Sec. 722(a)(1)), Oct. 30,

2000, 114 Stat. 1654, 1654A-185; Pub. L. 107-296, title XVII, Sec.

1704(b)(1), Nov. 25, 2002, 116 Stat. 2314.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1074(a) 1074(b) 37:421(a). June 7, 1956, ch.

37:402(a)(3) (as 374, Sec. 102(a)(3)

applicable to (as applicable to

37:421(b)). Sec. 301(b)),

37:421(b). 301(a), (b), 70

Stat. 250, 253.

-------------------------------

In subsection (a), words of entitlement are substituted for the

correlative words of obligation.

In subsection (b), the words ''active duty (other than for

training)'' are substituted for the words ''active duty as defined

in section 901(b) of Title 50'' to reflect section 101(22) of this

title. The words ''and dental'' are inserted before the word

''staff'' for clarity. The words ''retirement'' and ''retirement

pay'' are omitted as surplusage.

PRIOR PROVISIONS

Provisions similar to those in subsec. (c) of this section were

contained in Pub. L. 98-212, title VII, Sec. 735, Dec. 8, 1983, 97

Stat. 1444, which was formerly set out as a note under section 138

(now 114) of this title, and which was amended by Pub. L. 98-525,

title XIV, Sec. 1403(a)(2), 1404, Oct. 19, 1984, 98 Stat. 2621,

eff. Oct. 1, 1985, to strike out these provisions.

A prior section 1074, act Aug. 10, 1956, ch. 1041, 70A Stat. 82,

related to enactment of legislation relating to voting in other

elections, prior to repeal by Pub. L. 85-861, Sec. 36B(5), Sept. 2,

1958, 72 Stat. 1570, as superseded by the Federal Voting Assistance

Act of 1955 which is classified to subchapter I-D (Sec. 1973cc et

seq.) of chapter 20 of Title 42, The Public Health and Welfare.

AMENDMENTS

2002 - Subsec. (c)(1). Pub. L. 107-296 substituted ''of Homeland

Security'' for ''of Transportation''.

2000 - Subsec. (c). Pub. L. 106-398, Sec. 1 ((div. A), title VII,

Sec. 722(a)(1)(A)), substituted ''uniformed services'' for ''armed

forces'' in pars. (1), (2)(A), and (3)(B).

Subsec. (c)(1). Pub. L. 106-398, Sec. 1 ((div. A), title VII,

Sec. 722(a)(1)(B)), inserted '', the Department of Transportation

(with respect to the Coast Guard when it is not operating as a

service in the Navy), or the Department of Health and Human

Services (with respect to the National Oceanic and Atmospheric

Administration and the Public Health Service)'' after ''military

department''.

Subsec. (c)(2)(C). Pub. L. 106-398, Sec. 1 ((div. A), title VII,

Sec. 722(a)(1)(C)), added subpar. (C).

Subsec. (c)(3)(A). Pub. L. 106-398, Sec. 1 ((div. A), title VII,

Sec. 722(a)(1)(D)), substituted ''A member of the uniformed

services described in subparagraph (B) may not be required'' for

''The Secretary of Defense may not require a member of the armed

forces described in subparagraph (B)''.

1997 - Subsec. (c). Pub. L. 105-85 designated existing provisions

as par. (1) and added pars. (2) and (3).

1996 - Subsec. (d). Pub. L. 104-201 struck out subsec. (d) which

read as follows:

''(d)(1) The Secretary of Defense may require, by regulation, a

private CHAMPUS provider to apply the CHAMPUS payment rules

(subject to any modifications considered appropriate by the

Secretary) in imposing charges for health care that the private

CHAMPUS provider provides to a member of the uniformed services who

is enrolled in a health care plan of a facility deemed to be a

facility of the uniformed services under section 911(a) of the

Military Construction Authorization Act, 1982 (42 U.S.C. 248c(a))

when the health care is provided outside the catchment area of the

facility.

''(2) In this subsection:

''(A) The term 'private CHAMPUS provider' means a private

facility or health care provider that is a health care provider

under the Civilian Health and Medical Program of the Uniformed

Services.

''(B) The term 'CHAMPUS payment rules' means the payment rules

referred to in subsection (c).

''(3) The Secretary of Defense shall prescribe regulations under

this subsection after consultation with the other administering

Secretaries.''

Pub. L. 104-106 added subsec. (d).

1990 - Subsec. (b). Pub. L. 101-510 substituted ''Secretary of

Veterans Affairs'' for ''Administrator'' after ''operated by the''.

1989 - Subsec. (b). Pub. L. 101-189, Sec. 1621(a)(2), substituted

''Secretary of Veterans Affairs'' for ''Administrator of Veterans'

Affairs''.

Subsec. (c). Pub. L. 101-189, Sec. 729, inserted at end ''If a

private facility or health care provider providing care under this

subsection is a health care provider under the Civilian Health and

Medical Program of the Uniformed Services, the Secretary of

Defense, after consultation with the other administering

Secretaries, may by regulation require the private facility or

health care provider to provide such care in accordance with the

same payment rules (subject to any modifications considered

appropriate by the Secretary) as apply under that program.''

1984 - Subsecs. (a), (b). Pub. L. 98-557 substituted reference to

administering Secretaries for reference to Secretary of Defense and

Secretary of Health and Human Services wherever appearing.

Subsec. (c). Pub. L. 98-525 added subsec. (c).

1980 - Subsec. (a). Pub. L. 96-513, Sec. 511(36), substituted

''Secretary of Health and Human Services'' for ''Secretary of

Health, Education, and Welfare''.

Subsec. (b). Pub. L. 96-513, Sec. 511(36), (37), substituted

''Secretary of Health and Human Services'' and ''President'' for

''Secretary of Health, Education, and Welfare'' and ''Bureau of the

Budget'', respectively.

1966 - Subsec. (b). Pub. L. 89-614 struck out provision which

excepted from medical and dental care a member or former member who

is entitled to retired pay under chapter 67 of this title and has

served less than eight years on active duty (other than for

training) and authorized care to be provided to persons covered by

subsec. (b) in facilities operated by the Administrator of

Veterans' Affairs and available on a reimbursable basis at rates

approved by the Bureau of the Budget.

EFFECTIVE DATE OF 2002 AMENDMENT

Amendment by Pub. L. 107-296 effective on the date of transfer of

the Coast Guard to the Department of Homeland Security, see section

1704(g) of Pub. L. 107-296, set out as a note under section 101 of

this title.

EFFECTIVE DATE OF 2000 AMENDMENT

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 722(c)(1)),

Oct. 30, 2000, 114 Stat. 1654, 1654A-186, provided that: ''The

amendments made by subsections (a)(1) and (b)(1) (amending this

section and section 1079 of this title) shall take effect on

October 1, 2001.''

EFFECTIVE DATE OF 1997 AMENDMENT

Section 731(a)(2) of Pub. L. 105-85 provided that: ''The

amendments made by paragraph (1) (amending this section) shall

apply with respect to coverage of medical care for, and the

provision of such care to, a member of the Armed Forces under

section 1074(c) of title 10, United States Code, on and after the

later of the following:

''(A) April 1, 1998.

''(B) The date on which the TRICARE program is in place in the

service area of the member.''

EFFECTIVE DATE OF 1984 AMENDMENT

Amendment by Pub. L. 98-525 effective Oct. 1, 1985, see section

1404 of Pub. L. 98-525, set out as an Effective Date note under

section 520b of this title.

EFFECTIVE DATE OF 1980 AMENDMENT

Amendment by Pub. L. 96-513 effective Dec. 12, 1980, see section

701(b)(3) of Pub. L. 96-513, set out as a note under section 101 of

this title.

EFFECTIVE DATE OF 1966 AMENDMENT

For effective date of amendment by Pub. L. 89-614, see section 3

of Pub. L. 89-614, set out as a note under section 1071 of this

title.

-TRANS-

DELEGATION OF FUNCTIONS

Authority of President under subsec. (b) to approve uniform rates

of reimbursement for care provided in facilities operated by

Secretary of Veterans Affairs delegated to Secretary of Veterans

Affairs, see section 7(a) of Ex. Ord. No. 11609, July 22, 1971, 36

F.R. 13747, set out as a note under section 301 of Title 3, The

President.

-MISC5-

DISCLOSURE OF INFORMATION ON PROJECT 112 TO DEPARTMENT OF VETERANS

AFFAIRS

Pub. L. 107-314, div. A, title VII, Sec. 709, Dec. 2, 2002, 116

Stat. 2586, provided that:

''(a) Plan for Disclosure of Information. - Not later than 90

days after the date of the enactment of this Act (Dec. 2, 2002),

the Secretary of Defense shall submit to Congress and the Secretary

of Veterans Affairs a comprehensive plan for the review,

declassification, and submittal to the Department of Veterans

Affairs of all records and information of the Department of Defense

on Project 112 that are relevant to the provision of benefits by

the Secretary of Veterans Affairs to members of the Armed Forces

who participated in that project.

''(b) Plan Requirements. - (1) The records and information

covered by the plan under subsection (a) shall be the records and

information necessary to permit the identification of members of

the Armed Forces who were or may have been exposed to chemical or

biological agents as a result of Project 112.

''(2) The plan shall provide for completion of all activities

contemplated by the plan not later than one year after the date of

the enactment of this Act (Dec. 2, 2002).

''(c) Identification of Other Projects or Tests. - The Secretary

of Defense also shall work with veterans and veterans service

organizations to identify other projects or tests conducted by the

Department of Defense that may have exposed members of the Armed

Forces to chemical or biological agents.

''(d) GAO Reports on Plan and Implementation. - (1) Not later

than 30 days after submission of the plan under subsection (a), the

Comptroller General shall submit to Congress a report reviewing the

plan. The report shall include an examination of whether adequate

resources have been committed, the timeliness of the information to

be released to the Department of Veterans Affairs, and the adequacy

of the procedures to notify affected veterans of potential

exposure.

''(2) Not later than six months after implementation of the plan

begins, the Comptroller General shall submit to Congress a report

evaluating the progress in the implementation of the plan.

''(e) DOD Reports on Implementation. - (1) Not later than six

months after the date of the enactment of this Act (Dec. 2, 2002),

and upon completion of all activities contemplated by the plan

under subsection (a), the Secretary of Defense shall submit to

Congress and the Secretary of Veterans Affairs a report on progress

in the implementation of the plan.

''(2) Each report under paragraph (1) shall include, for the

period covered by such report -

''(A) the number of records reviewed;

''(B) each test, if any, under Project 112 identified during

such review;

''(C) for each test so identified -

''(i) the test name;

''(ii) the test objective;

''(iii) the chemical or biological agent or agents involved;

and

''(iv) the number of members of the Armed Forces, and

civilian personnel, potentially effected by such test; and

''(D) the extent of submittal of records and information to the

Secretary of Veterans Affairs under this section.

''(f) Project 112. - For purposes of this section, Project 112

refers to the chemical and biological weapons vulnerability-testing

program of the Department of Defense conducted by the Deseret Test

Center from 1963 to 1969. The project included the Shipboard Hazard

and Defense (SHAD) project of the Navy.''

HEALTH CARE AT FORMER UNIFORMED SERVICES TREATMENT FACILITIES FOR

ACTIVE DUTY MEMBERS STATIONED AT CERTAIN REMOTE LOCATIONS

Pub. L. 106-65, div. A, title VII, Sec. 706, Oct. 5, 1999, 113

Stat. 684, as amended by Pub. L. 106-398, Sec. 1 ((div. A), title

VII, Sec. 722(a)(3)), Oct. 30, 2000, 114 Stat. 1654, 1654A-185,

provided that:

''(a) Authority. - Health care may be furnished by a designated

provider pursuant to any contract entered into by the designated

provider under section 722(b) of the National Defense Authorization

Act for Fiscal Year 1997 (Public Law 104-201; 10 U.S.C. 1073 note)

to eligible members who reside within the service area of the

designated provider.

''(b) Eligibility. - A member of the uniformed services (as

defined in section 1072(1) of title 10, United States Code) is

eligible for health care under subsection (a) if the member is a

member described in section 731(c) of the National Defense

Authorization Act for Fiscal Year 1998 (Public Law 105-85; 111

Stat. 1811; 10 U.S.C. 1074 note).

''(c) Applicable Policies. - In furnishing health care to an

eligible member under subsection (a), a designated provider shall

adhere to the Department of Defense policies applicable to the

furnishing of care under the TRICARE Prime Remote program,

including coordinating with uniformed services medical authorities

for hospitalizations and all referrals for specialty care.

''(d) Reimbursement Rates. - The Secretary of Defense, in

consultation with the designated providers, shall prescribe

reimbursement rates for care furnished to eligible members under

subsection (a). The rates prescribed for health care may not exceed

the amounts allowable under the TRICARE Standard plan for the same

care.''

TEMPORARY AUTHORITY FOR MANAGED CARE EXPANSION TO MEMBERS ON ACTIVE

DUTY AT CERTAIN REMOTE LOCATIONS; ''TRICARE PROGRAM'' AND ''TRICARE

PRIME PLAN'' DEFINED

Pub. L. 105-85, div. A, title VII, Sec. 731(b)-(f), Nov. 18,

1997, 111 Stat. 1811, 1812, as amended by Pub. L. 106-398, Sec. 1

((div. A), title VII, Sec. 722(a)(2), (b)(2)), Oct. 30, 2000, 114

Stat. 1654, 1654A-185, 1654A-186, provided that:

''(b) Temporary Authority for Managed Care Expansion to Members

on Active Duty at Certain Remote Locations. - (1) A member of the

uniformed services described in subsection (c) is entitled to

receive care under the Civilian Health and Medical Program of the

Uniformed Services. In connection with such care, the Secretary of

Defense shall waive the obligation of the member to pay a

deductible, copayment, or annual fee that would otherwise be

applicable under that program for care provided to the members

under the program. A dependent of the member, as described in

subparagraph (A), (D), or (I) of section 1072(2) of title 10,

United States Code, who is residing with the member shall have the

same entitlement to care and to waiver of charges as the member.

''(2) A member or dependent of the member, as the case may be,

who is entitled under paragraph (1) to receive health care services

under CHAMPUS shall receive such care from a network provider under

the TRICARE program if such a provider is available in the service

area of the member.

''(3) Paragraph (1) shall take effect on the date of the

enactment of this Act (Nov. 18, 1997) and shall expire with respect

to a member upon the later of the following:

''(A) The date that is one year after the date of the enactment

of this Act.

''(B) The date on which the amendments made by subsection (a)

(amending this section) apply with respect to the coverage of

medical care for, and provision of such care to, the member.

''(4) The Secretary of Defense shall consult with the other

administering Secretaries in the administration of this subsection.

''(c) Eligible Members. - A member referred to in subsection (b)

is a member of the uniformed services on active duty who -

''(1) receives a duty assignment described in subsection (d);

and

''(2) pursuant to the assignment of such duty, resides at a

location that is more than 50 miles, or approximately one hour of

driving time, from -

''(A) the nearest health care facility of the uniformed

services adequate to provide the needed care under chapter 55

of title 10, United States Code; and

''(B) the nearest source of the needed care that is available

to the member under the TRICARE Prime plan.

''(d) Duty Assignments Covered. - A duty assignment referred to

in subsection (c)(1) means any of the following:

''(1) Permanent duty as a recruiter.

''(2) Permanent duty at an educational institution to instruct,

administer a program of instruction, or provide administrative

services in support of a program of instruction for the Reserve

Officers' Training Corps.

''(3) Permanent duty as a full-time adviser to a unit of a

reserve component of the uniformed services.

''(4) Any other permanent duty designated by the Secretary

concerned for purposes of this subsection.

''(e) Payment of Costs. - Deductibles, copayments, and annual

fees not payable by a member by reason of a waiver granted under

the regulations prescribed pursuant to subsection (b) shall be paid

out of funds available to the Department of Defense for the Defense

Health Program.

''(f) Definitions. - In this section (amending this section and

enacting provisions set out as a note above):

''(1) The term 'TRICARE program' has the meaning given that

term in section 1072(7) of title 10, United States Code.

''(2) The term 'TRICARE Prime plan' means a plan under the

TRICARE program that provides for the voluntary enrollment of

persons for the receipt of health care services to be furnished

in a manner similar to the manner in which health care services

are furnished by health maintenance organizations.

''(3) The terms 'uniformed services' and 'administering

Secretaries' have the meanings given those terms in section 1072

of title 10, United States Code.''

(Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 722(c)(2),

(3)), Oct. 30, 2000, 114 Stat. 1654, 1654A-186, provided that:

(''(2) The amendments made by subsection (a)(2) (amending section

731(b)-(f) of Pub. L. 105-85, set out above), with respect to

members of the uniformed services, and the amendments made by

subsection (b)(2) (amending section 731(b)-(f) of Pub. L. 105-85,

set out above), with respect to dependents of members, shall take

effect on the date of the enactment of this Act (Oct. 30, 2000) and

shall expire with respect to a member or the dependents of a

member, respectively, on the later of the following:

(''(A) The date that is one year after the date of the

enactment of this Act.

(''(B) The date on which the policies required by the

amendments made by subsection (a)(1) or (b)(1) (amending this

section and section 1079 of this title) are implemented with

respect to the coverage of medical care for and provision of such

care to the member or dependents, respectively.

(''(3) Section 731(b)(3) of Public Law 105-85 (set out above)

does not apply to a member of the Coast Guard, the National Oceanic

and Atmospheric Administration, or the Commissioned Corps of the

Public Health Service, or to a dependent of a member of a uniformed

service.'')

INDEPENDENT RESEARCH REGARDING GULF WAR SYNDROME

Section 743 of Pub. L. 104-201 provided that:

''(a) Definitions. - For purposes of this section:

''(1) The term 'Gulf War service' means service on active duty

as a member of the Armed Forces in the Southwest Asia theater of

operations during the Persian Gulf War.

''(2) The term 'Gulf War syndrome' means the complex of

illnesses and symptoms commonly known as Gulf War syndrome.

''(3) The term 'Persian Gulf War' has the meaning given that

term in section 101(33) of title 38, United States Code.

''(b) Research. - The Secretary of Defense shall provide, by

contract, grant, or other transaction, for scientific research to

be carried out by entities independent of the Federal Government on

possible causal relationships between Gulf War syndrome and -

''(1) the possible exposures of members of the Armed Forces to

chemical warfare agents or other hazardous materials during Gulf

War service; and

''(2) the use by the Department of Defense during the Persian

Gulf War of combinations of various inoculations and

investigational new drugs.

''(c) Procedures for Awarding Grants. - The Secretary shall

prescribe the procedures to be used to make research awards under

subsection (b). The procedures shall -

''(1) include a comprehensive, independent peer-review process

for the evaluation of proposals for scientific research that are

submitted to the Department of Defense; and

''(2) provide for the final selection of proposals for award to

be based on the scientific merit and program relevance of the

proposed research.

''(d) Availability of Funds. - Of the amount authorized to be

appropriated under section 301(21) (110 Stat. 2475) for defense

medical programs, $10,000,000 is available for research under

subsection (b).''

PERSIAN GULF ILLNESS

Sections 761, 762, and 770 of title VII of Pub. L. 105-85

provided that:

''SEC. 761. DEFINITIONS.

''For purposes of this subtitle (subtitle F (Sec. 761-771) of

title VII of Pub. L. 105-85, enacting sections 1074e, 1074f, and

1107 of this title and this note):

''(1) The term 'Gulf War illness' means any one of the complex

of illnesses and symptoms that might have been contracted by

members of the Armed Forces as a result of service in the

Southwest Asia theater of operations during the Persian Gulf War.

''(2) The term 'Persian Gulf War' has the meaning given that

term in section 101 of title 38, United States Code.

''(3) The term 'Persian Gulf veteran' means an individual who

served on active duty in the Armed Forces in the Southwest Asia

theater of operations during the Persian Gulf War.

''(4) The term 'contingency operation' has the meaning given

that term in section 101(a) of title 10, United States Code, and

includes a humanitarian operation, peacekeeping operation, or

similar operation.

''SEC. 762. PLAN FOR HEALTH CARE SERVICES FOR PERSIAN GULF

VETERANS.

''(a) Plan Required. - The Secretary of Defense and the Secretary

of Veterans Affairs, acting jointly, shall prepare a plan to

provide appropriate health care to Persian Gulf veterans (and

dependents eligible by law) who suffer from a Gulf War illness.

''(b) Contents of Plan. - In preparing the plan, the Secretaries

shall -

''(1) use the presumptions of service connection and illness

specified in paragraphs (1) and (2) of section 721(d) of the

National Defense Authorization Act for Fiscal Year 1995 (Public

Law 103-337; 10 U.S.C. 1074 note) to determine the Persian Gulf

veterans (and dependents eligible by law) who should be covered

by the plan;

''(2) consider the need and methods available to provide health

care services to Persian Gulf veterans who are no longer on

active duty in the Armed Forces, such as Persian Gulf veterans

who are members of the reserve components and Persian Gulf

veterans who have been separated from the Armed Forces; and

''(3) estimate the costs to the Government of providing full or

partial health care services under the plan to covered Persian

Gulf veterans (and covered dependents eligible by law).

''(c) Follow-up Treatment. - The plan required by subsection (a)

shall specifically address the measures to be used to monitor the

quality, appropriateness, and effectiveness of, and patient

satisfaction with, health care services provided to Persian Gulf

veterans after their initial medical examination as part of

registration in the Persian Gulf War Veterans Health Registry or

the Comprehensive Clinical Evaluation Program.

''(d) Submission of Plan. - Not later than March 1, 1998, the

Secretaries shall submit to Congress the plan required by

subsection (a).

''SEC. 770. PERSIAN GULF ILLNESS CLINICAL TRIALS PROGRAM.

''(a) Findings. - Congress finds the following:

''(1) There are many ongoing studies that investigate risk

factors which may be associated with the health problems

experienced by Persian Gulf veterans; however, there have been no

studies that examine health outcomes and the effectiveness of the

treatment received by such veterans.

''(2) The medical literature and testimony presented in

hearings on Gulf War illnesses indicate that there are therapies,

such as cognitive behavioral therapy, that have been effective in

treating patients with symptoms similar to those seen in many

Persian Gulf veterans.

''(b) Establishment of Program. - The Secretary of Defense and

the Secretary of Veterans Affairs, acting jointly, shall establish

a program of cooperative clinical trials at multiple sites to

assess the effectiveness of protocols for treating Persian Gulf

veterans who suffer from ill-defined or undiagnosed conditions.

Such protocols shall include a multidisciplinary treatment model,

of which cognitive behavioral therapy is a component.

''(c) Funding. - Of the funds authorized to be appropriated in

section 201(1) (111 Stat. 1655) for research, development, test,

and evaluation for the Army, the sum of $4,500,000 shall be

available for program element 62787A (medical technology) in the

budget of the Department of Defense for fiscal year 1998 to carry

out the clinical trials program established pursuant to subsection

(b).''

Pub. L. 103-337, div. A, title VII, Sec. 721, 722, Oct. 5, 1994,

108 Stat. 2804, 2807, as amended by Pub. L. 104-106, div. A, title

XV, Sec. 1504(a)(4), (5), Feb. 10, 1996, 110 Stat. 513, provided

that:

''SEC. 721. PROGRAMS RELATED TO DESERT STORM MYSTERY ILLNESS.

''(a) Outreach Program to Persian Gulf Veterans and Families. -

The Secretary of Defense shall institute a comprehensive outreach

program to inform members of the Armed Forces who served in the

Southwest Asia theater of operations during the Persian Gulf

Conflict, and the families of such members, of illnesses that may

result from such service. The program shall be carried out through

both medical and command channels, as well as any other means the

Secretary considers appropriate. Under the program, the Secretary

shall -

''(1) inform such individuals regarding -

''(A) common disease symptoms reported by Persian Gulf

veterans that may be due to service in the Southwest Asia

theater of operations;

''(B) blood donation policy;

''(C) available counseling and medical care for such members;

and

''(D) possible health risks to children of Persian Gulf

veterans;

''(2) inform such individuals of the procedures for registering

in either the Persian Gulf Veterans Health Surveillance System of

the Department of Defense or the Persian Gulf War Health Registry

of the Department of Veterans Affairs; and

''(3) encourage such members to report any symptoms they may

have and to register in the appropriate health surveillance

registry.

''(b) Incentives to Persian Gulf Veterans To Register. - In order

to encourage Persian Gulf veterans to register any symptoms they

may have in one of the existing health registries, the Secretary of

Defense shall provide the following:

''(1) For any Persian Gulf veteran who is on active duty and

who registers with the Department of Defense's Persian Gulf War

Veterans Health Surveillance System, a full medical evaluation

and any required medical care.

''(2) For any Persian Gulf War veteran who is, as of the date

of the enactment of this Act (Oct. 5, 1994), a member of a

reserve component, opportunity to register at a military medical

facility in the Persian Gulf Veterans Health Care Surveillance

System and, in the case of a Reserve who registers in that

registry, a full medical evaluation by the Department of Defense.

Depending on the results of the evaluation and on eligibility

status, reserve personnel may be provided medical care by the

Department of Defense.

''(3) For a Persian Gulf veteran who is not, as of the date of

the enactment of this Act (Oct. 5, 1994), on active duty or a

member of a reserve component, assistance and information at a

military medical facility on registering with the Persian Gulf

War Registry of the Department of Veterans Affairs and

information related to support services provided by the

Department of Veterans Affairs.

''(c) Compatibility of Department of Defense and Department of

Veterans Affairs Registries. - The Secretary of Defense shall take

appropriate actions to ensure -

''(1) that the data collected by and the testing protocols of

the Persian Gulf War Health Surveillance System maintained by the

Department of Defense are compatible with the data collected by

and the testing protocols of the Persian Gulf War Veterans Health

Registry maintained by the Department of Veterans Affairs; and

''(2) that all information on individuals who register with the

Department of Defense for purposes of the Persian Gulf War Health

Surveillance System is provided to the Secretary of Veterans

Affairs for incorporation into the Persian Gulf War Veterans

Health Registry.

''(d) Presumptions on Behalf of Service Member. - (1) A member of

the Armed Forces who is a Persian Gulf veteran, who has symptoms of

illness, and who the Secretary concerned finds may have become ill

as a result of serving on active duty in the Southwest Asia theater

of operations during the Persian Gulf War shall be considered for

Department of Defense purposes to have become ill as a result of

serving in that theater of operations.

''(2) A member of the Armed Forces who is a Persian Gulf veteran

and who reports being ill as a result of serving on active duty in

the Southwest Asia theater of operations during the Persian Gulf

War shall be considered for Department of Defense purposes to have

become ill as a result of serving in that theater of operations

until such time as the weight of medical evidence establishes other

cause or causes of the member's illness.

''(3) The Secretary concerned shall ensure that, for the purposes

of health care treatment by the Department of Defense, health care

and personnel administration, and disability evaluation by the

Department of Defense, the symptoms of any member of the Armed

Forces covered by paragraph (1) or (2) are examined in light of the

member's service in the Persian Gulf War and in light of the

reported symptoms of other Persian Gulf veterans. The Secretary

shall ensure that, in providing health care diagnosis and treatment

of the member, a broad range of potential causes of the member's

symptoms are considered and that the member's symptoms are

considered collectively, as well as by type of symptom or medical

specialty, and that treatment across medical specialties is

coordinated appropriately.

''(4) The Secretary of Defense shall ensure that the presumptions

of service connection and illness specified in paragraphs (1) and

(2) are incorporated in appropriate service medical and personnel

regulations and are widely disseminated throughout the Department

of Defense.

''(e) Revision of the Physical Evaluation Board Criteria. - (1)

The Secretary of Defense, in consultation with the Secretary of

Veterans Affairs and the Secretary of Health and Human Services,

shall ensure that case definitions of Persian Gulf related

illnesses, as well as the Physical Evaluation Board criteria used

to set disability ratings for members no longer medically qualified

for continuation on active duty, are established as soon as

possible to permit accurate disability ratings related to a

diagnosis of Persian Gulf illnesses.

''(2) Until revised disability criteria can be implemented and

members of the Armed Forces can be rated against those criteria,

the Secretary of Defense shall ensure -

''(A) that any member of the Armed Forces on active duty who

may be suffering from a Persian Gulf-related illness is afforded

continued military medical care; and

''(B) that any member of the Armed Forces on active duty who is

found by a Physical Evaluation Board to be unfit for continuation

on active duty as a result of a Persian Gulf-related illness for

which the board has no rating criteria (or inadequate rating

criteria) for the illness or condition from which the member

suffers is placed on the temporary disability retired list.

''(f) Review of Records and Rerating of Previously Discharged

Gulf War Veterans. - (1) The Secretary of Defense, in consultation

with the Secretary of Veterans Affairs, shall ensure that a review

is made of the health and personnel records of each Persian Gulf

veteran who before the date of the enactment of this Act (Oct. 5,

1994) was discharged from active duty, or was medically retired, as

a result of a Physical Evaluation Board process.

''(2) The review under paragraph (1) shall be carried out to

ensure that former Persian Gulf veterans who may have been

suffering from a Persian Gulf-related illness at the time of

discharge or retirement from active duty as a result of the

Physical Evaluation Board process are reevaluated in accordance

with the criteria established under subsection (e)(1) and, if

appropriate, are rerated.

''(g) Persian Gulf Illness Medical Referral Centers. - The

Secretary of Defense shall evaluate the feasibility of establishing

one or more medical referral centers to provide uniform,

coordinated medical care for Persian Gulf veterans on active duty

who are or may be suffering from a Persian Gulf-related illness.

The Secretary shall submit a report on such feasibility to the

Committees on Armed Services of the Senate and House of

Representatives not later than six months after the date of the

enactment of this Act (Oct. 5, 1994).

''(h) Annual Report to Congress. - (1) The Secretary of Defense

shall submit to the Committees on Armed Services of the Senate and

House of Representatives an annual report on -

''(A) efforts taken and results achieved in notifying members

of the Armed Forces and their families as part of the outreach

program required by subsection (a);

''(B) efforts taken to revise the Physical Evaluation Board

disability rating criteria and interim efforts to adjudicate

cases before the revision of the criteria; and

''(C) results of the review and rerating of previously

separated servicemembers.

''(2) The first report under paragraph (1) shall be submitted not

later than 120 days after the date of the enactment of this Act

(Oct. 5, 1994).

''(i) Persian Gulf Veteran. - For purposes of this section, a

Persian Gulf veteran is an individual who served on active duty in

the Armed Forces in the Southwest Asia theater of operations during

the Persian Gulf Conflict.

''SEC. 722. STUDIES OF HEALTH CONSEQUENCES OF MILITARY SERVICE OR

EMPLOYMENT IN SOUTHWEST ASIA DURING THE PERSIAN GULF WAR.

''(a) In General. - The Secretary of Defense, in coordination

with the Secretary of Veterans Affairs and the Secretary of Health

and Human Services, shall conduct studies and administer grants for

studies to determine -

''(1) the nature and causes of illnesses suffered by

individuals as a consequence of service or employment by the

United States in the Southwest Asia theater of operations during

the Persian Gulf War; and

''(2) the appropriate treatment for those illnesses.

''(b) Nature of the Studies. - (1) Studies under subsection (a) -

''(A) shall include consideration of the range of potential

exposure of individuals to environmental, battlefield, and other

conditions incident to service in the theater;

''(B) shall be conducted so as to provide assessments of both

short-term and long-term effects to the health of individuals as

a result of those exposures; and

''(C) shall include, at a minimum, the following types of

studies:

''(i) An epidemiological study or studies on the incidence,

prevalence, and nature of the illness and symptoms and the risk

factors associated with symptoms or illnesses.

''(ii) Studies to determine the health consequences of the

use of pyridostigmine bromide as a pretreatment antidote

enhancer during the Persian Gulf War, alone or in combination

with exposure to pesticides, environmental toxins, and other

hazardous substances.

''(iii) Clinical research and other studies on the causes,

possible transmission, and treatment of Persian Gulf-related

illnesses.

''(2)(A) The first project carried out under paragraph (1)(C)(ii)

shall be a retrospective study of members of the Armed Forces who

served in the Southwest Asia theater of operations during the

Persian Gulf War.

''(B) The second project carried out under paragraph (1)(C)(ii)

shall consist of animal research and nonanimal research, including

in vitro systems, as required, designed to determine whether the

use of pyridostigmine bromide in combination with exposure to

pesticides or other organophosphates, carbamates, or relevant

chemicals will result in increased toxicity in animals and is

likely to have a similar effect on humans.

''(c) Individuals Covered by the Studies. - Studies conducted

pursuant to subsections (sic) (a) shall apply to the following

individuals:

''(1) Individuals who served as members of the Armed Forces in

the Southwest Asia theater of operations during the Persian Gulf

War.

''(2) Individuals who were civilian employees of the Department

of Defense in that theater during that period.

''(3) To the extent appropriate, individuals who were employees

of contractors of the Department of Defense in that theater

during that period.

''(4) To the extent appropriate, the spouses and children of

individuals described in paragraph (1).

''(d) Plan for the Studies. - (1) The Secretary of Defense shall

prepare a coordinated plan for the studies to be conducted pursuant

to subsection (a). The plan shall include plans and requirements

for research grants in support of the studies. The Secretary shall

submit the plan to the National Academy of Sciences for review and

comment.

''(2) The plan for studies pursuant to subsection (a) shall be

updated annually. The Secretary of Defense shall request an annual

review by the National Academy of Sciences of the updated plan and

study progress and results achieved during the preceding year.

''(3) The plan, and annual updates to the plan, shall be prepared

in coordination with the Secretary of Veterans Affairs and the

Secretary of Health and Human Services.

''(e) Funding. - (1) From the amount authorized to be

appropriated pursuant to section 201 (108 Stat. 2690) for

Defense-wide activities, the Secretary of Defense shall make

available such funds as the Secretary considers necessary to

support the studies conducted pursuant to subsection (a).

''(2) For each year in which activities continue in support of

the studies conducted pursuant to subsection (a), the Secretary of

Defense shall include in the budget request for the Department of

Defense a request for such funds as the Secretary determines

necessary to continue the activities during that fiscal year.

''(f) Reports. - (1) Not later than March 31, 1995, the Secretary

of Defense shall submit to Congress the coordinated plan for the

studies to be conducted pursuant to subsection (a) and the results

of the review of that plan by the National Academy of Sciences.

''(2) Not later than October 1 of each year through 1998, the

Secretary shall submit to Congress a report on the results of the

studies conducted pursuant to subsection (a), plans for

continuation of the studies, and the results of the annual review

of the studies by the National Academy of Sciences.

''(3) Each report under this section shall be prepared in

coordination with the Secretary of Veterans Affairs and the

Secretary of Health and Human Services.

''(g) Definition. - In this section, the term 'Persian Gulf War'

has the meaning given such term in section 101 of title 38, United

States Code.''

(For provisions establishing the Persian Gulf War Veterans Health

Registry, provisions requiring a study by the Office of Technology

Assessment of the Persian Gulf Registry and the Persian Gulf War

Veterans Health Registry, provisions relating to an agreement with

the National Academy of Sciences for review of health consequences

of service during the Persian Gulf War, and coordination of

government activities on health-related research on the Persian

Gulf War, see title VII of Pub. L. 102-585, set out as a note under

section 527 of Title 38, Veterans' Benefits.)

FUNDING OF FISHER HOUSES ASSOCIATED WITH ARMY MEDICAL TREATMENT

FACILITIES

Pub. L. 103-335, title VIII, Sec. 8017, Sept. 30, 1994, 108 Stat.

2620, which provided that during fiscal year 1995 and thereafter,

proceeds from investment of Fisher House Investment Trust Fund were

to be used to support operation and maintenance of Fisher Houses

associated with Army medical treatment facilities, was repealed and

restated in section 2221(c)(1) of this title by Pub. L. 104-106,

div. A, title IX, Sec. 914(a)(1), (d)(4), Feb. 10, 1996, 110 Stat.

412, 413.

MENTAL HEALTH EVALUATIONS OF MEMBERS OF ARMED FORCES

Pub. L. 102-484, div. A, title V, Sec. 546(a)-(h), Oct. 23,

1992, 106 Stat. 2416-2419, directed Secretary of Defense, not later

than 180 days after Oct. 23, 1992, to revise applicable regulations

to incorporate certain requirements with respect to mental health

evaluations of members of Armed Forces, including requirements

relating to procedures for outpatient and inpatient evaluations,

rights of members, additional rights of members and procedures for

emergency or involuntary inpatient evaluations, and prohibition

against use of referrals for mental health evaluations to retaliate

against whistleblowers, and directed Secretary to submit to

Committees on Armed Services of Senate and House of Representatives

a report describing process of preparing regulations.

STUDY ON RISK-SHARING CONTRACTS FOR HEALTH CARE

Pub. L. 102-484, div. A, title VII, Sec. 725, Oct. 23, 1992, 106

Stat. 2440, directed Secretary of Defense, in consultation with

Secretary of Health and Human Services, not later than 18 months

after Oct. 23, 1992, to carry out a study of the feasibility and

advisability of entering into risk-sharing contracts with eligible

organizations described in 42 U.S.C. 1395mm(b) to furnish health

care services to persons entitled to health care in a facility of a

uniformed service under section 1074(b) or 1076(b) of this title,

to develop a plan for the entry into contracts in accordance with

the Secretary's determinations under the study, and to submit to

Congress a report describing the results of the study and

containing any plan developed.

REGISTRY OF MEMBERS OF ARMED FORCES SERVING IN OPERATION DESERT

STORM

Pub. L. 102-190, div. A, title VII, Sec. 734, Dec. 5, 1991, 105

Stat. 1411, as amended by Pub. L. 102-585, title VII, Sec. 704,

Nov. 4, 1992, 106 Stat. 4977, provided that:

''(a) Establishment of Registry. - The Secretary of Defense shall

establish and maintain a special record (in this section referred

to as the 'Registry') relating to the following members of the

Armed Forces:

''(1) Members who, as determined by the Secretary, were exposed

to the fumes of burning oil in the Operation Desert Storm theater

of operations during the Persian Gulf conflict.

''(2) Any other members who served in the Operation Desert

Storm theater of operations during the Persian Gulf conflict.

''(b) Contents of Registry. - (1) The Registry shall include -

''(A) with respect to each class of members referred to in each

of paragraphs (1) and (2) of subsection (a) -

''(i) a list containing each such member's name and other

relevant identifying information with respect to the member;

and

''(ii) to the extent that data are available and inclusion of

the data is feasible, a description of the circumstances of the

member's service during the Persian Gulf conflict, including

the locations in the Operation Desert Storm theater of

operations in which such service occurred and the atmospheric

and other environmental circumstances in such locations at the

time of such service; and

''(B) with respect to the members referred to in subsection

(a)(1), a description of the circumstances of each exposure of

each such member to the fumes of burning oil as described in such

subsection (a)(1), including the length of time of the exposure.

''(2) The Secretary shall establish the Registry with the advice

of an independent scientific organization.

''(c) Reporting Requirement Relating to Exposure Studies. - The

Secretary shall submit to Congress each year, at or about the time

that the President's budget is submitted that year under section

1105 of title 31, United States Code, a report regarding -

''(1) the results of all on-going studies on the members

referred to in subsection (a)(1) to determine the health

consequences (including any short- or long-term consequences) of

the exposure of such members to the fumes of burning oil; and

''(2) the need for additional studies relating to the exposure

of such members to such fumes.

''(d) Medical Examination. - Upon the request of any member

listed in the Registry pursuant to subsection (a)(1), the Secretary

of the military department concerned shall, if medically

appropriate, furnish a pulmonary function examination and chest

x-ray to such person.

''(e) Effective Date. - The Secretary shall establish the

Registry not later than 180 days after the date of the enactment of

this Act (Dec. 5, 1991).

''(f) Definitions. - For purposes of this section:

''(1) The term 'Operation Desert Storm' has the meaning given

such term in section 3(1) of the Persian Gulf Conflict

Supplemental Authorization and Personnel Benefits Act of 1991

(Public Law 102-25; 105 Stat. 77; 10 U.S.C. 101 note).

''(2) The term 'Persian Gulf conflict' has the meaning given

such term in section 3(3) of such Act.''

(For provisions relating to the Persian Gulf War Veterans Health

Registry, see title VII of Pub. L. 102-585, set out as a note under

section 527 of Title 38, Veterans' Benefits.)

ADVISORY COMMITTEE ON MENTAL HEALTH EVALUATION PROTECTIONS

Section 554 of Pub. L. 101-510, as amended by Pub. L. 102-484,

div. A, title V, Sec. 546(j)((i)), Oct. 23, 1992, 106 Stat. 2419,

directed Secretary of Defense, not later than 60 days after Nov. 5,

1990, to establish an advisory committee to develop and recommend

to the Secretary, not later than 6 months after Nov. 5, 1990,

regulations on procedural protections that should be afforded to

any member of the Armed Forces who is referred by a commanding

officer for a mental health evaluation by a mental health

professional and directed Secretary, not later than 30 days after

receipt of the report, to submit to Congress the report of the

advisory committee, along with such additional comments and

recommendations by the Secretary as the Secretary considers

appropriate.

PROHIBITION ON FEE FOR OUTPATIENT CARE AT MILITARY MEDICAL

TREATMENT FACILITIES

Section 721 of Pub. L. 101-189 provided that during fiscal years

1990 and 1991, the Secretary of Defense could not impose a charge

for the receipt of outpatient medical or dental care at a military

medical treatment facility. Similar provisions were contained in

the following prior authorization act:

Pub. L. 100-180, div. A, title VII, Sec. 722, Dec. 4, 1987, 101

Stat. 1116.

RESTRICTION ON USE OF INFORMATION OBTAINED DURING CERTAIN

EPIDEMIOLOGIC-ASSESSMENT INTERVIEWS

Pub. L. 99-661, div. A, title VII, Sec. 705(c), Nov. 14, 1986,

100 Stat. 3904, provided that:

''(1) Information obtained by the Department of Defense during or

as a result of an epidemiologic-assessment interview with a

serum-positive member of the Armed Forces may not be used to

support any adverse personnel action against the member.

''(2) For purposes of paragraph (1):

''(A) The term 'epidemiologic-assessment interview' means

questioning of a serum-positive member of the Armed Forces for

purposes of medical treatment or counseling or for epidemiologic

or statistical purposes.

''(B) The term 'serum-positive member of the Armed Forces'

means a member of the Armed Forces who has been identified as

having been exposed to a virus associated with the acquired

immune deficiency syndrome.

''(C) The term 'adverse personnel action' includes -

''(i) a court-martial;

''(ii) non-judicial punishment;

''(iii) involuntary separation (other than for medical

reasons);

''(iv) administrative or punitive reduction in grade;

''(v) denial of promotion;

''(vi) an unfavorable entry in a personnel record;

''(vii) a bar to reenlistment; and

''(viii) any other action considered by the Secretary

concerned to be an adverse personnel action.''

STUDY OF MEDICAL NEEDS OF ARMED FORCES; REPORT TO PRESIDENT AND

CONGRESS

Pub. L. 92-129, title I, Sec. 101(c), Sept. 28, 1971, 85 Stat.

354, authorized Secretary of Defense and Secretary of Health,

Education, and Welfare to conduct a joint study of means of meeting

medical needs of Armed Forces through means requiring less

dependence on Armed Forces medical personnel, giving consideration

to providing medical care for military personnel and their

dependents under contracts with clinics, hospitals, and individual

members of the medical profession at or near military installations

within and outside the United States. The study and recommendations

were to be submitted to President and Congress no later than 6

months after Sept. 28, 1971.

-EXEC-

EXECUTIVE ORDER NO. 13075

Ex. Ord. No. 13075, Feb. 19, 1997, 63 F.R. 9085, which

established the Special Oversight Board for Department of Defense

Investigations of Gulf War Chemical and Biological Incidents, was

revoked by Ex. Ord. No. 13225, Sec. 3(e), Sept. 28, 2001, 66 F.R.

50292.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1072, 1074a, 1074d,

1074e, 1075, 1078a, 1079, 1086, 1087, 1095, 1095a, 1097, 1097a,

1108 of this title; title 38 section 8111; title 42 section

1395ggg.

-CITE-

10 USC Sec. 1074a 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074a. Medical and dental care: members on duty other than

active duty for a period of more than 30 days

-STATUTE-

(a) Under joint regulations prescribed by the administering

Secretaries, the following persons are entitled to the benefits

described in subsection (b):

(1) Each member of a uniformed service who incurs or aggravates

an injury, illness, or disease in the line of duty while

performing -

(A) active duty for a period of 30 days or less;

(B) inactive-duty training; or

(C) service on funeral honors duty under section 12503 of

this title or section 115 of title 32.

(2) Each member of a uniformed service who incurs or aggravates

an injury, illness, or disease while traveling directly to or

from the place at which that member is to perform or has

performed -

(A) active duty for a period of 30 days or less;

(B) inactive-duty training; or

(C) service on funeral honors duty under section 12503 of

this title or section 115 of title 32.

(3) Each member of the armed forces who incurs or aggravates an

injury, illness, or disease in the line of duty while remaining

overnight immediately before the commencement of inactive-duty

training, or while remaining overnight, between successive

periods of inactive-duty training, at or in the vicinity of the

site of the inactive-duty training.

(4) Each member of the armed forces who incurs or aggravates an

injury, illness, or disease in the line of duty while remaining

overnight immediately before serving on funeral honors duty under

section 12503 of this title or section 115 of title 32 at or in

the vicinity of the place at which the member was to so serve, if

the place is outside reasonable commuting distance from the

member's residence.

(b) A person described in subsection (a) is entitled to -

(1) the medical and dental care appropriate for the treatment

of the injury, illness, or disease of that person until the

resulting disability cannot be materially improved by further

hospitalization or treatment; and

(2) subsistence during hospitalization.

(c) A member is not entitled to benefits under subsection (b) if

the injury, illness, or disease, or aggravation of an injury,

illness, or disease described in subsection (a)(2), is the result

of the gross negligence or misconduct of the member.

(d)(1) The Secretary of the Army shall provide to members of the

Selected Reserve of the Army who are assigned to units scheduled

for deployment within 75 days after mobilization the following

medical and dental services:

(A) An annual medical screening.

(B) For members who are over 40 years of age, a full physical

examination not less often than once every two years.

(C) An annual dental screening.

(D) The dental care identified in an annual dental screening as

required to ensure that a member meets the dental standards

required for deployment in the event of mobilization.

(2) The services provided under this subsection shall be provided

at no cost to the member.

(e)(1) A member of a uniformed service on active duty for health

care or recuperation reasons, as described in paragraph (2), is

entitled to medical and dental care on the same basis and to the

same extent as members covered by section 1074(a) of this title

while the member remains on active duty.

(2) Paragraph (1) applies to a member described in paragraph (1)

or (2) of subsection (a) who, while being treated for (or

recovering from) an injury, illness, or disease incurred or

aggravated in the line of duty, is continued on active duty

pursuant to a modification or extension of orders, or is ordered to

active duty, so as to result in active duty for a period of more

than 30 days.

-SOURCE-

(Added Pub. L. 98-94, title X, Sec. 1012(a)(1), Sept. 24, 1983, 97

Stat. 664; amended Pub. L. 98-525, title VI, Sec. 631(a)(1), Oct.

19, 1984, 98 Stat. 2542; Pub. L. 98-557, Sec. 19(4), Oct. 30, 1984,

98 Stat. 2869; Pub. L. 99-145, title XIII, Sec. 1303(a)(7), Nov. 8,

1985, 99 Stat. 739; Pub. L. 99-661, div. A, title VI, Sec.

604(a)(1), Nov. 14, 1986, 100 Stat. 3874; Pub. L. 104-106, div. A,

title VII, Sec. 702(a), 704(a), Feb. 10, 1996, 110 Stat. 371, 372;

Pub. L. 105-85, div. A, title V, Sec. 513(a), Nov. 18, 1997, 111

Stat. 1730; Pub. L. 106-65, div. A, title V, Sec. 578(i)(1), title

VII, Sec. 705(b), Oct. 5, 1999, 113 Stat. 629, 683; Pub. L.

107-107, div. A, title V, Sec. 513(a), Dec. 28, 2001, 115 Stat.

1093.)

-MISC1-

AMENDMENTS

2001 - Subsec. (a)(3). Pub. L. 107-107 struck out '', if the site

is outside reasonable commuting distance from the member's

residence'' before period at end.

1999 - Subsec. (a)(1)(C). Pub. L. 106-65, Sec. 578(i)(1)(A),

added subpar. (C).

Subsec. (a)(2)(C). Pub. L. 106-65, Sec. 578(i)(1)(A), added

subpar. (C).

Subsec. (a)(4). Pub. L. 106-65, Sec. 578(i)(1)(B), added par.

(4).

Subsec. (e). Pub. L. 106-65, Sec. 705(b), amended subsec. (e)

generally. Prior to amendment, subsec. (e) read as follows: ''A

member of a uniformed service described in paragraph (1)(A) or

(2)(A) of subsection (a) whose orders are modified or extended,

while the member is being treated for (or recovering from) the

injury, illness, or disease incurred or aggravated in the line of

duty, so as to result in active duty for a period of more than 30

days shall be entitled, while the member remains on active duty, to

medical and dental care on the same basis and to the same extent as

members covered by section 1074(a) of this title.''

1997 - Subsec. (a)(3). Pub. L. 105-85, Sec. 513(a)(1), inserted

''while remaining overnight immediately before the commencement of

inactive-duty training, or'' after ''in the line of duty''.

Subsec. (e). Pub. L. 105-85, Sec. 513(a)(2), added subsec. (e).

1996 - Subsec. (a)(3). Pub. L. 104-106, Sec. 702(a), added par.

(3).

Subsec. (c). Pub. L. 104-106, Sec. 704(a)(1), substituted

''subsection (b)'' for ''this section''.

Subsec. (d). Pub. L. 104-106, Sec. 704(a)(2), added subsec. (d).

1986 - Pub. L. 99-661 amended section generally substituting

''active duty for a period of more than 30 days'' for ''active

duty; injuries, diseases and illnesses incident to duty'' in

section catchline and new text for prior text which read as

follows:

''(a) Under joint regulations prescribed by the administering

Secretaries, the following persons are entitled to the benefits

described in subsection (b):

''(1) Each member of a uniformed service who contracts a

disease or becomes ill in line of duty while on active duty for a

period of 30 days or less, or while traveling to or from that

duty.

''(2) Each member of the National Guard who contracts a disease

or becomes ill in line of duty while on full-time National Guard

duty, or while traveling to or from that duty.

''(3) Each member of a uniformed service who contracts a

disease or becomes ill in line of duty while on inactive duty

training under circumstances in which it is determined that the

disease or illness was contracted or aggravated as an incident of

that inactive duty training.

''(4) Each member of a uniformed service who incurs or

aggravates an injury while traveling directly to or from the

place at which he is to perform, or has performed, inactive duty

training, unless the injury is incurred or aggravated as a result

of the member's own gross negligence or misconduct.

''(b) A person described in subsection (a) is entitled to -

''(1) the medical and dental care appropriate for the treatment

of his injury, disease, or illness until the resulting disability

cannot be materially improved by further hospitalization or

treatment; and

''(2) subsistence during hospitalization.''

1985 - Subsec. (a). Pub. L. 99-145 substituted reference to the

administering Secretaries, for references to Secretaries of

Defense, Transportation, and Health and Human Services.

1984 - Pub. L. 98-525 substituted ''Medical and dental care:

members on duty other than active duty; injuries, diseases and

illnesses incident to duty'' for ''Medical and dental care for

members of the uniformed services for injuries incurred or

aggravated while traveling to and from inactive duty training'' in

section catchline.

Subsec. (a). Pub. L. 98-557, which directed the amendment of

subsec. (a) by substituting ''administering Secretaries'' for

''Secretary of Defense and the Secretary of Health and Human

Services'', could not be executed in view of the prior amendment by

Pub. L. 98-525.

Pub. L. 98-525 amended subsec. (a) generally, thereby authorizing

the Secretary of Transportation to participate in issuance of joint

regulations, adding pars. (1) to (3), and incorporating existing

provisions in par. (4).

Subsec. (b). Pub. L. 98-525 amended subsec. (b) generally,

thereby including treatment of diseases or illnesses.

EFFECTIVE DATE OF 1986 AMENDMENT

Section 604(g) of Pub. L. 99-661 provided that: ''The amendments

made by this section (amending this section, sections 1076, 1086,

1204-1206, 1475, 1476, 1481, 3723, and 8723 of this title, and

sections 204 and 206 of Title 37, Pay and Allowances of the

Uniformed Services and repealing sections 3687, 3721, 3722, 6148,

8687, 8721, and 8722 of this title and sections 318-321 of Title

32, National Guard) shall apply with respect to persons who, after

the date of enactment of this Act (Nov. 14, 1986), incur or

aggravate an injury, illness, or disease or die.''

EFFECTIVE DATE OF 1984 AMENDMENT

Section 631(c) of Pub. L. 98-525 provided that: ''The amendments

made by this section (amending this section and section 6148 of

this title) shall apply only with respect to injuries incurred or

aggravated and diseases or illnesses contracted or aggravated after

September 30, 1984.''

EFFECTIVE DATE

Section 1012(c) of Pub. L. 98-94 provided that: ''The amendments

made by subsections (a) and (b) (enacting this section and amending

section 204 of Title 37, Pay and Allowances of the Uniformed

Services) shall apply only in cases of injuries incurred or

aggravated on or after the date of the enactment of this Act (Sept.

24, 1983).''

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1074d, 1076, 12322 of

this title; title 37 section 204.

-CITE-

10 USC Sec. 1074b 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

(Sec. 1074b. Repealed. Pub. L. 107-107, div. A, title VII, Sec.

736(c)(1), Dec. 28, 2001, 115 Stat. 1173)

-MISC1-

Section, added Pub. L. 102-190, div. A, title VI, Sec.

640(a)(2), Dec. 5, 1991, 105 Stat. 1385; amended Pub. L. 104-106,

div. A, title XV, Sec. 1501(c)(10), Feb. 10, 1996, 110 Stat. 499,

related to transitional medical and dental care for members on

active duty in support of contingency operations.

A prior section 1074b was renumbered section 1074c of this title.

TRANSITION PROVISION

Pub. L. 107-107, div. A, title VII, Sec. 736(d), Dec. 28, 2001,

115 Stat. 1173, provided that: ''Notwithstanding the repeal of

section 1074b of title 10, United States Code, by subsection (c),

the provisions of that section, as in effect before the date of the

enactment of this Act (Dec. 28, 2001), shall continue to apply to a

member of the Armed Forces who is released from active duty in

support of a contingency operation before that date.''

-CITE-

10 USC Sec. 1074c 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074c. Medical care: authority to provide a wig

-STATUTE-

A person entitled to medical care under this chapter who has

alopecia resulting from the treatment of a malignant disease may be

furnished a wig if the person has not previously been furnished one

at the expense of the United States.

-SOURCE-

(Added Pub. L. 98-525, title XIV, Sec. 1401(e)(2)(A), Oct. 19,

1984, 98 Stat. 2616, Sec. 1074b; renumbered Sec. 1074c, Pub. L.

102-190, div. A, title VI, Sec. 640(a)(1), Dec. 5, 1991, 105 Stat.

1385.)

-MISC1-

PRIOR PROVISIONS

Provisions similar to those in this section were contained in the

following appropriation acts:

Pub. L. 98-473, title I, Sec. 101(h) (title VIII, Sec. 8033),

Oct. 12, 1984, 98 Stat. 1904, 1929.

Pub. L. 98-212, title VII, Sec. 739, Dec. 8, 1983, 97 Stat. 1445.

Pub. L. 97-377, title I, Sec. 101(c) (title VII, Sec. 742), Dec.

21, 1982, 96 Stat. 1833, 1858.

Pub. L. 97-114, title VII, Sec. 743, Dec. 29, 1981, 95 Stat.

1586.

Pub. L. 96-527, title VII, Sec. 744, Dec. 15, 1980, 94 Stat.

3089.

AMENDMENTS

1991 - Pub. L. 102-190 renumbered section 1074b of this title as

this section.

EFFECTIVE DATE

Section effective Oct. 1, 1985, see section 1404 of Pub. L.

98-525, set out as a note under section 520b of this title.

-CITE-

10 USC Sec. 1074d 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074d. Certain primary and preventive health care services

-STATUTE-

(a) Services Available. - (1) Female members and former members

of the uniformed services entitled to medical care under section

1074 or 1074a of this title shall also be entitled to primary and

preventive health care services for women as part of such medical

care.

(2) Male members and former members of the uniformed services

entitled to medical care under section 1074 or 1074a of this title

shall also be entitled to preventive health care screening for

colon or prostate cancer at such intervals and using such screening

methods as the administering Secretaries consider appropriate.

(b) Definition. - In this section, the term ''primary and

preventive health care services for women'' means health care

services, including related counseling services, provided to women

with respect to the following:

(1) Papanicolaou tests (pap smear).

(2) Breast examinations and mammography.

(3) Comprehensive obstetrical and gynecological care, including

care related to pregnancy and the prevention of pregnancy.

(4) Infertility and sexually transmitted diseases, including

prevention.

(5) Menopause, including hormone replacement therapy and

counseling regarding the benefits and risks of hormone

replacement therapy.

(6) Physical or psychological conditions arising out of acts of

sexual violence.

(7) Gynecological cancers.

(8) Colon cancer screening, at the intervals and using the

screening methods prescribed under subsection (a)(2).

-SOURCE-

(Added Pub. L. 103-160, div. A, title VII, Sec. 701(a)(1), Nov.

30, 1993, 107 Stat. 1685; amended Pub. L. 104-201, div. A, title

VII, Sec. 701(a)(1), (2)(A), Sept. 23, 1996, 110 Stat. 2587.)

-MISC1-

AMENDMENTS

1996 - Pub. L. 104-201, Sec. 701(a)(2)(A), amended catchline

generally, substituting ''Certain primary and preventive health

care services'' for ''Primary and preventive health care services

for women''.

Subsec. (a). Pub. L. 104-201, Sec. 701(a)(1)(A), designated

existing provisions as par. (1) and added par. (2).

Subsec. (b)(8). Pub. L. 104-201, Sec. 701(a)(1)(B), added par.

(8).

DEFENSE WOMEN'S HEALTH RESEARCH PROGRAM

Pub. L. 103-337, div. A, title II, Sec. 241, Oct. 5, 1994, 108

Stat. 2701, provided that:

''(a) Continuation of Program. - The Secretary of Defense shall

continue the Defense Women's Health Research Program established in

fiscal year 1994 pursuant to the authority in section 251 of the

National Defense Authorization Act for Fiscal Year 1994 (Public Law

103-160; 107 Stat. 1606) (set out below). The program shall

continue to serve as the coordinating agent for multi-disciplinary

and multi-institutional research within the Department of Defense

on women's health issues related to service in the Armed Forces.

The program also shall continue to coordinate with research

supported by other Federal agencies that is aimed at improving the

health of women.

''(b) Participation by All Military Departments. - The

Departments of the Army, Navy, and Air Force shall each participate

in the activities under the program.

''(c) Army To Be Executive Agent. - The Secretary of Defense

shall designate the Secretary of the Army to be the executive agent

for administering the program.

''(d) Implementation Plan. - If the Secretary of Defense intends

to change the plan for the implementation of the program previously

submitted to the Committees on Armed Services of the Senate and

House of Representatives, the amended plan shall be submitted to

such committees before implementation.

''(e) Program Activities. - The program shall include the

following activities regarding health risks and health care for

women in the Armed Forces:

''(1) The coordination and support activities described in

section 251 of Public Law 103-160 (set out below).

''(2) Epidemiologic research regarding women deployed for

military operations, including research on patterns of illness

and injury, environmental and occupational hazards (including

exposure to toxins), side-effects of pharmaceuticals used by

women so deployed, psychological stress associated with military

training, deployment, combat and other traumatic incidents, and

other conditions of life, and human factor research regarding

women so deployed.

''(3) Development of a data base to facilitate long-term

research studies on issues related to the health of women in

military service, and continued development and support of a

women's health information clearinghouse to serve as an

information resource for clinical, research, and policy issues

affecting women in the Armed Forces.

''(4) Research on policies and standards issues, including

research supporting the development of military standards related

to training, operations, deployment, and retention and the

relationship between such activities and factors affecting

women's health.

''(5) Research on interventions having a potential for

addressing conditions of military service that adversely affect

the health of women in the Armed Forces.

''(f) Funding. - Of the amount authorized to be appropriated

pursuant to section 201 (108 Stat. 2690), $40,000,000 shall be

available for the Defense Women's Health Research Program referred

to in subsection (a).''

Pub. L. 103-160, div. A, title II, Sec. 251, Nov. 30, 1993, 107

Stat. 1606, provided that:

''(a) Authority To Establish Center. - The Secretary of Defense

may establish a Defense Women's Health Research Center (hereinafter

in this section referred to as the 'Center') at an existing

Department of Defense medical center to serve as the coordinating

agent for multidisciplinary and multi-institutional research within

the Department of Defense on women's health issues related to

service in the Armed Forces. The Secretary shall determine whether

or not to establish the Center not later than May 1, 1994. If

established, the Center shall also coordinate with research

supported by the Department of Health and Human Services and other

agencies that is aimed at improving the health of women.

''(b) Support of Research. - The Center shall support health

research into matters relating to the service of women in the

military, including the following matters:

''(1) Combat stress and trauma.

''(2) Exposure to toxins and other environmental hazards

associated with military equipment.

''(3) Psychology related stress in warfare situations.

''(4) Mental health, including post-traumatic stress disorder

and depression.

''(5) Human factor studies related to women in combat areas.

''(c) Competition Requirement Relating to Establishment of

Center. - The Center may be established only pursuant to a

competition among existing Department of Defense medical centers.

''(d) Implementation Plan. - The Secretary of Defense shall

prepare a plan for the implementation of subsection (a). The plan

shall be submitted to the Committees on Armed Services of the

Senate and House of Representatives before May 1, 1994.

''(e) Activities for Fiscal Year 1994. - During fiscal year 1994,

the Center may address the following:

''(1) Program planning, infrastructure development, baseline

information gathering, technology infusion, and connectivity.

''(2) Management and technical staffing.

''(3) Data base development of health issues related to service

by women on active duty as compared to service by women in the

National Guard or Reserves.

''(4) Research protocols, cohort development, health

surveillance, and epidemiologic studies, to be developed in

coordination with the Centers for Disease Control and the

National Institutes of Health whenever possible.

''(f) Funding. - Of the funds authorized to be appropriated

pursuant to section 201 (107 Stat. 1583), $20,000,000 shall be

available for the establishment of the Center or for medical

research at existing Department of Defense medical centers into

matters relating to service by women in the military.

''(g) Report. - (1) If the Secretary of Defense determines not to

establish a women's health center under subsection (a), the

Secretary shall submit to the Committees on Armed Services of the

Senate and House of Representatives, not later than May 1, 1994, a

report on the plans of the Secretary for the use of the funds

described in subsection (f).

''(2) If the Secretary determines to establish the Center, the

Secretary shall, not less than 60 days before the establishment of

the Center, submit to those committees a report describing the

planned location for the Center and the competitive process used in

the selection of that location.''

REPORT ON PROVISION OF PRIMARY AND PREVENTATIVE HEALTH CARE

SERVICES FOR WOMEN

Section 735 of Pub. L. 103-160 provided that:

''(a) Report Required. - The Secretary of Defense shall prepare a

report evaluating the provision of primary and preventive health

care services through military medical treatment facilities and the

Civilian Health and Medical Program of the Uniformed Services to

female members of the uniformed services and female covered

beneficiaries eligible for health care under chapter 55 of title

10, United States Code.

''(b) Contents. - The report required by subsection (a) shall

contain the following:

''(1) A description of the number and types of health care

providers who are providing health care services in military

medical treatment facilities or through the Civilian Health and

Medical Program of the Uniformed Services to female members and

female covered beneficiaries.

''(2) A description of the health care programs implemented (or

planned) by the administering Secretaries to assess the health

needs of women or to meet the special health needs of women.

''(3) A description of the demographics of the population of

female members and female covered beneficiaries and the leading

categories of morbidity and mortality among such members and

beneficiaries.

''(4) A description of any actions, including the use of

special pays and incentives, undertaken by the Secretary during

fiscal year 1993 -

''(A) to ensure the retention of health care providers who

are providing health care services to female members and female

covered beneficiaries;

''(B) to recruit additional health care providers to provide

such health care services; and

''(C) to replace departing health care providers who provided

such health care services.

''(5) A description of any existing or proposed programs to

encourage specialization of health care providers in fields

related to primary and preventive health care services for women.

''(6) An assessment of any difficulties experienced by military

medical treatment facilities or health care providers under the

Civilian Health and Medical Program of the Uniformed Services in

furnishing primary and preventive health care services for women

and a description of the actions taken by the Secretary to

resolve such difficulties.

''(7) A description of the actions taken by the Secretary to

foster and encourage the expansion of research relating to health

care issues of concern to female members of the uniformed

services and female covered beneficiaries.

''(c) Study of the Needs of Female Members and Female Covered

Beneficiaries for Health Care Services. - (1) As part of the report

required by subsection (a), the Secretary shall conduct a study to

determine the needs of female members of the uniformed services and

female covered beneficiaries for health care services, including

primary and preventive health care services for women.

''(2) The study shall examine the health care needs of current

female members and female covered beneficiaries and anticipated

future female members and female covered beneficiaries, taking into

consideration the anticipated size and composition of the Armed

Forces in the year 2000 and the demographics of the entire United

States.

''(d) Submission and Revision. - The Secretary shall submit to

Congress the report required by subsection (a) not later than

October 1, 1994. The Secretary shall revise and resubmit the report

to Congress not later than October 1, 1999.

''(e) Definitions. - For purposes of this section:

''(1) The term 'primary and preventive health care services for

women' has the meaning given that term in section 1074d(b) of

title 10, United States Code, as added by section 701(a)).

''(2) The term 'covered beneficiary' has the meaning given that

term in section 1072(5) of such title.''

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 1077 of this title.

-CITE-

10 USC Sec. 1074e 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074e. Medical care: certain Reserves who served in Southwest

Asia during the Persian Gulf Conflict

-STATUTE-

(a) Entitlement to Medical Care. - A member of the armed forces

described in subsection (b) is entitled to medical care for a

qualifying Persian Gulf symptom or illness to the same extent and

under the same conditions (other than the requirement that the

member be on active duty) as a member of a uniformed service who is

entitled to such care under section 1074(a) of this title.

(b) Covered Members. - Subsection (a) applies to a member of a

reserve component who -

(1) is a Persian Gulf veteran;

(2) has a qualifying Persian Gulf symptom or illness; and

(3) is not otherwise entitled to medical care for such symptom

or illness under this chapter and is not otherwise eligible for

hospital care and medical services for such symptom or illness

under section 1710 of title 38.

(c) Definitions. - In this section:

(1) The term ''Persian Gulf veteran'' means a member of the

armed forces who served on active duty in the Southwest Asia

theater of operations during the Persian Gulf Conflict.

(2) The term ''qualifying Persian Gulf symptom or illness''

means, with respect to a member described in subsection (b), a

symptom or illness -

(A) that the member registered before September 1, 1997, in

the Comprehensive Clinical Evaluation Program of the Department

of Defense and that is presumed under section 721(d) of the

National Defense Authorization Act for Fiscal Year 1995 (10

U.S.C. 1074 note) to be a result of service in the Southwest

Asia theater of operations during the Persian Gulf Conflict; or

(B) that the member registered before September 1, 1997, in

the Persian Gulf War Veterans Health Registry maintained by the

Department of Veterans Affairs pursuant to section 702 of the

Persian Gulf War Veterans' Health Status Act (38 U.S.C. 527

note).

-SOURCE-

(Added Pub. L. 105-85, div. A, title VII, Sec. 764(a), Nov. 18,

1997, 111 Stat. 1825.)

-REFTEXT-

REFERENCES IN TEXT

Section 721(d) of the National Defense Authorization Act for

Fiscal Year 1995, referred to in subsec. (c)(2)(A), is section

721(d) of Pub. L. 103-337, which is set out as a note under section

1074 of this title.

Section 702 of the Persian Gulf War Veterans' Health Status Act,

referred to in subsec. (c)(2)(B), is section 702 of Pub. L.

102-585, which is set out as a note under section 527 of Title 38,

Veterans' Benefits.

-CITE-

10 USC Sec. 1074f 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074f. Medical tracking system for members deployed overseas

-STATUTE-

(a) System Required. - The Secretary of Defense shall establish a

system to assess the medical condition of members of the armed

forces (including members of the reserve components) who are

deployed outside the United States or its territories or

possessions as part of a contingency operation (including a

humanitarian operation, peacekeeping operation, or similar

operation) or combat operation.

(b) Elements of System. - The system described in subsection (a)

shall include the use of predeployment medical examinations and

postdeployment medical examinations (including an assessment of

mental health and the drawing of blood samples) to accurately

record the medical condition of members before their deployment and

any changes in their medical condition during the course of their

deployment. The postdeployment examination shall be conducted when

the member is redeployed or otherwise leaves an area in which the

system is in operation (or as soon as possible thereafter).

(c) Recordkeeping. - The results of all medical examinations

conducted under the system, records of all health care services

(including immunizations) received by members described in

subsection (a) in anticipation of their deployment or during the

course of their deployment, and records of events occurring in the

deployment area that may affect the health of such members shall be

retained and maintained in a centralized location to improve future

access to the records.

(d) Quality Assurance. - The Secretary of Defense shall establish

a quality assurance program to evaluate the success of the system

in ensuring that members described in subsection (a) receive

predeployment medical examinations and postdeployment medical

examinations and that the recordkeeping requirements with respect

to the system are met.

-SOURCE-

(Added Pub. L. 105-85, div. A, title VII, Sec. 765(a)(1), Nov. 18,

1997, 111 Stat. 1826.)

-CITE-

10 USC Sec. 1074g 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074g. Pharmacy benefits program

-STATUTE-

(a) Pharmacy Benefits. - (1) The Secretary of Defense, after

consulting with the other administering Secretaries, shall

establish an effective, efficient, integrated pharmacy benefits

program under this chapter (hereinafter in this section referred to

as the ''pharmacy benefits program'').

(2)(A) The pharmacy benefits program shall include a uniform

formulary of pharmaceutical agents, which shall assure the

availability of pharmaceutical agents in the complete range of

therapeutic classes. The selection for inclusion on the uniform

formulary of particular pharmaceutical agents in each therapeutic

class shall be based on the relative clinical and cost

effectiveness of the agents in such class.

(B) In considering the relative clinical effectiveness of agents

under subparagraph (A), the Secretary shall presume inclusion in a

therapeutic class of a pharmaceutical agent, unless the Pharmacy

and Therapeutics Committee established under subsection (b) finds

that a pharmaceutical agent does not have a significant, clinically

meaningful therapeutic advantage in terms of safety, effectiveness,

or clinical outcome over the other drugs included on the uniform

formulary.

(C) In considering the relative cost effectiveness of agents

under subparagraph (A), the Secretary shall rely on the evaluation

by the Pharmacy and Therapeutics Committee of the costs of agents

in a therapeutic class in relation to the safety, effectiveness,

and clinical outcomes of such agents.

(D) The Secretary shall establish procedures for the selection of

particular pharmaceutical agents for the uniform formulary. Such

procedures shall be established so as best to accomplish, in the

judgment of the Secretary, the objectives set forth in paragraph

(1). No pharmaceutical agent may be excluded from the uniform

formulary except upon the recommendation of the Pharmacy and

Therapeutics Committee. The Secretary shall begin to implement the

uniform formulary not later than October 1, 2000.

(E) Pharmaceutical agents included on the uniform formulary shall

be available to eligible covered beneficiaries through -

(i) facilities of the uniformed services, consistent with the

scope of health care services offered in such facilities;

(ii) retail pharmacies designated or eligible under the TRICARE

program or the Civilian Health and Medical Program of the

Uniformed Services to provide pharmaceutical agents to covered

beneficiaries; or

(iii) the national mail-order pharmacy program.

(3) The pharmacy benefits program shall assure the availability

of clinically appropriate pharmaceutical agents to members of the

armed forces, including, where appropriate, agents not included on

the uniform formulary described in paragraph (2).

(4) The pharmacy benefits program may provide that prior

authorization be required for certain pharmaceutical agents to

assure that the use of such agents is clinically appropriate.

(5) The pharmacy benefits program shall assure the availability

to eligible covered beneficiaries of pharmaceutical agents not

included on the uniform formulary. Such pharmaceutical agents

shall be available through at least one of the means described in

paragraph (2)(E) under terms and conditions that may include cost

sharing by the eligible covered beneficiary in addition to any such

cost sharing applicable to agents on the uniform formulary.

(6) The Secretary, in the regulations prescribed under subsection

(g), may establish cost sharing requirements (which may be

established as a percentage or fixed dollar amount) under the

pharmacy benefits program for generic, formulary, and nonformulary

agents. For nonformulary agents, cost sharing shall be consistent

with common industry practice and not in excess of amounts

generally comparable to 20 percent for beneficiaries covered by

section 1079 of this title or 25 percent for beneficiaries covered

by section 1086 of this title.

(7) The Secretary shall establish procedures for eligible covered

beneficiaries to receive pharmaceutical agents that are not

included on the uniform formulary but that are considered to be

clinically necessary. Such procedures shall include peer review

procedures under which the Secretary may determine that there is a

clinical justification for the use of a pharmaceutical agent that

is not on the uniform formulary, in which case the pharmaceutical

agent shall be provided under the same terms and conditions as an

agent on the uniform formulary. Such procedures shall also include

an expeditious appeals process for an eligible covered beneficiary,

or a network or uniformed provider on behalf of the beneficiary, to

establish clinical justification for the use of a pharmaceutical

agent that is not on the uniform formulary.

(8) In carrying out this subsection, the Secretary shall ensure

that an eligible covered beneficiary may continue to receive

coverage for any maintenance pharmaceutical that is not on the

uniform formulary and that was prescribed for the beneficiary

before October 5, 1999, and stabilized the medical condition of the

beneficiary.

(b) Establishment of Committee. - (1) The Secretary of Defense

shall, in consultation with the Secretaries of the military

departments, establish a Pharmacy and Therapeutics Committee for

the purpose of developing the uniform formulary of pharmaceutical

agents required by subsection (a), reviewing such formulary on a

periodic basis, and making additional recommendations regarding the

formulary as the committee determines necessary and appropriate.

The committee shall include representatives of pharmacies of the

uniformed services facilities, contractors responsible for the

TRICARE retail pharmacy program, contractors responsible for the

national mail-order pharmacy program, providers in facilities of

the uniformed services, and TRICARE network providers. Committee

members shall have expertise in treating the medical needs of the

populations served through such entities and in the range of

pharmaceutical and biological medicines available for treating such

populations. The committee shall function under procedures

established by the Secretary under the regulations prescribed under

subsection (g).

(2) Not later than 90 days after the establishment of the

Pharmacy and Therapeutics Committee by the Secretary, the committee

shall convene to design a proposed uniform formulary for submission

to the Secretary. After such 90-day period, the committee shall

meet at least quarterly and shall, during meetings, consider for

inclusion on the uniform formulary under the standards established

in subsection (a) any drugs newly approved by the Food and Drug

Administration.

(c) Advisory Panel. - (1) Concurrent with the establishment of

the Pharmacy and Therapeutics Committee under subsection (b), the

Secretary shall establish a Uniform Formulary Beneficiary Advisory

Panel to review and comment on the development of the uniform

formulary. The Secretary shall consider the comments of the panel

before implementing the uniform formulary or implementing changes

to the uniform formulary.

(2) The Secretary shall determine the size and membership of the

panel established under paragraph (1), which shall include members

that represent nongovernmental organizations and associations that

represent the views and interests of a large number of eligible

covered beneficiaries.

(d) Procedures. - (1) In the operation of the pharmacy benefits

program under subsection (a), the Secretary of Defense shall assure

through management and new contractual arrangements that financial

resources are aligned such that the cost of prescriptions is borne

by the organization that is financially responsible for the health

care of the eligible covered beneficiary.

(2) Effective not later than April 5, 2000, the Secretary shall

use a modification to the bid price adjustment methodology in the

current managed care support contracts to ensure equitable and

timely reimbursement to the TRICARE managed care support

contractors for pharmaceutical products delivered in the

nonmilitary environments. The methodology shall take into account

the ''at-risk'' nature of the contracts as well as managed care

support contractor pharmacy costs attributable to changes to

pharmacy service or formulary management at military medical

treatment facilities, and other military activities and policies

that affect costs of pharmacy benefits provided through the

Civilian Health and Medical Program of the Uniformed Services. The

methodology shall also account for military treatment facility

costs attributable to the delivery of pharmaceutical products in

the military facility environment which were prescribed by a

network provider.

(e) Pharmacy Data Transaction Service. - The Secretary of Defense

shall implement the use of the Pharmacy Data Transaction Service in

all fixed facilities of the uniformed services under the

jurisdiction of the Secretary, in the TRICARE retail pharmacy

program, and in the national mail-order pharmacy program.

(f) Definitions. - In this section:

(1) The term ''eligible covered beneficiary'' means a covered

beneficiary for whom eligibility to receive pharmacy benefits

through the means described in subsection (a)(2)(E) is

established under this chapter or another provision of law.

(2) The term ''pharmaceutical agent'' means drugs, biological

products, and medical devices under the regulatory authority of

the Food and Drug Administration.

(g) Regulations. - The Secretary of Defense shall, after

consultation with the other administering Secretaries, prescribe

regulations to carry out this section.

-SOURCE-

(Added Pub. L. 106-65, div. A, title VII, Sec. 701(a)(1), Oct. 5,

1999, 113 Stat. 677; amended Pub. L. 106-398, Sec. 1 ((div. A),

title X, Sec. 1087(a)(5)), Oct. 30, 2000, 114 Stat. 1654,

1654A-290; Pub. L. 107-107, div. A, title X, Sec. 1048(c)(4), Dec.

28, 2001, 115 Stat. 1226.)

-MISC1-

AMENDMENTS

2001 - Subsec. (a)(8). Pub. L. 107-107 substituted ''October 5,

1999,'' for ''the date of the enactment of this section''.

2000 - Subsec. (a)(6). Pub. L. 106-398, Sec. 1 ((div. A), title

X, Sec. 1087(a)(5)(A)), substituted ''in the regulations

prescribed'' for ''as part of the regulations established''.

Subsec. (a)(7). Pub. L. 106-398, Sec. 1 ((div. A), title X, Sec.

1087(a)(5)(B)), substituted ''that are not included on the uniform

formulary but that are'' for ''not included on the uniform

formulary, but,''.

Subsec. (b)(1). Pub. L. 106-398, Sec. 1 ((div. A), title X, Sec.

1087(a)(5)(C)), substituted ''prescribed under'' for ''required

by'' in last sentence.

Subsec. (d)(2). Pub. L. 106-398, Sec. 1 ((div. A), title X, Sec.

1087(a)(5)(D)), substituted ''Effective not later than April 5,

2000, the Secretary shall use'' for ''Not later than 6 months after

the date of the enactment of this section, the Secretary shall

utilize''.

Subsec. (e). Pub. L. 106-398, Sec. 1 ((div. A), title X, Sec.

1087(a)(5)(E)), substituted ''The'' for ''Not later than April 1,

2000, the'' and inserted ''in'' before ''the TRICARE'' and before

''the national''.

Subsec. (f). Pub. L. 106-398, Sec. 1 ((div. A), title X, Sec.

1087(a)(5)(F)), substituted ''In this section:'' for ''As used in

this section - '' in introductory provisions, ''The term'' for

''the term'' in pars. (1) and (2), and a period for ''; and'' at

end of par. (1).

Subsec. (g). Pub. L. 106-398, Sec. 1 ((div. A), title X, Sec.

1087(a)(5)(G)), substituted ''prescribe'' for ''promulgate''.

TERMINATION OF ADVISORY PANELS

Advisory panels established after Jan. 5, 1973, to terminate not

later than the expiration of the 2-year period beginning on the

date of their establishment, unless, in the case of a panel

established by the President or an officer of the Federal

Government, such panel is renewed by appropriate action prior to

the expiration of such 2-year period, or in the case of a panel

established by Congress, its duration is otherwise provided for by

law. See sections 3(2) and 14 of Pub. L. 92-463, Oct. 6, 1972, 86

Stat. 770, 776, set out in the Appendix to Title 5, Government

Organization and Employees.

INTEROPERABILITY OF DEPARTMENT OF VETERANS AFFAIRS AND DEPARTMENT

OF DEFENSE PHARMACY DATA SYSTEMS

Pub. L. 107-314, div. A, title VII, Sec. 724, Dec. 2, 2002, 116

Stat. 2598, provided that:

''(a) Interoperability. - The Secretary of Veterans Affairs and

the Secretary of Defense shall seek to ensure that on or before

October 1, 2004, the Department of Veterans Affairs pharmacy data

system and the Department of Defense pharmacy data system (known as

the 'Pharmacy Data Transaction System') are interoperable for both

Department of Defense beneficiaries and Department of Veterans

Affairs beneficiaries by achieving real-time interface, data

exchange, and checking of prescription drug data of outpatients,

and using national standards for the exchange of outpatient

medication information.

''(b) Alternative Requirement. - If the interoperability

specified in subsection (a) is not achieved by October 1, 2004, as

determined jointly by the Secretary of Defense and the Secretary of

Veterans Affairs, the Secretary of Veterans Affairs shall adopt the

Department of Defense Pharmacy Data Transaction System for use by

the Department of Veterans Affairs health care system. Such system

shall be fully operational not later than October 1, 2005.

''(c) Implementation Funding for Alternative Requirement. - The

Secretary of Defense shall transfer to the Secretary of Veterans

Affairs, or shall otherwise bear the cost of, an amount sufficient

to cover three-fourths of the cost to the Department of Veterans

Affairs for computer programming activities and relevant staff

training expenses related to implementation of subsection (b). Such

amount shall be determined in such manner as agreed to by the two

Secretaries.''

DEADLINE FOR ESTABLISHMENT OF COMMITTEE

Pub. L. 106-65, div. A, title VII, Sec. 701(b), Oct. 5, 1999,

113 Stat. 680, provided that: ''Not later than 30 days after the

date of the enactment of this Act (Oct. 5, 1999), the Secretary

shall establish the Pharmacy and Therapeutics Committee required by

section 1074g(b) of title 10, United States Code.''

REPORTS REQUIRED

Pub. L. 106-65, div. A, title VII, Sec. 701(c), Oct. 5, 1999,

113 Stat. 680, provided that: ''Not later than April 1 and October

1 of fiscal years 2000 and 2001, the Secretary of Defense shall

submit to Congress a report on -

''(1) implementation of the uniform formulary required under

subsection (a) of section 1074g of title 10, United States Code

(as added by subsection (a));

''(2) the results of a confidential survey conducted by the

Secretary of prescribers for military medical treatment

facilities and TRICARE contractors to determine -

''(A) during the most recent fiscal year, how often

prescribers attempted to prescribe non-formulary or

non-preferred prescription drugs, how often such prescribers

were able to do so, and whether covered beneficiaries were able

to fill such prescriptions without undue delay;

''(B) the understanding by prescribers of the reasons that

military medical treatment facilities or civilian contractors

preferred certain pharmaceuticals to others; and

''(C) the impact of any restrictions on access to

non-formulary prescriptions on the clinical decisions of the

prescribers and the aggregate cost, quality, and accessibility

of health care provided to covered beneficiaries;

''(3) the operation of the Pharmacy Data Transaction Service

required by subsection (e) of such section 1074g; and

''(4) any other actions taken by the Secretary to improve

management of the pharmacy benefits program under such section.''

STUDY FOR DESIGN OF PHARMACY BENEFIT FOR CERTAIN COVERED

BENEFICIARIES

Pub. L. 106-65, div. A, title VII, Sec. 701(d), Oct. 5, 1999,

113 Stat. 680, required the Secretary of Defense to prepare and

submit to Congress, by Apr. 15, 2001, a study on a design for a

comprehensive pharmacy benefit for covered beneficiaries under

chapter 55 of title 10, who are entitled to benefits under part A,

and enrolled under part B, of title XVIII of the Social Security

Act, and to provide an estimate of the costs of implementing and

operating such design, prior to repeal by Pub. L. 107-107, div. A,

title VII, Sec. 723, Dec. 28, 2001, 115 Stat. 1168.

-CITE-

10 USC Sec. 1074h 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074h. Medical and dental care: medal of honor recipients;

dependents

-STATUTE-

(a) Medal of Honor Recipients. - A former member of the armed

forces who is a Medal of Honor recipient and who is not otherwise

entitled to medical and dental benefits under this chapter may,

upon request, be given medical and dental care provided by the

administering Secretaries in the same manner as if entitled to

retired pay.

(b) Immediate Dependents. - A person who is an immediate

dependent of a Medal of Honor recipient and who is not otherwise

entitled to medical and dental benefits under this chapter may,

upon request, be given medical and dental care provided by the

administering Secretaries in the same manner as if the Medal of

Honor recipient were, or (if deceased) was at the time of death,

entitled to retired pay.

(c) Definitions. - In this section:

(1) The term ''Medal of Honor recipient'' means a person who

has been awarded a medal of honor under section 3741, 6241, or

8741 of this title or section 491 of title 14.

(2) The term ''immediate dependent'' means a dependent

described in subparagraph (A), (B), (C), or (D) of section

1072(2) of this title.

-SOURCE-

(Added Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec.

706(a)(1)), Oct. 30, 2000, 114 Stat. 1654, 1654A-175.)

-MISC1-

EFFECTIVE DATE

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 706(b)), Oct.

30, 2000, 114 Stat. 1654, 1654A-175, provided that: ''Section 1074h

of title 10, United States Code, shall apply with respect to

medical and dental care provided on or after the date of the

enactment of this Act (Oct. 30, 2000).''

-CITE-

10 USC Sec. 1074i 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074i. Reimbursement for certain travel expenses

-STATUTE-

In any case in which a covered beneficiary is referred by a

primary care physician to a specialty care provider who provides

services more than 100 miles from the location in which the primary

care provider provides services to the covered beneficiary, the

Secretary shall provide reimbursement for reasonable travel

expenses for the covered beneficiary and, when accompaniment by an

adult is necessary, for a parent or guardian of the covered

beneficiary or another member of the covered beneficiary's family

who is at least 21 years of age.

-SOURCE-

(Added Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 758(a)),

Oct. 30, 2000, 114 Stat. 1654, 1654A-199; amended Pub. L. 107-107,

div. A, title VII, Sec. 706, Dec. 28, 2001, 115 Stat. 1163.)

-MISC1-

AMENDMENTS

2001 - Pub. L. 107-107 inserted before period at end ''and, when

accompaniment by an adult is necessary, for a parent or guardian of

the covered beneficiary or another member of the covered

beneficiary's family who is at least 21 years of age''.

-CITE-

10 USC Sec. 1074j 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074j. Sub-acute care program

-STATUTE-

(a) Establishment. - The Secretary of Defense shall establish an

effective, efficient, and integrated sub-acute care benefits

program under this chapter (hereinafter referred to in this section

as the ''program''). Except as otherwise provided in this section,

the types of health care authorized under the program shall be the

same as those provided under section 1079 of this title. The

Secretary, after consultation with the other administering

Secretaries, shall promulgate regulations to carry out this

section.

(b) Benefits. - (1) The program shall include a uniform skilled

nursing facility benefit that shall be provided in the manner and

under the conditions described in section 1861 (h) and (i) of the

Social Security Act (42 U.S.C. 1395x (h) and (i)), except that the

limitation on the number of days of coverage under section 1812 (a)

and (b) of such Act (42 U.S.C. 1395d (a) and (b)) shall not be

applicable under the program. Skilled nursing facility care for

each spell of illness shall continue to be provided for as long as

medically necessary and appropriate.

(2) In this subsection:

(A) The term ''skilled nursing facility'' has the meaning given

such term in section 1819(a) of the Social Security Act (42

U.S.C. 1395i-3(a)).

(B) The term ''spell of illness'' has the meaning given such

term in section 1861(a) of such Act (42 U.S.C. 1395x(a)).

(3) The program shall include a comprehensive, part-time or

intermittent home health care benefit that shall be provided in the

manner and under the conditions described in section 1861(m) of the

Social Security Act (42 U.S.C. 1395x(m)).

-SOURCE-

(Added Pub. L. 107-107, div. A, title VII, Sec. 701(a)(1), Dec.

28, 2001, 115 Stat. 1158.)

-CITE-

10 USC Sec. 1074k 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1074k. Long-term care insurance

-STATUTE-

Provisions regarding long-term care insurance for members and

certain former members of the uniformed services and their families

are set forth in chapter 90 of title 5.

-SOURCE-

(Added Pub. L. 107-107, div. A, title VII, Sec. 701(f)(1), Dec.

28, 2001, 115 Stat. 1161.)

-CITE-

10 USC Sec. 1075 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1075. Officers and certain enlisted members: subsistence

charges

-STATUTE-

When an officer or former officer of a uniformed service, or an

enlisted member of a uniformed service entitled to basic allowance

for subsistence, is hospitalized under section 1074 of this title,

he shall pay an amount equal to the part of the charge prescribed

under section 1078 of this title that is attributable to

subsistence. An enlisted member, or former enlisted member, of a

uniformed service who is entitled to retired or retainer pay, or

equivalent pay may not be so charged.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1447;

amended Pub. L. 97-22, Sec. 10(b)(2), July 10, 1981, 95 Stat. 137.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1075 37:422. June 7, 1956, ch.

374, Sec. 302, 70

Stat. 254.

-------------------------------

The word ''officer'' is substituted for the words ''Commissioned

officers and warrant officers'' to reflect section 101(14) of this

title. The words ''or former officer'' are substituted for the

words ''and retired''. The word ''active'' is omitted as

surplusage.

PRIOR PROVISIONS

A prior section 1075, act Aug. 10, 1956, ch. 1041, 70A Stat. 82,

related to post card requests for absentee ballots, and for

printing and transmission thereof, prior to repeal by Pub. L.

85-861, Sec. 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by

the Federal Voting Assistance Act of 1955 which is classified to

subchapter I-D (Sec. 1973cc et seq.) of chapter 20 of Title 42, The

Public Health and Welfare.

AMENDMENTS

1981 - Pub. L. 97-22 inserted '', or an enlisted member of a

uniformed service entitled to basic allowance for subsistence,''

after ''officer of a uniformed service''.

EFFECTIVE DATE OF 1981 AMENDMENT

Section 10(b) of Pub. L. 97-22 provided that the amendment made

by that section is effective Sept. 15, 1981.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 1096 of this title.

-CITE-

10 USC Sec. 1076 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1076. Medical and dental care for dependents: general rule

-STATUTE-

(a)(1) A dependent described in paragraph (2) is entitled, upon

request, to the medical and dental care prescribed by section 1077

of this title in facilities of the uniformed services, subject to

the availability of space and facilities and the capabilities of

the medical and dental staff.

(2) A dependent referred to in paragraph (1) is a dependent of a

member of a uniformed service described in one of the following

subparagraphs:

(A) A member who is on active duty for a period of more than 30

days or died while on that duty.

(B) A member who died from an injury, illness, or disease

incurred or aggravated -

(i) while the member was on active duty under a call or order

to active duty of 30 days or less, on active duty for training,

or on inactive-duty training; or

(ii) while the member was traveling to or from the place at

which the member was to perform, or had performed, such active

duty, active duty for training, or inactive-duty training.

(C) A member who died from an injury, illness, or disease

incurred or aggravated in the line of duty while the member

remained overnight immediately before the commencement of

inactive-duty training, or while the member remained overnight

between successive periods of inactive-duty training, at or in

the vicinity of the site of the inactive-duty training.

(D) A member on active duty who is entitled to benefits under

subsection (e) of section 1074a of this title by reason of

paragraph (1), (2), or (3) of subsection (a) of such section.

(E) A member who died from an injury, illness, or disease

incurred or aggravated while the member -

(i) was serving on funeral honors duty under section 12503 of

this title or section 115 of title 32;

(ii) was traveling to or from the place at which the member

was to so serve; or

(iii) remained overnight at or in the vicinity of that place

immediately before so serving, if the place is outside

reasonable commuting distance from the member's residence.

(b) Under regulations to be prescribed jointly by the

administering Secretaries, a dependent of a member or former member

-

(1) who is, or (if deceased) was at the time of his death,

entitled to retired or retainer pay or equivalent pay; or

(2) who died before attaining age 60 and at the time of his

death would have been eligible for retired pay under chapter 1223

of this title (or under chapter 67 of this title as in effect

before December 1, 1994) but for the fact that he was under 60

years of age;

may, upon request, be given the medical and dental care prescribed

by section 1077 of this title in facilities of the uniformed

services, subject to the availability of space and facilities and

the capabilities of the medical and dental staff, except that a

dependent of a member or former member described in paragraph (2)

may not be given such medical or dental care until the date on

which such member or former member would have attained age 60.

(c) A determination by the medical or dental officer in charge,

or the contract surgeon in charge, or his designee, as to the

availability of space and facilities and to the capabilities of the

medical and dental staff is conclusive. Care under this section

may not be permitted to interfere with the primary mission of those

facilities.

(d) To utilize more effectively the medical and dental facilities

of the uniformed services, the administering Secretaries shall

prescribe joint regulations to assure that dependents entitled to

medical or dental care under this section will not be denied equal

opportunity for that care because the facility concerned is that of

a uniformed service other than that of the member.

(e)(1) Subject to paragraph (3), the administering Secretary

shall furnish an abused dependent of a former member of a uniformed

service described in paragraph (4), during that period that the

abused dependent is in receipt of transitional compensation under

section 1059 of this title, with medical and dental care, including

mental health services, in facilities of the uniformed services in

accordance with the same eligibility and benefits as were

applicable for that abused dependent during the period of active

service of the former member.

(2) Subject to paragraph (3), upon request of any dependent of a

former member of a uniformed service punished for an abuse

described in paragraph (4), the administering Secretary for such

uniformed service may furnish medical care in facilities of the

uniformed services to the dependent for the treatment of any

adverse health condition resulting from such dependent's knowledge

of (A) the abuse, or (B) any injury or illness suffered by the

abused person as a result of such abuse.

(3) Medical and dental care furnished to a dependent of a former

member of the uniformed services in facilities of the uniformed

services under paragraph (1) or (2) -

(A) shall be limited to the health care prescribed by section

1077 of this title; and

(B) shall be subject to the availability of space and

facilities and the capabilities of the medical and dental staff.

(4)(A) A former member of a uniformed service referred to in

paragraph (1) is a member who -

(i) received a dishonorable or bad-conduct discharge or was

dismissed from a uniformed service as a result of a court-martial

conviction for an offense, under either military or civil law,

involving abuse of a dependent of the member; or

(ii) was administratively discharged from a uniformed service

as a result of such an offense.

(B) A determination of whether an offense involved abuse of a

dependent of the member shall be made in accordance with

regulations prescribed by the administering Secretary for such

uniformed service.

(f)(1) The administering Secretaries shall furnish an eligible

dependent a physical examination that is required by a school in

connection with the enrollment of the dependent as a student in

that school.

(2) A dependent is eligible for a physical examination under

paragraph (1) if the dependent -

(A) is entitled to receive medical care under subsection (a) or

is authorized to receive medical care under subsection (b); and

(B) is at least 5 years of age and less than 12 years of age.

(3) Nothing in paragraph (2) may be construed to prohibit the

furnishing of a school-required physical examination to any

dependent who, except for not satisfying the age requirement under

that paragraph, would otherwise be eligible for a physical

examination required to be furnished under this subsection.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1447;

amended Pub. L. 89-614, Sec. 2(3), Sept. 30, 1966, 80 Stat. 862;

Pub. L. 95-397, title III, Sec. 301, Sept. 30, 1978, 92 Stat. 849;

Pub. L. 96-513, title V, Sec. 511(36), Dec. 12, 1980, 94 Stat.

2923; Pub. L. 97-252, title X, Sec. 1004(b), Sept. 8, 1982, 96

Stat. 737; Pub. L. 98-557, Sec. 19(5), Oct. 30, 1984, 98 Stat.

2869; Pub. L. 99-145, title VI, Sec. 652(a), Nov. 8, 1985, 99 Stat.

656; Pub. L. 99-661, div. A, title VI, Sec. 604(f)(1)(C), 652(c),

Nov. 14, 1986, 100 Stat. 3877, 3889; Pub. L. 100-456, div. A,

title VI, Sec. 651(a), Sept. 29, 1988, 102 Stat. 1990; Pub. L.

101-189, div. A, title VI, Sec. 653(a)(4), title VII, Sec.

731(c)(1), Nov. 29, 1989, 103 Stat. 1462, 1482; Pub. L. 103-337,

div. A, title VII, Sec. 704(a), (b), title XVI, Sec.

1671(c)(7)(A), Oct. 5, 1994, 108 Stat. 2798, 2799, 3014; Pub. L.

104-106, div. A, title VII, Sec. 703, title XV, Sec. 1501(c)(11),

Feb. 10, 1996, 110 Stat. 372, 499; Pub. L. 105-85, div. A, title

V, Sec. 513(b), title X, Sec. 1073(d)(1)(D), Nov. 18, 1997, 111

Stat. 1730, 1905; Pub. L. 105-261, div. A, title VII, Sec. 732,

Oct. 17, 1998, 112 Stat. 2071; Pub. L. 106-65, div. A, title V,

Sec. 578(i)(2), title VII, Sec. 705(c), Oct. 5, 1999, 113 Stat.

629, 684; Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 703),

Oct. 30, 2000, 114 Stat. 1654, 1654A-174; Pub. L. 107-107, div. A,

title V, Sec. 513(a), Dec. 28, 2001, 115 Stat. 1093.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1076(a) 1076(b) 37:402(a)(2) (as June 7, 1956, ch.

applicable to 374, Sec. 102(a)(2)

37:403(a)). (as applicable to

37:403(a) (1st Sec. 103(a)), (3)

sentence). (as applicable to

37:402(a)(3) (as Sec. 301(c)),

applicable to 103(a), (b),

37:421(c)). 301(c), 70 Stat.

37:421(c) (less 250, 251, 253.

last 28 words).

1076(c) 37:403(a) (less 1st

sentence).

37:421(c) (last 28

words).

1076(d) 37:403(b).

-------------------------------

Appropriate references are made to dental care throughout the

section to reflect the fact that in certain limited situations

dependents are entitled to dental care under 37:403(h)(4), restated

as section 1077 of this title.

In subsection (a), the words ''appointed, enlisted, inducted or

called, ordered or conscripted in a uniformed service'' are omitted

as surplusage, since it does not matter how a member became a

member. The words ''active duty for a period of more than 30

days'' are substituted for the words ''active duty or active duty

for training pursuant to a call or order that does not specify a

period of thirty days or less'' to reflect section 101(22) and (23)

of this title.

In subsection (b), the words ''active duty (other than for

training)'' are substituted for the words ''active duty as defined

in section 901(b) of title 50'' to reflect section 101(22) of this

title. The words ''retirement'' and ''retirement pay'' are omitted

as surplusage.

In subsection (c), 37:421(c) (last 28 words) is omitted as

unnecessary since this subsection and section 1077 of this title

are written so as to apply to subsection (b) as well as subsection

(a).

In subsection (d), the words ''because the facility concerned is

that of a uniformed service other than that of the member'' is

substituted for the words ''because of the service affiliation of

the service member''.

-REFTEXT-

REFERENCES IN TEXT

Chapter 67 of this title as in effect before December 1, 1994,

referred to in subsec. (b)(2), means chapter 67 (Sec. 1331 et seq.)

of this title prior to its transfer to part II of subtitle E of

this title, its renumbering as chapter 1223, and its general

revision by section 1662(j)(1) of Pub. L. 103-337. A new chapter 67

(Sec. 1331) of this title was added by section 1662(j)(7) of Pub.

L. 103-337.

-MISC2-

PRIOR PROVISIONS

A prior section 1076, act Aug. 10, 1956, ch. 1041, 70A Stat. 84,

related to use of post cards, waiver of registration, and voting by

discharged persons, prior to repeal by Pub. L. 85-861, Sec. 36B(5),

Sept. 2, 1958, 72 Stat. 1570, as superseded by the Federal Voting

Assistance Act of 1955 which is classified to subchapter I-D (Sec.

1973cc et seq.) of chapter 20 of Title 42, The Public Health and

Welfare.

AMENDMENTS

2001 - Subsec. (a)(2)(C). Pub. L. 107-107 struck out '', if the

site was outside reasonable commuting distance from the member's

residence'' before period at end.

2000 - Subsec. (f). Pub. L. 106-398 added subsec. (f).

1999 - Subsec. (a)(2)(D). Pub. L. 106-65, Sec. 705(c), amended

subpar. (D) generally. Prior to amendment, subpar. (D) read as

follows: ''A member who incurred or aggravated an injury, illness,

or disease in the line of duty while serving on active duty for a

period of 30 days or less (or while traveling to or from the place

of such duty) and the member's orders are modified or extended,

while the member is being treated for (or recovering from) the

injury, illness, or disease, so as to result in active duty for a

period of more than 30 days. However, this subparagraph entitles

the dependent to medical and dental care only while the member

remains on active duty.''

Subsec. (a)(2)(E). Pub. L. 106-65, Sec. 578(i)(2), added subpar.

(E).

1998 - Subsec. (e)(1). Pub. L. 105-261, Sec. 732(1), amended par.

(1) generally. Prior to amendment, par. (1) read as follows:

''Subject to paragraph (3), if an abused dependent of a former

member of a uniformed service described in paragraph (4) needs

medical or dental care for an injury or illness resulting from

abuse by the member, the administering Secretary may, upon request

of the abused dependent, furnish medical or dental care to the

dependent for the treatment of such injury or illness in facilities

of the uniformed services.''

Subsec. (e)(3). Pub. L. 105-261, Sec. 732(2), inserted ''and'' at

end of subpar. (A), substituted a period for ''; and'' at end of

subpar. (B), and struck out subpar. (C) which read as follows:

''shall terminate one year after the date on which the former

member was discharged or dismissed from a uniformed service as

described in paragraph (4).''

1997 - Subsec. (a)(2). Pub. L. 105-85, Sec. 513(b), added par.

(2) and struck out former par. (2) which read as follows: ''A

dependent referred to in paragraph (1) is a dependent of a member

of a uniformed service -

''(A) who is on active duty for a period of more than 30 days

or who died while on that duty; or

''(B) who died from an injury, illness, or disease incurred or

aggravated -

''(i) while on active duty under a call or order to active

duty of 30 days or less, on active duty for training, or on

inactive duty training; or

''(ii) while traveling to or from the place at which the

member is to perform, or has performed, such active duty,

active duty for training, or inactive duty training.''

Subsec. (b). Pub. L. 105-85, Sec. 1073(d)(1)(D), made technical

correction to directory language of Pub. L. 104-106, Sec. 703(b).

See 1996 Amendment note below.

1996 - Subsec. (b). Pub. L. 104-106, Sec. 703(b), as amended by

Pub. L. 105-85, Sec. 1073(d)(1)(D), in concluding provisions,

substituted ''paragraph (2) may'' for ''clause (2) may'' and struck

out ''A dependent described in section 1072(2)(F) of this title may

be provided medical and dental care pursuant to clause (2) without

regard to subclause (B) of such clause.'' after ''age 60.''

Subsec. (b)(2). Pub. L. 104-106, Sec. 703(a), substituted ''death

would'' for ''death (A) would'' and struck out '', and (B) had

elected to participate in the Survivor Benefit Plan established

under subchapter II of chapter 73 of this title'' after ''60 years

of age''.

Pub. L. 104-106, Sec. 1501(c)(11), substituted ''before December

1, 1994'' for ''before the effective date of the Reserve Officer

Personnel Management Act'' in subpar. (A).

1994 - Subsec. (b)(2)(A). Pub. L. 103-337, Sec. 1671(c)(7)(A),

substituted ''under chapter 1223 of this title (or under chapter 67

of this title as in effect before the effective date of the Reserve

Officer Personnel Management Act)'' for ''under chapter 67 of this

title''.

Subsec. (e)(1). Pub. L. 103-337, Sec. 704(a)(1), added par. (1)

and struck out former par. (1) which read as follows: ''Subject to

paragraph (3), if -

''(A) a member of a uniformed service receives a dishonorable

or bad-conduct discharge or is dismissed from a uniformed service

as a result of a court-martial conviction for an offense

involving abuse of a dependent of the member, as determined in

accordance with regulations prescribed by the administering

Secretary for such uniformed service; and

''(B) the abused dependent needs medical or dental care for an

injury or illness resulting from the abuse,

the administering Secretary may, upon request of the abused

dependent, furnish medical or dental care to the dependent for the

treatment of such injury or illness in facilities of the uniformed

services.''

Subsec. (e)(2). Pub. L. 103-337, Sec. 704(b)(1), (2), inserted

''former'' before ''member'' and substituted ''paragraph (4)'' for

''paragraph (1)(A)''.

Subsec. (e)(3). Pub. L. 103-337, Sec. 704(b)(1), (3), inserted

''former'' before ''member'' in introductory provisions and in

subpar. (C) and substituted ''was'' for ''is'' and ''paragraph

(4)'' for ''paragraph (1)(A)'' in subpar. (C).

Subsec. (e)(4). Pub. L. 103-337, Sec. 704(a)(2), added par. (4).

1989 - Subsec. (e)(3)(C). Pub. L. 101-189, Sec. 653(a)(4),

substituted ''one year'' for ''1 year''.

Subsec. (f). Pub. L. 101-189, Sec. 731(c)(1), struck out subsec.

(f) which read as follows:

''(1) A person described in paragraph (2) shall be considered a

dependent for purposes of this section for a period of one year

after the date of the person's final decree of divorce,

dissolution, or annulment. In addition, if such a person purchases

a conversion health policy within the one-year period referred to

in the preceding sentence, such person shall be entitled, upon

request, to medical and dental care prescribed by section 1077 of

this title for a period of one year after the purchase of the

policy for any condition of the person that existed on the date on

which coverage under the policy begins and for which care is not

provided under that policy.

''(2) A person referred to in paragraph (1) is a person who would

qualify as a dependent under section 1072(2)(G) but for the fact

that the person's final decree of divorce, dissolution, or

annulment is dated on or after April 1, 1985.

''(3) In this subsection, the term 'conversion health policy'

means a health insurance plan with a private insurer, developed

through negotiations between the Secretary of Defense and a private

insurer, that is available for purchase by or for the use of

persons described in paragraph (2).''

1988 - Subsec. (f). Pub. L. 100-456 added subsec. (f).

1986 - Subsec. (a)(2)(B). Pub. L. 99-661, Sec. 604(f)(1)(C),

inserted reference to disease.

Subsec. (e). Pub. L. 99-661, Sec. 652(c), added subsec. (e).

1985 - Subsec. (a). Pub. L. 99-145 amended subsec. (a)

generally. Prior to amendment, subsec. (a) read as follows: ''A

dependent of a member of a uniformed service who is on active duty

for a period of more than 30 days, or of such a member who died

while on that duty, is entitled, upon request, to the medical and

dental care prescribed by section 1077 of this title in facilities

of the uniformed services, subject to the availability of space and

facilities and the capabilities of the medical and dental staff.''

1984 - Subsecs. (b), (d). Pub. L. 98-557 substituted reference to

administering Secretaries for reference to Secretary of Defense and

Secretary of Health and Human Services.

1982 - Subsec. (b). Pub. L. 97-252 provided for medical and

dental care, for a dependent described in section 1072(2)(F) of

this title, pursuant to clause (2) without regard to subclause (B)

of such clause.

1980 - Subsecs. (b), (d). Pub. L. 96-513 substituted ''Secretary

of Health and Human Services'' for ''Secretary of Health,

Education, and Welfare''.

1978 - Subsec. (b). Pub. L. 95-397 substituted ''Under

regulations to be prescribed jointly by the Secretary of Defense

and the Secretary of Health, Education, and Welfare, a dependent of

a member or former member-'' for ''Under joint regulations to be

prescribed by the Secretary of Defense and the Secretary of Health,

Education, and Welfare, a dependent of a member or former member

who is, or was at the time of his death, entitled to retired or

retainer pay, or equivalent pay, may, upon request, be given the

medical and dental care prescribed by section 1077 of this title in

facilities of the uniformed services, subject to the availability

of space and facilities and the capabilities of the medical and

dental staff'', added pars. (1), (2), and provisions following par.

(2) relating to medical and dental care on request in facilities of

the uniformed services subject to the availability of space,

facilities and capabilities of staff, and excepting from such care

provision a dependent of a member or former member until such

member or former member would have attained age 60.

1966 - Subsec. (b). Pub. L. 89-614 struck out provision which

excepted from medical and dental care a member or former member who

is, or was at the time of his death, entitled to retired pay under

chapter 67 of this title and has served less than eight years on

active duty (other than for training).

EFFECTIVE DATE OF 1997 AMENDMENT

Section 1073(d)(1) of Pub. L. 105-85 provided that the amendment

made by that section is effective Feb. 10, 1996, and as if included

in the National Defense Authorization Act for Fiscal Year 1996,

Pub. L. 104-106, as enacted.

EFFECTIVE DATE OF 1996 AMENDMENT

Section 1501(c) of Pub. L. 104-106 provided that the amendment

made by that section is effective as of Dec. 1, 1994, and as if

included as an amendment made by the Reserve Officer Personnel

Management Act, title XVI of Pub. L. 103-337, as originally

enacted.

EFFECTIVE DATE OF 1994 AMENDMENT

Amendment by section 1671(c)(7)(A) of Pub. L. 103-337 effective

Dec. 1, 1994, except as otherwise provided, see section 1691 of

Pub. L. 103-337, set out as an Effective Date note under section

10001 of this title.

EFFECTIVE DATE OF 1989 AMENDMENT

Amendment by section 731(c)(1) of Pub. L. 101-189 applicable to a

person referred to in 10 U.S.C. 1072(2)(H) whose decree of divorce,

dissolution, or annulment becomes final on or after Nov. 29, 1989,

and to a person so referred to whose decree became final during the

period from Sept. 29, 1988 to Nov. 28, 1989, as if the amendment

had become effective on Sept. 29, 1988, see section 731(d) of Pub.

L. 101-189, set out as a note under section 1072 of this title.

EFFECTIVE DATE OF 1988 AMENDMENT

Section 651(d) of Pub. L. 100-456 provided that: ''Section

1076(f) of title 10, United States Code, as added by subsection

(a), shall take effect on the date of enactment of this Act (Sept.

29, 1988) or 30 days after the Secretary of Defense first makes

available a conversion health policy (as defined in such section),

whichever is later. Such section shall apply to persons whose

decree of divorce, dissolution, or annulment becomes final after

the date of the enactment of this Act.''

EFFECTIVE DATE OF 1986 AMENDMENT

Amendment by section 604 of Pub. L. 99-661 applicable with

respect to persons who, after Nov. 14, 1986, incur or aggravate an

injury, illness, or disease or die, see section 604(g) of Pub. L.

99-661, set out as a note under section 1074a of this title.

Section 652(e)(3) of Pub. L. 99-661 provided that: ''The

amendment made by subsection (c) (amending this section) shall

apply only with respect to dependents who request medical or dental

care on or after the date of the enactment of this Act (Nov. 14,

1986).''

EFFECTIVE DATE OF 1985 AMENDMENT

Section 652(c) of Pub. L. 99-145 provided that: ''The amendments

made by this section (amending this section and section 1086 of

this title) shall apply only with respect to dependents of members

of the uniformed services whose deaths occur after September 30,

1985.''

EFFECTIVE DATE OF 1982 AMENDMENT; TRANSITION PROVISIONS

Amendment by Pub. L. 97-252 effective Feb. 1, 1983, and

applicable in the case of any former spouse of a member or former

member of the uniformed services whether final decree of divorce,

dissolution, or annulment of marriage of former spouse and such

member or former member is dated before, on, or after Feb. 1, 1983,

see section 1006 of Pub. L. 97-252, set out as an Effective Date;

Transition Provisions note under section 1408 of this title.

EFFECTIVE DATE OF 1980 AMENDMENT

Amendment by Pub. L. 96-513 effective Dec. 12, 1980, see section

701(b)(3) of Pub. L. 96-513, set out as a note under section 101 of

this title.

EFFECTIVE DATE OF 1978 AMENDMENT

Section 302 of Pub. L. 95-397 provided that: ''The amendment made

by section 301 (amending this section) shall become effective on

October 1, 1978, or on the date of the enactment of this Act (Sept.

30, 1978), whichever is later.''

EFFECTIVE DATE OF 1966 AMENDMENT

For effective date of amendment by Pub. L. 89-614, see section 3

of Pub. L. 89-614, set out as a note under section 1071 of this

title.

TRANSITIONAL HEALTH CARE FOR MEMBERS, OR DEPENDENTS OF MEMBERS,

UPON RELEASE OF MEMBER FROM ACTIVE DUTY IN CONNECTION WITH

OPERATION DESERT STORM

Pub. L. 102-25, title III, Sec. 313, Apr. 6, 1991, 105 Stat. 85,

provided that:

''(a) Health Care Provided. - A member of the Armed Forces

described in subsection (b), and the dependents of the member,

shall be entitled to receive health care described in subsection

(c) upon the release of the member from active duty in connection

with Operation Desert Storm until the earlier of -

''(1) 30 days after the date of the release of the member from

active duty; or

''(2) the date on which the member and the dependents of the

member are covered by a health plan sponsored by an employer.

''(b) Eligible Member Described. - A member of the Armed Forces

referred to in subsection (a) is a member who -

''(1) is a member of a reserve component of the Armed Forces

and is called or ordered to active duty under chapter 39 of title

10, United States Code, in connection with Operation Desert

Storm;

''(2) is involuntarily retained on active duty under section

673c (now 12305) of title 10, United States Code, in connection

with Operation Desert Storm; or

''(3) voluntarily agrees to remain on active duty for a period

of less than one year in connection with Operation Desert Storm.

''(c) Health Care Described. - The health care referred to in

subsection (a) is -

''(1) medical and dental care under section 1076 of title 10,

United States Code, in the same manner as a dependent described

in subsection (a)(2) of that section; and

''(2) health benefits contracted under the authority of section

1079(a) of that title and subject to the same rates and

conditions as apply to persons covered under that section.

''(d) Dependent Defined. - For purposes of this section, the term

'dependent' has the meaning given that term in section 1072(2) of

title 10, United States Code.''

DEPENDENT; QUALIFICATION AS; TRANSITION

Section 651(c) of Pub. L. 100-456 provided that: ''Any person who

qualified as a dependent under section 645(c) of the Department of

Defense Authorization Act, 1985 (Pub. L. 98-525, formerly set out

as a note under section 1072 of this title), as in effect before

its repeal by subsection (b), shall remain qualified as a dependent

as specified in that section and shall become eligible for benefits

in accordance with section 1076(f) of title 10, United States Code

(as added by subsection (a)), when no longer qualified as a

dependent pursuant to such section 645(c).''

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1077, 1078, 1079, 1080,

1086, 1086a, 1087, 1095a, 1097, 1097a, 1108, 1111, 1145 of this

title; title 42 section 1395ggg.

-CITE-

10 USC Sec. 1076a 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1076a. TRICARE dental program

-STATUTE-

(a) Establishment of Dental Plans. - The Secretary of Defense may

establish, and in the case of the dental plan described in

paragraph (1) shall establish, the following voluntary enrollment

dental plans:

(1) Plan for selected reserve and individual ready reserve. - A

dental insurance plan for members of the Selected Reserve of the

Ready Reserve and for members of the Individual Ready Reserve

described in subsection 10144(b) of this title.

(2) Plan for other reserves. - A dental insurance plan for

members of the Individual Ready Reserve not eligible to enroll in

the plan established under paragraph (1).

(3) Plan for active duty dependents. - Dental benefits plans

for eligible dependents of members of the uniformed services who

are on active duty for a period of more than 30 days.

(4) Plan for ready reserve dependents. - A dental benefits plan

for eligible dependents of members of the Ready Reserve of the

reserve components who are not on active duty for more than 30

days.

(b) Administration of Plans. - The plans established under this

section shall be administered under regulations prescribed by the

Secretary of Defense in consultation with the other administering

Secretaries.

(c) Care Available Under Plans. - Dental plans established under

subsection (a) may provide for the following dental care:

(1) Diagnostic, oral examination, and preventive services and

palliative emergency care.

(2) Basic restorative services of amalgam and composite

restorations, stainless steel crowns for primary teeth, and

dental appliance repairs.

(3) Orthodontic services, crowns, gold fillings, bridges,

complete or partial dentures, and such other services as the

Secretary of Defense considers to be appropriate.

(d) Premiums. -

(1) Premium sharing plans. - (A) The dental insurance plan

established under subsection (a)(1) and the dental benefits plans

established under subsection (a)(3) are premium sharing plans.

(B) Members enrolled in a premium sharing plan for themselves

or for their dependents shall be required to pay a share of the

premium charged for the benefits provided under the plan. The

member's share of the premium charge may not exceed $20 per month

for the enrollment.

(C) Effective as of January 1 of each year, the amount of the

premium required under subparagraph (A) shall be increased by the

percent equal to the lesser of -

(i) the percent by which the rates of basic pay of members of

the uniformed services are increased on such date; or

(ii) the sum of one-half percent and the percent computed

under section 5303(a) of title 5 for the increase in rates of

basic pay for statutory pay systems for pay periods beginning

on or after such date.

(D) The Secretary of Defense may reduce the monthly premium

required to be paid under paragraph (1) in the case of enlisted

members in pay grade E-1, E-2, E-3, or E-4 if the Secretary

determines that such a reduction is appropriate to assist such

members to participate in a dental plan referred to in

subparagraph (A).

(2) Full premium plans. - (A) The dental insurance plan

established under subsection (a)(2) and the dental benefits plan

established under subsection (a)(4) are full premium plans.

(B) Members enrolled in a full premium plan for themselves or

for their dependents shall be required to pay the entire premium

charged for the benefits provided under the plan.

(3) Payment procedures. - A member's share of the premium for a

plan established under subsection (a) may be paid by deductions

from the basic pay of the member and from compensation paid under

section 206 of title 37, as the case may be. The regulations

prescribed under subsection (b) shall specify the procedures for

payment of the premiums by enrollees who do not receive such pay.

(e) Copayments Under Premium Sharing Plans. - A member or

dependent who receives dental care under a premium sharing plan

referred to in subsection (d)(1) shall -

(1) in the case of care described in subsection (c)(1), pay no

charge for the care;

(2) in the case of care described in subsection (c)(2), pay 20

percent of the charges for the care; and

(3) in the case of care described in subsection (c)(3), pay a

percentage of the charges for the care that is determined

appropriate by the Secretary of Defense, after consultation with

the other administering Secretaries.

(f) Transfer of Members. - If a member whose dependents are

enrolled in the plan established under subsection (a)(3) is

transferred to a duty station where dental care is provided to the

member's eligible dependents under a program other than that plan,

the member may discontinue participation under the plan. If the

member is later transferred to a duty station where dental care is

not provided to such member's eligible dependents except under the

plan established under subsection (a)(3), the member may re-enroll

the dependents in that plan.

(g) Care Outside the United States. - The Secretary of Defense

may exercise the authority provided under subsection (a) to

establish dental insurance plans and dental benefits plans for

dental benefits provided outside the United States for the eligible

members and dependents of members of the uniformed services. In

the case of such an overseas dental plan, the Secretary may waive

or reduce any copayments required by subsection (e) to the extent

the Secretary determines appropriate for the effective and

efficient operation of the plan.

(h) Waiver of Requirements for Surviving Dependents. - The

Secretary of Defense may waive (in whole or in part) any

requirements of a dental plan established under this section as the

Secretary determines necessary for the effective administration of

the plan for a dependent who is an eligible dependent described in

subsection (k)(2).

(i) Authority Subject to Appropriations. - The authority of the

Secretary of Defense to enter into a contract under this section

for any fiscal year is subject to the availability of

appropriations for that purpose.

(j) Limitation on Reduction of Benefits. - The Secretary of

Defense may not reduce benefits provided under a plan established

under this section until -

(1) the Secretary provides notice of the Secretary's intent to

reduce such benefits to the Committees on Armed Services of the

Senate and the House of Representatives; and

(2) one year has elapsed following the date of such notice.

(k) Eligible Dependent Defined. - In this section, the term

''eligible dependent'' -

(1) means a dependent described in subparagraph (A), (D), or

(I) of section 1072(2) of this title; and

(2) includes any such dependent of a member who dies while on

active duty for a period of more than 30 days or a member of the

Ready Reserve if, on the date of the death of the member, the

dependent is enrolled in a dental benefits plan established under

subsection (a) or is not enrolled in such a plan by reason of a

discontinuance of a former enrollment under subsection (f),

except that the term does not include the dependent after the end

of the three-year period beginning on the date of the member's

death.

-SOURCE-

(Added Pub. L. 106-65, div. A, title VII, Sec. 711(a), Oct. 5,

1999, 113 Stat. 685; amended Pub. L. 106-398, Sec. 1 ((div. A),

title VII, Sec. 704(a)), Oct. 30, 2000, 114 Stat. 1654, 1654A-174;

Pub. L. 107-314, div. A, title VII, Sec. 703, Dec. 2, 2002, 116

Stat. 2584.)

-MISC1-

PRIOR PROVISIONS

A prior section 1076a, added Pub. L. 99-145, title VI, Sec.

651(a)(1), Nov. 8, 1985, 99 Stat. 655; amended Pub. L. 99-661,

div. A, title VII, Sec. 707(a), (b), Nov. 14, 1986, 100 Stat.

3905; Pub. L. 102-190, div. A, title VII, Sec. 701, Dec. 5, 1991,

105 Stat. 1399; Pub. L. 102-484, div. A, title VII, Sec.

701(a)-(e), Oct. 23, 1992, 106 Stat. 2430; Pub. L. 103-337, div.

A, title VII, Sec. 702(b), 703(a), 707(b), Oct. 5, 1994, 108 Stat.

2797, 2798, 2800; Pub. L. 105-85, div. A, title VII, Sec. 732,

Nov. 18, 1997, 111 Stat. 1812; Pub. L. 105-261, div. A, title VII,

Sec. 701(a)(1), (b), Oct. 17, 1998, 112 Stat. 2056; Pub. L. 106-65,

div. A, title X, Sec. 1066(a)(8), Oct. 5, 1999, 113 Stat. 770;

Pub. L. 106-398, Sec. 1 ((div. A), title X, Sec. 1087(d)(4)), Oct.

30, 2000, 114 Stat. 1654, 1654A-293, related to dependents' dental

program, prior to repeal by Pub. L. 106-65, div. A, title VII,

Sec. 711(a), Oct. 5, 1999, 113 Stat. 685.

AMENDMENTS

2002 - Subsec. (k)(2). Pub. L. 107-314 substituted ''if, on the

date of the death of the member, the dependent is enrolled in a

dental benefits plan established under subsection (a) or is not

enrolled in such a plan by reason of a discontinuance of a former

enrollment under subsection (f)'' for ''if the dependent is

enrolled on the date of the death of the member in a dental

benefits plan established under subsection (a)''.

2000 - Subsec. (k)(2). Pub. L. 106-398 substituted ''three-year

period'' for ''one-year period''.

AUTHORIZATION TO EXPAND ENROLLMENT IN DEPENDENTS' DENTAL PROGRAM TO

CERTAIN MEMBERS RETURNING FROM OVERSEAS ASSIGNMENTS

Pub. L. 103-160, div. A, title VII, Sec. 703, Nov. 30, 1993, 107

Stat. 1687, provided that:

''(a) Authority To Expand Program. - After March 31, 1994, the

Secretary of Defense may expand the dependents' dental program

established under section 1076a of title 10, United States Code, to

permit a member of the uniformed services described in subsection

(b) to enroll dependents described in subsection (a) of such

section in a dental benefits plan under the program without regard

to the length of the uncompleted portion of the member's period of

obligated service.

''(b) Covered Members. - A member referred to in subsection (a)

is a member of the uniformed services who is -

''(1) on active duty for a period of more than 30 days (as

defined in section 101(d)(2) of title 10, United States Code);

and

''(2) reassigned from a permanent duty station where a dental

benefits plan under the dependents' dental program is not

available to a permanent duty station where such a plan is

available.

''(c) Report on Advisability of Expansion. - Not later than

February 28, 1994, the Secretary shall submit to Congress a report

evaluating the advisability of expanding the enrollment eligibility

of members of the uniformed services in the dependents' dental

program in the manner authorized in subsection (a). The report

shall include an analysis of the cost implications for such an

expansion to the Federal Government, beneficiaries under the

dependents' dental program, and contractors under the program.

''(d) Notification of Exercise of Authority. - The Secretary

shall notify Congress of any decision to expand the enrollment

eligibility of dependents in the dependents' dental program as

provided in subsection (a) not later than 30 days before such

expansion takes effect.''

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1076c, 1077 of this

title.

-CITE-

10 USC Sec. 1076b 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

(Sec. 1076b. Repealed. Pub. L. 106-65, div. A, title VII, Sec.

711(a), Oct. 5, 1999, 113 Stat. 685)

-MISC1-

Section, added Pub. L. 104-106, div. A, title VII, Sec.

705(a)(1), Feb. 10, 1996, 110 Stat. 372; amended Pub. L. 104-201,

div. A, title VII, Sec. 702(a), (b), Sept. 23, 1996, 110 Stat.

2588; Pub. L. 105-85, div. A, title VII, Sec. 733(a), Nov. 18,

1997, 111 Stat. 1812, related to Selected Reserve dental insurance.

-CITE-

10 USC Sec. 1076c 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1076c. Dental insurance plan: certain retirees and their

surviving spouses and other dependents

-STATUTE-

(a) Requirement for Plan. - The Secretary of Defense, in

consultation with the other administering Secretaries, shall

establish a dental insurance plan for retirees of the uniformed

services, certain unremarried surviving spouses, and dependents in

accordance with this section.

(b) Persons Eligible for Plan. - The following persons are

eligible to enroll in the dental insurance plan established under

subsection (a):

(1) Members of the uniformed services who are entitled to

retired pay.

(2) Members of the Retired Reserve who would be entitled to

retired pay under chapter 1223 of this title but for being under

60 years of age.

(3) Eligible dependents of a member described in paragraph (1)

or (2) who are covered by the enrollment of the member in the

plan.

(4) Eligible dependents of a member described in paragraph (1)

or (2) who is not enrolled in the plan and who -

(A) is enrolled under section 1705 of title 38 to receive

dental care from the Secretary of Veterans Affairs;

(B) is enrolled in a dental plan that -

(i) is available to the member as a result of employment by

the member that is separate from the military service of the

member; and

(ii) is not available to dependents of the member as a

result of such separate employment by the member; or

(C) is prevented by a medical or dental condition from being

able to obtain benefits under the plan.

(5) The unremarried surviving spouse and eligible child

dependents of a deceased member -

(A) who died while in a status described in paragraph (1) or

(2);

(B) who is described in section 1448(d)(1) of this title; or

(C) who died while on active duty for a period of more than

30 days and whose eligible dependents are not eligible, or no

longer eligible, for dental benefits under section 1076a of

this title.

(c) Premiums. - (1) A member enrolled in the dental insurance

plan established under subsection (a) shall pay the premiums

charged for the insurance coverage.

(2) The Secretary of Defense shall establish procedures for the

collection of the premiums charged for coverage by the dental

insurance plan. To the maximum extent practicable, the premiums

payable by a member entitled to retired pay shall be deducted and

withheld from the retired pay of the member (if pay is available to

the member).

(d) Benefits Available Under the Plan. - The dental insurance

plan established under subsection (a) shall provide benefits for

dental care and treatment which may be comparable to the benefits

authorized under section 1076a of this title for plans established

under that section and shall include diagnostic services,

preventative services, endodontics and other basic restorative

services, surgical services, and emergency services.

(e) Coverage. - (1) The Secretary shall prescribe a minimum

required period for enrollment by a member or surviving spouse in

the dental insurance plan established under subsection (a).

(2) The dental insurance plan shall provide for voluntary

enrollment of participants and shall authorize a member or eligible

unremarried surviving spouse to enroll for self only or for self

and eligible dependents.

(f) Required Terminations of Enrollment. - The Secretary shall

terminate the enrollment of any enrollee, and any eligible

dependents of the enrollee covered by the enrollment, in the dental

insurance plan established under subsection (a) upon the occurrence

of the following:

(1) In the case of an enrollment under subsection (b)(1),

termination of the member's entitlement to retired pay.

(2) In the case of an enrollment under subsection (b)(2),

termination of the member's status as a member of the Retired

Reserve.

(3) In the case of an enrollment under subsection (b)(5),

remarriage of the surviving spouse.

(g) Continuation of Dependents' Enrollment Upon Death of

Enrollee. - Coverage of a dependent in the dental insurance plan

established under subsection (a) under an enrollment of a member or

a surviving spouse who dies during the period of enrollment shall

continue until the end of that period and may be renewed by (or

for) the dependent, so long as the premium paid is sufficient to

cover continuation of the dependent's enrollment. The Secretary

may terminate coverage of the dependent when the premiums paid are

no longer sufficient to cover continuation of the enrollment. The

Secretary shall prescribe in regulations under subsection (h) the

parties responsible for paying the remaining premiums due on the

enrollment and the manner for collection of the premiums.

(h) Regulations. - The dental insurance plan established under

subsection (a) shall be administered under regulations prescribed

by the Secretary of Defense, in consultation with the other

administering Secretaries.

(i) Voluntary Disenrollment. - (1) With respect to enrollment in

the dental insurance plan established under subsection (a), the

Secretary of Defense -

(A) shall allow for a period of up to 30 days at the beginning

of the prescribed minimum enrollment period during which an

enrollee may disenroll; and

(B) shall provide for limited circumstances under which

disenrollment shall be permitted during the prescribed enrollment

period, without jeopardizing the fiscal integrity of the dental

program.

(2) The circumstances described in paragraph (1)(B) shall include

-

(A) a case in which a retired member, surviving spouse, or

dependent of a retired member who is also a Federal employee is

assigned to a location outside the jurisdiction of the dental

insurance plan established under subsection (a) that prevents

utilization of dental benefits under the plan;

(B) a case in which a retired member, surviving spouse, or

dependent of a retired member is prevented by a serious medical

condition from being able to obtain benefits under the plan;

(C) a case in which severe financial hardship would result; and

(D) any other circumstances which the Secretary considers

appropriate.

(3) The Secretary shall establish procedures for timely decisions

on requests for disenrollment under this section and for appeal to

the TRICARE Management Activity of adverse decisions.

(j) Definitions. - In this section:

(1) The term ''eligible dependent'' means a dependent described

in subparagraph (A), (D), or (I) of section 1072(2) of this

title.

(2) The term ''eligible child dependent'' means a dependent

described in subparagraph (D) or (I) of section 1072(2) of this

title.

(3) The term ''retired pay'' includes retainer pay.

-SOURCE-

(Added Pub. L. 104-201, div. A, title VII, Sec. 703(a)(1), Sept.

23, 1996, 110 Stat. 2588; amended Pub. L. 105-85, div. A, title

VII, Sec. 701, 733(b), 734, Nov. 18, 1997, 111 Stat. 1807, 1812,

1813; Pub. L. 105-261, div. A, title VII, Sec. 702, Oct. 17, 1998,

112 Stat. 2056; Pub. L. 106-65, div. A, title VII, Sec. 704, Oct.

5, 1999, 113 Stat. 683; Pub. L. 106-398, Sec. 1 ((div. A), title

VII, Sec. 726, title X, Sec. 1087(a)(6)), Oct. 30, 2000, 114 Stat.

1654, 1654A-187, 1654A-290.)

-MISC1-

AMENDMENTS

2000 - Subsec. (b)(5)(C). Pub. L. 106-398, Sec. 1 ((div. A),

title X, Sec. 1087(a)(6)), struck out ''pursuant to subsection

(i)(2) of such section'' after ''section 1076a of this title''.

Subsec. (f). Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec.

726(b)), substituted ''Required Terminations'' for ''Termination''

in heading.

Subsecs. (i), (j). Pub. L. 106-398, Sec. 1 ((div. A), title VII,

Sec. 726(a)), added subsec. (i) and redesignated former subsec. (i)

as (j).

1999 - Subsec. (d). Pub. L. 106-65 amended heading and text of

subsec. (d) generally. Text read as follows: ''The dental

insurance plan established under subsection (a) shall provide

benefits for basic dental care and treatment, including diagnostic

services, preventative services, basic restorative services

(including endodontics), surgical services, and emergency

services.''

1998 - Subsec. (b)(4), (5). Pub. L. 105-261, Sec. 702(a), added

par. (4) and redesignated former par. (4) as (5).

Subsec. (f)(3). Pub. L. 105-261, Sec. 702(b), substituted

''(b)(5)'' for ''(b)(4)''.

1997 - Subsec. (a). Pub. L. 105-85, Sec. 734(a)(1), (b)(1),

substituted ''The Secretary of Defense, in consultation with the

other administering Secretaries, shall establish a dental insurance

plan for retirees of the uniformed services'' for ''The Secretary

of Defense shall establish a dental insurance plan for military

retirees''.

Subsec. (b)(1). Pub. L. 105-85, Sec. 734(a)(2), substituted

''uniformed services'' for ''Armed Forces''.

Subsec. (b)(4)(A). Pub. L. 105-85, Sec. 701(1)(A), substituted

''died'' for ''dies''.

Subsec. (b)(4)(C). Pub. L. 105-85, Sec. 701(1)(B), (2), (3),

added subpar. (C).

Subsec. (c)(2). Pub. L. 105-85, Sec. 733(b), amended par. (2)

generally. Prior to amendment, par. (2) read as follows: ''The

amount of the premiums payable by a member entitled to retired pay

shall be deducted and withheld from the retired pay and shall be

disbursed to pay the premiums. The regulations prescribed under

subsection (h) shall specify the procedures for payment of the

premiums by other enrolled members and by enrolled surviving

spouses.''

Subsec. (h). Pub. L. 105-85, Sec. 734(b)(2), substituted ''other

administering Secretaries'' for ''Secretary of Transportation''.

LIMITATION ON IMPLEMENTATION OF ALTERNATIVE COLLECTION PROCEDURES

Pub. L. 105-85, div. A, title VII, Sec. 733(d), Nov. 18, 1997,

111 Stat. 1813, provided that: ''The Secretary of Defense may not

implement procedures for collecting premiums under (former) section

1076b(b)(3) of title 10, United States Code, or section 1076c(c)(2)

of such title other than by deductions and withholding from pay

until 120 days after the date that the Secretary submits a report

to Congress describing the justifications for implementing such

alternative procedures.''

IMPLEMENTATION OF DENTAL PLAN

Section 703(b) of Pub. L. 104-201, as amended by Pub. L. 105-85,

div. A, title VII, Sec. 733(e), Nov. 18, 1997, 111 Stat. 1813,

provided that: ''Beginning not later than April 1, 1998, the

Secretary of Defense shall -

''(1) offer members of the Armed Forces and other persons

described in subsection (b) of section 1076c of title 10, United

States Code (as added by subsection (a)(1) of this section), the

opportunity to enroll in the dental insurance plan required under

that section; and

''(2) begin to provide benefits under the plan.''

-CITE-

10 USC Sec. 1077 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1077. Medical care for dependents: authorized care in

facilities of uniformed services

-STATUTE-

(a) Only the following types of health care may be provided under

section 1076 of this title:

(1) Hospitalization.

(2) Outpatient care.

(3) Drugs.

(4) Treatment of medical and surgical conditions.

(5) Treatment of nervous, mental, and chronic conditions.

(6) Treatment of contagious diseases.

(7) Physical examinations, including eye examinations, and

immunizations.

(8) Maternity and infant care, including well-baby care that

includes one screening of an infant for the level of lead in the

blood of the infant.

(9) Diagnostic tests and services, including laboratory and

X-ray examinations.

(10) Dental care.

(11) Ambulance service and home calls when medically necessary.

(12) Durable equipment, which may be provided on a loan basis.

(13) Primary and preventive health care services for women (as

defined in section 1074d(b) of this title).

(14) Preventive health care screening for colon or prostate

cancer, at the intervals and using the screening methods

prescribed under section 1074d(a)(2) of this title.

(15) Prosthetic devices, as determined by the Secretary of

Defense to be necessary because of significant conditions

resulting from trauma, congenital anomalies, or disease.

(16) A hearing aid, but only for a dependent of a member of the

uniformed services on active duty and only if the dependent has a

profound hearing loss, as determined under standards prescribed

in regulations by the Secretary of Defense in consultation with

the administering Secretaries.

(17) Any rehabilitative therapy to improve, restore, or

maintain function, or to minimize or prevent deterioration of

function, of a patient when prescribed by a physician.

(b) The following types of health care may not be provided under

section 1076 of this title:

(1) Domiciliary or custodial care.

(2) Orthopedic footwear and spectacles, except that, outside of

the United States and at stations inside the United States where

adequate civilian facilities are unavailable, such items may be

sold to dependents at cost to the United States.

(3) The elective correction of minor dermatological blemishes

and marks or minor anatomical anomalies.

(c) A dependent participating under a dental plan established

under section 1076a of this title may not be provided dental care

under section 1076(a) of this title except for emergency dental

care, dental care provided outside the United States, and dental

care that is not covered by such plan.

(d)(1) Notwithstanding subsection (b)(1), hospice care may be

provided under section 1076 of this title in facilities of the

uniformed services to a terminally ill patient who chooses

(pursuant to regulations prescribed by the Secretary of Defense in

consultation with the other administering Secretaries) to receive

hospice care rather than continuing hospitalization or other health

care services for treatment of the patient's terminal illness.

(2) In this section, the term ''hospice care'' means the items

and services described in section 1861(dd) of the Social Security

Act (42 U.S.C. 1395x(dd)).

(e)(1) Authority to provide a prosthetic device under subsection

(a)(15) includes authority to provide the following:

(A) Any accessory or item of supply that is used in conjunction

with the device for the purpose of achieving therapeutic benefit

and proper functioning.

(B) Services necessary to train the recipient of the device in

the use of the device.

(C) Repair of the device for normal wear and tear or damage.

(D) Replacement of the device if the device is lost or

irreparably damaged or the cost of repair would exceed 60 percent

of the cost of replacement.

(2) An augmentative communication device may be provided as a

voice prosthesis under subsection (a)(15).

(3) A prosthetic device customized for a patient may be provided

under this section only by a prosthetic practitioner who is

qualified to customize the device, as determined under regulations

prescribed by the Secretary of Defense in consultation with the

administering Secretaries.

(f)(1) Items that may be provided to a patient under subsection

(a)(12) include the following:

(A) Any durable medical equipment that can improve, restore, or

maintain the function of a malformed, diseased, or injured body

part, or can otherwise minimize or prevent the deterioration of

the patient's function or condition.

(B) Any durable medical equipment that can maximize the

patient's function consistent with the patient's physiological or

medical needs.

(C) Wheelchairs.

(D) Iron lungs.

(E) Hospital beds.

(2) In addition to the authority to provide durable medical

equipment under subsection (a)(12), any customization of equipment

owned by the patient that is durable medical equipment authorized

to be provided to the patient under this section or section

1079(a)(5) of this title, and any accessory or item of supply for

any such equipment, may be provided to the patient if the

customization, accessory, or item of supply is essential for -

(A) achieving therapeutic benefit for the patient;

(B) making the equipment serviceable; or

(C) otherwise assuring the proper functioning of the equipment.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1447;

amended Pub. L. 89-614, Sec. 2(4), Sept. 30, 1966, 80 Stat. 863;

Pub. L. 98-525, title VI, Sec. 633(a), title XIV, Sec. 1401(e)(3),

1405(22), Oct. 19, 1984, 98 Stat. 2544, 2617, 2623; Pub. L. 99-145,

title VI, Sec. 651(b), Nov. 8, 1985, 99 Stat. 656; Pub. L. 102-190,

div. A, title VII, Sec. 702(a), 703, Dec. 5, 1991, 105 Stat. 1400,

1401; Pub. L. 103-160, div. A, title VII, Sec. 701(b), Nov. 30,

1993, 107 Stat. 1686; Pub. L. 103-337, div. A, title VII, Sec.

703(b), 705, Oct. 5, 1994, 108 Stat. 2798, 2799; Pub. L. 104-201,

div. A, title VII, Sec. 701(b)(1), Sept. 23, 1996, 110 Stat. 2587;

Pub. L. 105-85, div. A, title VII, Sec. 702, Nov. 18, 1997, 111

Stat. 1807; Pub. L. 107-107, div. A, title VII, Sec. 702, 703(a),

704, Dec. 28, 2001, 115 Stat. 1161, 1162.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1077(a) 1077(b) 37:403(f). June 7, 1956, ch.

1077(c) 37:403(g). 374, Sec. 103(f),

37:403(h) (less (g), (h), 70 Stat.

clause (4)). 251, 252.

1077(d) 37:403(h) (clause

(4)).

-------------------------------

In subsection (a), clause (6) is inserted to reflect subsection

(b).

PRIOR PROVISIONS

Provisions similar to those in subsec. (b)(3) of this section

were contained in the following appropriation acts:

Pub. L. 98-473, title I, Sec. 101(h) (title VIII, Sec. 8045),

Oct. 12, 1984, 98 Stat. 1904, 1931.

Pub. L. 98-212, title VII, Sec. 752, Dec. 8, 1983, 97 Stat. 1447.

Pub. L. 97-377, title I, Sec. 101(c) (title VII, Sec. 756), Dec.

21, 1982, 96 Stat. 1833, 1860.

Pub. L. 97-114, title VII, Sec. 759, Dec. 29, 1981, 95 Stat.

1588.

Pub. L. 96-527, title VII, Sec. 763, Dec. 15, 1980, 94 Stat.

3092.

Pub. L. 96-154, title VII, Sec. 769, Dec. 21, 1979, 93 Stat.

1163.

A prior section 1077, act Aug. 10, 1956, ch. 1041, 70A Stat. 84,

related to distribution of ballots, envelopes, and voting

instructions, prior to repeal by Pub. L. 85-861, Sec. 36B(5), Sept.

2, 1958, 72 Stat. 1570, as superseded by the Federal Voting

Assistance Act of 1955 which is classified to subchapter I-D (Sec.

1973cc et seq.) of chapter 20 of Title 42, The Public Health and

Welfare.

AMENDMENTS

2001 - Subsec. (a)(12). Pub. L. 107-107, Sec. 703(a)(1),

substituted ''which'' for ''such as wheelchairs, iron lungs, and

hospital beds''.

Subsec. (a)(16). Pub. L. 107-107, Sec. 702(1), added par. (16).

Subsec. (a)(17). Pub. L. 107-107, Sec. 704, added par. (17).

Subsec. (b)(2). Pub. L. 107-107, Sec. 702(2), substituted

''Orthopedic footwear'' for ''Hearing aids, orthopedic footwear,''.

Subsec. (e). Pub. L. 107-107, Sec. 702(3), added subsec. (e).

Subsec. (f). Pub. L. 107-107, Sec. 703(a)(2), added subsec. (f).

1997 - Subsec. (a)(15). Pub. L. 105-85, Sec. 702(a), added cl.

(15).

Subsec. (b)(2). Pub. L. 105-85, Sec. 702(b), added par. (2) and

struck out former par. (2) which read as follows: ''Prosthetic

devices, hearing aids, orthopedic footwear, and spectacles except

that -

''(A) outside the United States and at stations inside the

United States where adequate civilian facilities are unavailable,

such items may be sold to dependents at cost to the United

States, and

''(B) artificial limbs, voice prostheses, and artificial eyes

may be provided.''

1996 - Subsec. (a)(14). Pub. L. 104-201 added cl. (14).

1994 - Subsec. (b)(2)(B). Pub. L. 103-337, Sec. 705, inserted '',

voice prostheses,'' after ''artificial limbs''.

Subsec. (c). Pub. L. 103-337, Sec. 703(b), substituted '', dental

care provided outside the United States, and dental care'' for

''and care''.

1993 - Subsec. (a)(13). Pub. L. 103-160 added cl. (13).

1991 - Subsec. (a)(8). Pub. L. 102-190, Sec. 703, inserted before

period at end '', including well-baby care that includes one

screening of an infant for the level of lead in the blood of the

infant''.

Subsec. (d). Pub. L. 102-190, Sec. 702(a), added subsec. (d).

1985 - Subsec. (c). Pub. L. 99-145 added subsec. (c).

1984 - Pub. L. 98-525, Sec. 1405(22), substituted a colon for the

semicolon in section catchline.

Subsec. (a)(10). Pub. L. 98-525, Sec. 633(a)(1), added cl. (10).

Former cl. (10) ''Emergency dental care worldwide.'' was struck

out.

Subsec. (a)(11). Pub. L. 98-525, Sec. 633(a)(1), redesignated cl.

(13) as (11). Former cl. (11) ''Routine dental care outside the

United States and at stations in the United States where adequate

civilian facilities are unavailable.'' was struck out.

Subsec. (a)(12). Pub. L. 98-525, Sec. 633(a)(1), redesignated cl.

(14) as (12). Former cl. (12) ''Dental care worldwide as a

necessary adjunct of medical, surgical, or preventive treatment.''

was struck out.

Subsec. (a)(13), (14). Pub. L. 98-525, Sec. 633(a)(2),

redesignated cls. (13) and (14) as cls. (11) and (12),

respectively.

Subsec. (b)(3). Pub. L. 98-525, Sec. 1401(e)(3), added par. (3).

1966 - Pub. L. 89-614 authorized an improved health benefits

program for dependents of active duty members of the uniformed

services in facilities of such services, expanding health care to

be provided to include: hospitalization, outpatient care, and drugs

in clauses (1) to (3) of subsec. (a) (hospitalization being limited

by former subsec. (b) to treatment of nervous or mental

disturbances or chronic diseases or for elective medical and

surgical treatment to one year period in special cases); treatment

of mental and surgical conditions in clause (4) minus acute

condition restriction of former subsec. (a)(2); treatment of

nervous, mental, and chronic conditions in clause (5) formerly

restricted as stated above; clause (6) reenactment of former

subsec. (a)(3); physical, including eye, examinations in clause (7)

reenacting former subsec. (a)(4) immunization provisions; clause

(8) reenactment of former subsec. (a)(5); diagnostic tests and

services, including laboratory and X-ray examinations (diagnosis

being covered in former subsec. (a)(1)); dental care provisions in

clauses (10) to (12) (provided in former subsec. (d)) as (1)

emergency care to relieve pain and suffering, but not including

permanent restorative work or dental prosthesis, (2) care as a

necessary adjunct to medical or surgical treatment, and care

outside the United States, and in remote areas inside the United

States, where adequate civilian facilities are unavailable;

ambulance service and home calls in clause 13 (covering former

subsec. (c)(2), (3)); durable equipment on loan basis in clause

(14); and to exclude in subsec. (b)(1) (incorporating last sentence

of former subsec. (b)) custodial care; subsec. (b)(2)(A)

reenactment of former subsec. (e)(1); and permitted in subsec.

(b)(2)(B) artificial limbs and eyes to be provided.

EFFECTIVE DATE OF 1984 AMENDMENT

Section 633(b) of Pub. L. 98-525 provided that: ''The amendments

made by subsection (a) (amending this section) shall take effect on

July 1, 1985.''

Amendment by section 1401(e)(3) of Pub. L. 98-525 effective Oct.

1, 1985, see section 1404 of Pub. L. 98-525, set out as an

Effective Date note under section 520b of this title.

EFFECTIVE DATE OF 1966 AMENDMENT

For effective date of amendment by Pub. L. 89-614, see section 3

of Pub. L. 89-614, set out as a note under section 1071 of this

title.

PROVISION OF DOMICILIARY AND CUSTODIAL CARE FOR CERTAIN CHAMPUS

BENEFICIARIES

Pub. L. 106-65, div. A, title VII, Sec. 703, Oct. 5, 1999, 113

Stat. 682, as amended by Pub. L. 106-398, Sec. 1 ((div. A), title

VII, Sec. 701(a), (b), (c)(2)), Oct. 30, 2000, 114 Stat. 1654,

1654A-172, related to the continued provision of domiciliary and

custodial care for certain CHAMPUS beneficiaries, prohibited the

establishment of a limited transition period for such program,

required a survey and report of case management and custodial care

policies, and provided for cost limitations for each fiscal year,

prior to repeal by Pub. L. 107-107, div. A, title VII, Sec.

701(g)(1)(A), Dec. 28, 2001, 115 Stat. 1161.

OBSTETRICAL CARE FACILITIES

Pub. L. 89-188, title VI, Sec. 610, Sept. 16, 1965, 79 Stat. 818,

required that military hospitals in the United States and its

possessions be constructed so as to include facilities for

obstetrical care, prior to repeal by Pub. L. 97-214, Sec. 7(7),

July 12, 1982, 96 Stat. 173, eff. Oct. 1, 1982.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1075, 1076, 1079, 1080,

1086 of this title.

-CITE-

10 USC Sec. 1078 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1078. Medical and dental care for dependents: charges

-STATUTE-

(a) The Secretary of Defense, after consulting the other

administering Secretaries, shall prescribe fair charges for

inpatient medical and dental care given to dependents under section

1076 of this title. The charge or charges prescribed shall be

applied equally to all classes of dependents.

(b) As a restraint on excessive demands for medical and dental

care under section 1076 of this title, uniform minimal charges may

be imposed for outpatient care. Charges may not be more than such

amounts, if any, as the Secretary of Defense may prescribe after

consulting the other administering Secretaries, and after a finding

that such charges are necessary.

(c) Amounts received for subsistence and medical and dental care

given under section 1076 of this title shall be deposited to the

credit of the appropriation supporting the maintenance and

operation of the facility furnishing the care.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1448;

amended Pub. L. 89-614, Sec. 2(5), Sept. 30, 1966, 80 Stat. 863;

Pub. L. 96-513, title V, Sec. 511(36), Dec. 12, 1980, 94 Stat.

2923; Pub. L. 98-557, Sec. 19(6), Oct. 30, 1984, 98 Stat. 2869.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1078(a) 1078(b) 37:403(c). June 7, 1956, ch.

1078(c) 37:403(d). 374, Sec.

37:403(e). 103(c)(d), (e), 70

Stat. 251.

-------------------------------

Appropriate references are made to dental care throughout the

section to reflect the fact that in certain limited situations,

dependents are entitled to dental care under 37:403(h)(4), restated

as section 1077(d) of this title.

In subsection (b), the word ''special'' is omitted as surplusage.

PRIOR PROVISIONS

A prior section 1078, act Aug. 10, 1956, ch. 1041, 70A Stat. 84,

prescribed instructions for marking ballots, prior to repeal by

Pub. L. 85-861, Sec. 36B(5), Sept. 2, 1958, 72 Stat. 1570, as

superseded by the Federal Voting Assistance Act of 1955 which is

classified to subchapter I-D (Sec. 1973cc et seq.) of chapter 20 of

Title 42, The Public Health and Welfare.

AMENDMENTS

1984 - Subsecs. (a), (b). Pub. L. 98-557 substituted reference to

other administering Secretaries for reference to Secretary of

Health and Human Services.

1980 - Subsecs. (a), (b). Pub. L. 96-513 substituted ''Secretary

of Health and Human Services'' for ''Secretary of Health,

Education, and Welfare''.

1966 - Subsec. (a). Pub. L. 89-614 substituted ''The charge or

charges prescribed shall be applied equally to all classes of

dependents'' for ''Charges shall be the same for all dependents''.

EFFECTIVE DATE OF 1980 AMENDMENT

Amendment by Pub. L. 96-513 effective Dec. 12, 1980, see section

701(b)(3) of Pub. L. 96-513, set out as a note under section 101 of

this title.

EFFECTIVE DATE OF 1966 AMENDMENT

For effective date of amendment by Pub. L. 89-614, see section 3

of Pub. L. 89-614, set out as a note under section 1071 of this

title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1075, 1079, 1080, 1086,

1096 of this title; title 42 section 253a.

-CITE-

10 USC Sec. 1078a 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1078a. Continued health benefits coverage

-STATUTE-

(a) Provision of Continued Health Coverage. - The Secretary of

Defense shall implement and carry out a program of continued health

benefits coverage in accordance with this section to provide

persons described in subsection (b) with temporary health benefits

comparable to the health benefits provided for former civilian

employees of the Federal Government and other persons under section

8905a of title 5.

(b) Eligible Persons. - The persons referred to in subsection (a)

are the following:

(1) A member of the armed forces who -

(A) is discharged or released from active duty (or full-time

National Guard duty), whether voluntarily or involuntarily,

under other than adverse conditions, as characterized by the

Secretary concerned;

(B) immediately preceding that discharge or release, is

entitled to medical and dental care under section 1074(a) of

this title (except in the case of a member discharged or

released from full-time National Guard duty); and

(C) after that discharge or release and any period of

transitional health care provided under section 1145(a) of this

title, would not otherwise be eligible for any benefits under

this chapter.

(2) A person who -

(A) ceases to meet the requirements for being considered an

unmarried dependent child of a member or former member of the

armed forces under section 1072(2)(D) of this title or ceases

to meet the requirements for being considered an unmarried

dependent under section 1072(2)(I) of this title;

(B) on the day before ceasing to meet those requirements, was

covered under a health benefits plan under this chapter or

transitional health care under section 1145(a) of this title as

a dependent of the member or former member; and

(C) would not otherwise be eligible for any benefits under

this chapter.

(3) A person who -

(A) is an unremarried former spouse of a member or former

member of the armed forces; and

(B) on the day before the date of the final decree of

divorce, dissolution, or annulment was covered under a health

benefits plan under this chapter or transitional health care

under section 1145(a) of this title as a dependent of the

member or former member; and

(C) is not a dependent of the member or former member under

subparagraph (F) or (G) of section 1072(2) of this title or

ends a one-year period of dependency under subparagraph (H) of

such section.

(c) Notification of Eligibility. - (1) The Secretary of Defense

shall prescribe regulations to provide for persons described in

subsection (b) to be notified of eligibility to receive health

benefits under this section.

(2) In the case of a member who becomes (or will become) eligible

for continued coverage under subsection (b)(1), the regulations

shall provide for the Secretary concerned to notify the member of

the member's rights under this section as part of preseparation

counseling conducted under section 1142 of this title or any other

provision of other law.

(3) In the case of a dependent of a member or former member who

becomes eligible for continued coverage under subsection (b)(2),

the regulations shall provide that -

(A) the member or former member may submit to the Secretary

concerned a written notice of the dependent's change in status

(including the dependent's name, address, and such other

information as the Secretary of Defense may require); and

(B) the Secretary concerned shall, within 14 days after

receiving that notice, inform the dependent of the dependent's

rights under this section.

(4) In the case of a former spouse of a member or former member

who becomes eligible for continued coverage under subsection

(b)(3), the regulations shall provide appropriate notification

provisions and a 60-day election period under subsection (d)(3).

(d) Election of Coverage. - In order to obtain continued coverage

under this section, an appropriate written election (submitted in

such manner as the Secretary of Defense may prescribe) shall be

made as follows:

(1) In the case of a member described in subsection (b)(1), the

written election shall be submitted to the Secretary concerned

before the end of the 60-day period beginning on the later of -

(A) the date of the discharge or release of the member from

active duty or full-time National Guard duty;

(B) the date on which the period of transitional health care

applicable to the member under section 1145(a) of this title

ends; or

(C) the date the member receives the notification required

pursuant to subsection (c).

(2)(A) In the case of a dependent of a member or former member

who becomes eligible for continued coverage under subsection

(b)(2), the written election shall be submitted to the Secretary

concerned before the end of the 60-day period beginning on the

later of -

(i) the date on which the dependent first ceases to meet the

requirements for being considered a dependent under

subparagraph (D) or (I) of section 1072(2) of this title; or

(ii) the date the dependent receives the notification

pursuant to subsection (c).

(B) Notwithstanding subparagraph (A), if the Secretary

concerned determines that the dependent's parent has failed to

provide the notice referred to in subsection (c)(3)(A) with

respect to the dependent in a timely fashion, the 60-day period

under this paragraph shall be based only on the date under

subparagraph (A)(i).

(3) In the case of a former spouse of a member or a former

member who becomes eligible for continued coverage under

subsection (b)(3), the written election shall be submitted to the

Secretary concerned before the end of the 60-day period beginning

on the later of -

(A) the date as of which the former spouse first ceases to

meet the requirements for being considered a dependent under

section 1072(2) of this title; or

(B) such other date as the Secretary of Defense may

prescribe.

(e) Coverage of Dependents. - A person eligible under subsection

(b)(1) to elect to receive coverage may elect coverage either as an

individual or, if appropriate, for self and dependents. A person

eligible under subsection (b)(2) or subsection (b)(3) may elect

only individual coverage.

(f) Charges. - (1) Under arrangements satisfactory to the

Secretary of Defense, a person receiving continued coverage under

this section shall be required to pay into the Military Health Care

Account or other appropriate account an amount equal to the sum of

-

(A) the employee and agency contributions which would be

required in the case of a similarly situated employee enrolled in

a comparable health benefits plan under section 8905a(d)(1)(A)(i)

of title 5; and

(B) an amount, not to exceed 10 percent of the amount

determined under subparagraph (A), determined under regulations

prescribed by the Secretary of Defense to be necessary for

administrative expenses; and

(2) If a person elects to continue coverage under this section

before the end of the applicable period under subsection (d), but

after the person's coverage under this chapter (and any

transitional extension of coverage under section 1145(a) of this

title) expires, coverage shall be restored retroactively, with

appropriate contributions (determined in accordance with paragraph

(1)) and claims (if any), to the same extent and effect as though

no break in coverage had occurred.

(g) Period of Continued Coverage. - (1) Continued coverage under

this section may not extend beyond -

(A) in the case of a member described in subsection (b)(1), the

date which is 18 months after the date the member ceases to be

entitled to care under section 1074(a) of this title and any

transitional care under section 1145 of this title, as the case

may be;

(B) in the case of a person described in subsection (b)(2), the

date which is 36 months after the date on which the person first

ceases to meet the requirements for being considered a dependent

under subparagraph (D) or (I) of section 1072(2) of this title;

and

(C) in the case of a person described in subsection (b)(3),

except as provided in paragraph (4), the date which is 36 months

after the later of -

(i) the date on which the final decree of divorce,

dissolution, or annulment occurs; and

(ii) if applicable, the date the one-year extension of

dependency under section 1072(2)(H) of this title expires.

(2) Notwithstanding paragraph (1)(B), if a dependent of a member

becomes eligible for continued coverage under subsection (b)(2)

during a period of continued coverage of the member for self and

dependents under this section, extended coverage of the dependent

under this section may not extend beyond the date which is 36

months after the date the member became ineligible for medical and

dental care under section 1074(a) of this title and any

transitional health care under section 1145(a) of this title.

(3) Notwithstanding paragraph (1)(C), if a person becomes

eligible for continued coverage under subsection (b)(3) as the

former spouse of a member during a period of continued coverage of

the member for self and dependents under this section, extended

coverage of the former spouse under this section may not extend

beyond the date which is 36 months after the date the member became

ineligible for medical and dental care under section 1074(a) of

this title and any transitional health care under section 1145(a)

of this title.

(4)(A) Notwithstanding paragraph (1), in the case of a former

spouse described in subparagraph (B), continued coverage under this

section shall continue for such period as the former spouse may

request.

(B) A former spouse referred to in subparagraph (A) is a former

spouse of a member or former member (other than a former spouse

whose marriage was dissolved after the separation of the member

from the service unless such separation was by retirement) -

(i) who has not remarried before age 55 after the marriage to

the employee, former employee, or annuitant was dissolved;

(ii) who was enrolled in an approved health benefits plan under

this chapter as a family member at any time during the 18-month

period before the date of the divorce, dissolution, or annulment;

and

(iii)(I) who is receiving any portion of the retired or

retainer pay of the member or former member or an annuity based

on the retired or retainer pay of the member; or

(II) for whom a court order (as defined in section 1408(a)(2)

of this title) has been issued for payment of any portion of the

retired or retainer pay or for whom a court order (as defined in

section 1447(13) of this title) or a written agreement (whether

voluntary or pursuant to a court order) provides for an election

by the member or former member to provide an annuity to the

former spouse.

-SOURCE-

(Added Pub. L. 102-484, div. D, title XLIV, Sec. 4408(a)(1), Oct.

23, 1992, 106 Stat. 2708; amended Pub. L. 103-35, title II, Sec.

201(g)(1), May 31, 1993, 107 Stat. 99; Pub. L. 103-337, div. A,

title VII, Sec. 702(c), Oct. 5, 1994, 108 Stat. 2798; Pub. L.

104-201, div. A, title X, Sec. 1074(a)(4), Sept. 23, 1996, 110

Stat. 2658; Pub. L. 105-85, div. A, title X, Sec. 1073(a)(17),

Nov. 18, 1997, 111 Stat. 1901.)

-MISC1-

AMENDMENTS

1997 - Subsec. (g)(4)(B)(iii)(II). Pub. L. 105-85 substituted

''section 1447(13)'' for ''section 1447(8)''.

1996 - Subsec. (a). Pub. L. 104-201 substituted ''The Secretary''

for ''Beginning on October 1, 1994, the Secretary''.

1994 - Subsec. (b)(2)(A). Pub. L. 103-337, Sec. 702(c)(1),

inserted before semicolon ''or ceases to meet the requirements for

being considered an unmarried dependent under section 1072(2)(I) of

this title''.

Subsec. (c)(3). Pub. L. 103-337, Sec. 702(c)(2), substituted

''dependent'' for ''child'' in two places and ''dependent's'' for

''child's'' wherever appearing.

Subsec. (d)(2)(A). Pub. L. 103-337, Sec. 702(c)(3), substituted

''a dependent'' for ''a child'' in introductory provisions, ''the

dependent'' for ''the child'' in cls. (i) and (ii), and ''a

dependent under subparagraph (D) or (I) of section 1072(2) of this

title;'' for ''an unmarried dependent child under section

1072(2)(D) of this title,'' in cl. (i).

Subsec. (d)(2)(B). Pub. L. 103-337, Sec. 702(c)(4), substituted

''dependent's'' for ''child's'' and ''dependent'' for ''child''.

Subsec. (g)(1)(B). Pub. L. 103-337, Sec. 702(c)(5), substituted

''a dependent under subparagraph (D) or (I) of section 1072(2) of

this title'' for ''an unmarried dependent child under section

1072(2)(D) of this title''.

Subsec. (g)(2). Pub. L. 103-337, Sec. 702(c)(6), substituted

''dependent'' for ''child'' in two places.

1993 - Subsec. (b)(3)(C). Pub. L. 103-35, Sec. 201(g)(1)(A),

substituted ''subparagraph'' for ''subparagraphs'' after ''member

under''.

Subsec. (d)(2)(A). Pub. L. 103-35, Sec. 201(g)(1)(B), inserted

''under'' after ''coverage''.

-CITE-

10 USC Sec. 1079 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1079. Contracts for medical care for spouses and children:

plans

-STATUTE-

(a) To assure that medical care is available for dependents, as

described in subparagraphs (A), (D), and (I) of section 1072(2) of

this title, of members of the uniformed services who are on active

duty for a period of more than 30 days, the Secretary of Defense,

after consulting with the other administering Secretaries, shall

contract, under the authority of this section, for medical care for

those persons under such insurance, medical service, or health

plans as he considers appropriate. The types of health care

authorized under this section shall be the same as those provided

under section 1076 of this title, except as follows:

(1) With respect to dental care, only that care required as a

necessary adjunct to medical or surgical treatment may be

provided.

(2) Consistent with such regulations as the Secretary of

Defense may prescribe regarding the content of health promotion

and disease prevention visits, the schedule of pap smears and

mammograms, the schedule and method of colon and prostate cancer

screenings, and the types and schedule of immunizations -

(A) for dependents under six years of age, both health

promotion and disease prevention visits and immunizations may

be provided; and

(B) for dependents six years of age or older, health

promotion and disease prevention visits may be provided in

connection with immunizations or with diagnostic or preventive

pap smears and mammograms or colon and prostate cancer

screenings.

(3) Not more than one eye examination may be provided to a

patient in any calendar year.

(4) Under joint regulations to be prescribed by the

administering Secretaries, the services of Christian Science

practitioners and nurses and services obtained in Christian

Science sanatoriums may be provided.

(5) Durable equipment provided under this section may be

provided on a rental basis.

(6) Inpatient mental health services may not (except as

provided in subsection (i)) be provided to a patient in excess of

-

(A) 30 days in any year, in the case of a patient 19 years of

age or older;

(B) 45 days in any year, in the case of a patient under 19

years of age; or

(C) 150 days in any year, in the case of inpatient mental

health services provided as residential treatment care.

(7) Services in connection with nonemergency inpatient hospital

care may not be provided if such services are available at a

facility of the uniformed services located within a 40-mile

radius of the residence of the patient, except that those

services may be provided in any case in which another insurance

plan or program provides primary coverage for those services.

(8) Services of pastoral counselors, family and child

counselors, or marital counselors (other than certified marriage

and family therapists) may not be provided unless the patient has

been referred to the counselor by a medical doctor for treatment

of a specific problem with the results of that treatment to be

communicated back to the medical doctor who made the referral and

services of certified marriage and family therapists may be

provided consistent with such rules as may be prescribed by the

Secretary of Defense, including credentialing criteria and a

requirement that the therapists accept payment under this section

as full payment for all services provided.

(9) Special education may not be provided, except when provided

as secondary to the active psychiatric treatment on an

institutional inpatient basis.

(10) Therapy or counseling for sexual dysfunctions or sexual

inadequacies may not be provided.

(11) Treatment of obesity may not be provided if obesity is the

sole or major condition treated.

(12) Surgery which improves physical appearance but is not

expected to significantly restore functions (including mammary

augmentation, face lifts, and sex gender changes) may not be

provided, except that -

(A) breast reconstructive surgery following a mastectomy may

be provided;

(B) reconstructive surgery to correct serious deformities

caused by congenital anomalies or accidental injuries may be

provided; and

(C) neoplastic surgery may be provided.

(13) Any service or supply which is not medically or

psychologically necessary to prevent, diagnose, or treat a mental

or physical illness, injury, or bodily malfunction as assessed or

diagnosed by a physician, dentist, clinical psychologist,

certified marriage and family therapist, optometrist, podiatrist,

certified nurse-midwife, certified nurse practitioner, or

certified clinical social worker, as appropriate, may not be

provided, except as authorized in paragraph (4). Pursuant to an

agreement with the Secretary of Health and Human Services and

under such regulations as the Secretary of Defense may prescribe,

the Secretary of Defense may waive the operation of this

paragraph in connection with clinical trials sponsored or

approved by the National Institutes of Health if the Secretary of

Defense determines that such a waiver will promote access by

covered beneficiaries to promising new treatments and contribute

to the development of such treatments.

(14) The prohibition contained in section 1077(b)(3) of this

title shall not apply in the case of a member or former member of

the uniformed services.

(15) Electronic cardio-respiratory home monitoring equipment

(apnea monitors) for home use may be provided if a physician

prescribes and supervises the use of the monitor for an infant -

(A) who has had an apparent life-threatening event,

(B) who is a subsequent sibling of a victim of sudden infant

death syndrome,

(C) whose birth weight was 1,500 grams or less, or

(D) who is a pre-term infant with pathologic apnea,

in which case the coverage may include the cost of the equipment,

hard copy analysis of physiological alarms, professional visits,

diagnostic testing, family training on how to respond to apparent

life threatening events, and assistance necessary for proper use

of the equipment.

(16) Hospice care may be provided only in the manner and under

the conditions provided in section 1861(dd) of the Social

Security Act (42 U.S.C. 1395x(dd)).

(b) Plans covered by subsection (a) shall include provisions for

payment by the patient of the following amounts:

(1) $25 for each admission to a hospital, or the amount the

patient would have been charged under section 1078(a) of this

title had the care being paid for been obtained in a hospital of

the uniformed services, whichever amount is the greater. The

Secretary of Defense may exempt a patient from paying such amount

if the hospital to which the patient is admitted does not impose

a legal obligation on any of its patients to pay for inpatient

care.

(2) Except as provided in clause (3), the first $150 each

fiscal year of the charges for all types of care authorized by

subsection (a) and received while in an outpatient status and 20

percent of all subsequent charges for such care during a fiscal

year. Notwithstanding the preceding sentence, in the case of a

dependent of an enlisted member in a pay grade below E-5, the

initial deductible each fiscal year under this paragraph shall be

limited to $50.

(3) A family group of two or more persons covered by this

section shall not be required to pay collectively more than the

first $300 (or in the case of the family group of an enlisted

member in a pay grade below E-5, the first $100) each fiscal year

of the charges for all types of care authorized by subsection (a)

and received while in an outpatient status and 20 percent of the

additional charges for such care during a fiscal year.

(4) $25 for surgical care that is authorized by subsection (a)

and received while in an outpatient status and that has been

designated (under joint regulations to be prescribed by the

administering Secretaries) as care to be treated as inpatient

care for purposes of this subsection. Any care for which payment

is made under this clause shall not be considered to be care

received while in an outpatient status for purposes of clauses

(2) and (3).

(5) An individual or family group of two or more persons

covered by this section may not be required by reason of this

subsection to pay a total of more than $1,000 for health care

received during any fiscal year under a plan under subsection

(a).

(c) The methods for making payment under subsection (b) shall be

prescribed under joint regulations issued by the administering

Secretaries.

(d)(1) The Secretary of Defense shall establish a program to

provide extended benefits for eligible dependents, which may

include the provision of comprehensive health care services,

including case management services, to assist in the reduction of

the disabling effects of a qualifying condition of an eligible

dependent. Registration shall be required to receive the extended

benefits.

(2) The Secretary of Defense, after consultation with the other

administering Secretaries, shall promulgate regulations to carry

out this subsection.

(3) In this subsection:

(A) The term ''eligible dependent'' means a dependent of a

member of the uniformed services on active duty for a period of

more than 30 days, as described in subparagraph (A), (D), or (I)

of section 1072(2) of this title, who has a qualifying condition.

(B) The term ''qualifying condition'' means the condition of a

dependent who is moderately or severely mentally retarded, has a

serious physical disability, or has an extraordinary physical or

psychological condition.

(e) 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:

(1) Diagnosis.

(2) 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).

(3) Training, rehabilitation, special education, and assistive

technology devices.

(4) Institutional care in private nonprofit, public, and State

institutions and facilities and, if appropriate, transportation

to and from such institutions and facilities.

(5) Custodial care, notwithstanding the prohibition in section

1077(b)(1) of this title.

(6) Respite care for the primary caregiver of the eligible

dependent.

(7) Such other services and supplies as determined appropriate

by the Secretary, notwithstanding the limitations in subsection

(a)(13).

(f)(1) Members shall be required to share in the cost of any

benefits provided to their dependents under subsection (d) as

follows:

(A) Members in the lowest enlisted pay grade shall be required

to pay the first $25 incurred each month, and members in the

highest commissioned pay grade shall be required to pay the first

$250 incurred each month. The amounts to be paid by members in

all other pay grades shall be determined under regulations to be

prescribed by the Secretary of Defense in consultation with the

administering Secretaries.

(B) A member who has more than one dependent incurring expenses

in a given month under a plan covered by subsection (d) shall not

be required to pay an amount greater than would be required if

the member had only one such dependent.

(2) In the case of extended benefits provided under paragraph (3)

or (4) of subsection (e) to a dependent of a member of the

uniformed services -

(A) the Government's share of the total cost of providing such

benefits in any month shall not exceed $2,500, except for costs

that a member is exempt from paying under paragraph (3); and

(B) the member shall pay (in addition to any amount payable

under paragraph (1)) the amount, if any, by which the amount of

such total cost for the month exceeds the Government's maximum

share under subparagraph (A).

(3) A member of the uniformed services who incurs expenses under

paragraph (2) for a month for more than one dependent shall not be

required to pay for the month under subparagraph (B) of that

paragraph an amount greater than the amount the member would

otherwise be required to pay under that subparagraph for the month

if the member were incurring expenses under that subparagraph for

only one dependent.

(4) To qualify for extended benefits under paragraph (3) or (4)

of subsection (e), a dependent of a member of the uniformed

services shall be required to use public facilities to the extent

such facilities are available and adequate, as determined under

joint regulations of the administering Secretaries.

(5) The Secretary of Defense, in consultation with the other

administering Secretaries, shall prescribe regulations to carry out

this subsection.

(g) When a member dies while he is eligible for receipt of

hostile fire pay under section 310 of title 37 or from a disease or

injury incurred while eligible for such pay, his dependents who are

receiving benefits under a plan covered by subsection (d) shall

continue to be eligible for such benefits until they pass their

twenty-first birthday. In addition, when a member dies while on

active duty for a period of more than 30 days, the member's

dependents who are receiving benefits under a plan covered by

subsection (a) shall continue to be eligible for such benefits

during the three-year period beginning on the date of the death of

the member.

(h)(1) Except as provided in paragraphs (2) and (3), payment for

a charge for services by an individual health care professional (or

other noninstitutional health care provider) for which a claim is

submitted under a plan contracted for under subsection (a) shall be

equal to an amount determined to be appropriate, to the extent

practicable, in accordance with the same reimbursement rules as

apply to payments for similar services under title XVIII of the

Social Security Act (42 U.S.C. 1395 et seq.). The Secretary of

Defense shall determine the appropriate payment amount under this

paragraph in consultation with the other administering Secretaries.

(2) The Secretary of Defense, in consultation with the other

administering Secretaries, shall prescribe regulations to provide

for such exceptions to the payment limitations under paragraph (1)

as the Secretary determines to be necessary to assure that covered

beneficiaries retain adequate access to health care services. Such

exceptions may include the payment of amounts higher than the

amount allowed under paragraph (1) when enrollees in managed care

programs obtain covered services from nonparticipating providers.

To provide a suitable transition from the payment methodologies in

effect before February 10, 1996, to the methodology required by

paragraph (1), the amount allowable for any service may not be

reduced by more than 15 percent below the amount allowed for the

same service during the immediately preceding 12-month period (or

other period as established by the Secretary of Defense).

(3) In addition to the authority provided under paragraph (2),

the Secretary of Defense may authorize the commander of a facility

of the uniformed services, the lead agent (if other than the

commander), and the health care contractor to modify the payment

limitations under paragraph (1) for certain health care providers

when necessary to ensure both the availability of certain services

for covered beneficiaries and lower costs than would otherwise be

incurred to provide the services. With the consent of the health

care provider, the Secretary is also authorized to reduce the

authorized payment for certain health care services below the

amount otherwise required by the payment limitations under

paragraph (1).

(4)(A) The Secretary of Defense, in consultation with the other

administering Secretaries, shall prescribe regulations to establish

limitations (similar to the limitations established under title

XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)) on

beneficiary liability for charges of an individual health care

professional (or other noninstitutional health care provider).

(B) The regulations shall include a restriction that prohibits an

individual health care professional (or other noninstitutional

health care provider) from billing a beneficiary for services for

more than the amount that is equal to -

(i) the excess of the limiting charge (as defined in section

1848(g)(2) of the Social Security Act (42 U.S.C. 1395w-4(g)(2)))

that would be applicable if the services had been provided by the

professional (or other provider) as an individual health care

professional (or other noninstitutional health care provider) on

a nonassignment-related basis under part B of title XVIII of such

Act over the amount that is payable by the United States for

those services under this subsection, plus

(ii) any unpaid amounts of deductibles or copayments that are

payable directly to the professional (or other provider) by the

beneficiary.

(5) To assure access to care for all covered beneficiaries, the

Secretary of Defense, in consultation with the other administering

Secretaries, shall designate specific rates for reimbursement for

services in certain localities if the Secretary determines that

without payment of such rates access to health care services would

be severely impaired. Such a determination shall be based on

consideration of the number of providers in a locality who provide

the services, the number of such providers who are CHAMPUS

participating providers, the number of covered beneficiaries under

CHAMPUS in the locality, the availability of military providers in

the location or a nearby location, and any other factors determined

to be relevant by the Secretary.

(i)(1) The limitation in subsection (a)(6) does not apply in the

case of inpatient mental health services -

(A) provided under the program for the handicapped under

subsection (d);

(B) provided as partial hospital care; or

(C) provided pursuant to a waiver authorized by the Secretary

of Defense because of medical or psychological circumstances of

the patient that are confirmed by a health professional who is

not a Federal employee after a review, pursuant to rules

prescribed by the Secretary, which takes into account the

appropriate level of care for the patient, the intensity of

services required by the patient, and the availability of that

care.

(2) Notwithstanding subsection (b) or section 1086(b) of this

title, the Secretary of Defense (after consulting with the other

administering Secretaries) may prescribe separate payment

requirements (including deductibles, copayments, and catastrophic

limits) for the provision of mental health services to persons

covered by this section or section 1086 of this title. The payment

requirements may vary for different categories of covered

beneficiaries, by type of mental health service provided, and based

on the location of the covered beneficiaries.

(3)(A) Except as provided in subparagraph (B), the Secretary of

Defense shall require preadmission authorization before inpatient

mental health services may be provided to persons covered by this

section or section 1086 of this title. In the case of the

provision of emergency inpatient mental health services, approval

for the continuation of such services shall be required within 72

hours after admission.

(B) Preadmission authorization for inpatient mental health

services is not required under subparagraph (A) in the following

cases:

(i) In the case of an emergency.

(ii) In a case in which any benefits are payable for such

services under part A of title XVIII of the Social Security Act

(42 U.S.C. 1395c et seq.), subject to subparagraph (C).

(C) In a case of inpatient mental health services to which

subparagraph (B)(ii) applies, the Secretary shall require advance

authorization for a continuation of the provision of such services

after benefits cease to be payable for such services under such

part A.

(j)(1) A benefit may not be paid under a plan covered by this

section in the case of a person enrolled in, or covered by, any

other insurance, medical service, or health plan, including any

plan offered by a third-party payer (as defined in section

1095(h)(1) of this title), to the extent that the benefit is also a

benefit under the other plan, except in the case of a plan

administered under title XIX of the Social Security Act (42 U.S.C.

1396 et seq.).

(2) The amount to be paid to a provider of services for services

provided under a plan covered by this section shall be determined

under joint regulations to be prescribed by the administering

Secretaries which provide that the amount of such payments shall be

determined to the extent practicable in accordance with the same

reimbursement rules as apply to payments to providers of services

of the same type under title XVIII of the Social Security Act (42

U.S.C. 1395 et seq.).

(3) A contract for a plan covered by this section shall include a

clause that prohibits each provider of services under the plan from

billing any person covered by the plan for any balance of charges

for services in excess of the amount paid for those services under

the joint regulations referred to in paragraph (2), except for any

unpaid amounts of deductibles or copayments that are payable

directly to the provider by the person.

(4) In this subsection, the term ''provider of services'' means a

hospital, skilled nursing facility, comprehensive outpatient

rehabilitation facility, home health agency, hospice program (as

defined in section 1861(dd)(2) of the Social Security Act (42

U.S.C. 1395x(dd)(2))), or other institutional facility providing

services for which payment may be made under a plan covered by this

section.

(k) A plan covered by this section may include provision of liver

transplants (including the cost of acquisition and transportation

of the donated liver) in accordance with this subsection. Such a

liver transplant may be provided if -

(1) the transplant is for a dependent considered appropriate

for that procedure by the Secretary of Defense in consultation

with the other administering Secretaries and such other entities

as the Secretary considers appropriate; and

(2) the transplant is to be carried out at a health-care

facility that has been approved for that purpose by the Secretary

of Defense after consultation with the other administering

Secretaries and such other entities as the Secretary considers

appropriate.

(l)(1) Contracts entered into under subsection (a) shall also

provide for medical care for dependents of former members of the

uniformed services who are authorized to receive medical and dental

care under section 1076(e) of this title in facilities of the

uniformed services.

(2) Except as provided in paragraph (3), medical care in the case

of a dependent described in section 1076(e) shall be furnished

under the same conditions and subject to the same limitations as

medical care furnished under this section to spouses and children

of members of the uniformed services described in the first

sentence of subsection (a).

(3) Medical care may be furnished to a dependent pursuant to

paragraph (1) only for an injury, illness, or other condition

described in section 1076(e) of this title.

(m)(1) Subject to paragraph (2), the Secretary of Defense may,

upon request, make payments under this section for a charge for

services for which a claim is submitted under a plan contracted for

under subsection (a) to a hospital that does not impose a legal

obligation on any of its patients to pay for such services.

(2) A payment under paragraph (1) may not exceed the average

amount paid for comparable services in the geographic area in which

the hospital is located or, if no comparable services are available

in that area, in an area similar to the area in which the hospital

is located.

(3) The Secretary of Defense shall periodically review the

billing practices of each hospital the Secretary approves for

payment under this subsection to ensure that the hospital's

practices of not billing patients for payment are not resulting in

increased costs to the Government.

(4) The Secretary of Defense may require each hospital the

Secretary approves for payment under this subsection to provide

evidence that it has sources of revenue to cover unbilled costs.

(n) The Secretary of Defense may enter into contracts (or amend

existing contracts) with fiscal intermediaries under which the

intermediaries agree to organize and operate, directly or through

subcontractors, managed health care networks for the provision of

health care under this chapter. The managed health care networks

shall include cost containment methods, such as utilization review

and contracting for care on a discounted basis.

(o)(1) Health care services provided pursuant to this section or

section 1086 of this title (or pursuant to any other contract or

project under the Civilian Health and Medical Program of the

Uniformed Services) may not include services determined under the

CHAMPUS Peer Review Organization program to be not medically or

psychologically necessary.

(2) The Secretary of Defense, after consulting with the other

administering Secretaries, may adopt or adapt for use under the

CHAMPUS Peer Review Organization program, as the Secretary

considers appropriate, any of the quality and utilization review

requirements and procedures that are used by the Peer Review

Organization program under part B of title XI of the Social

Security Act (42 U.S.C. 1320c et seq.).

(p)(1) Subject to such exceptions as the Secretary of Defense

considers necessary, coverage for medical care under this section

for the dependents described in paragraph (3), and standards with

respect to timely access to such care, shall be comparable to

coverage for medical care and standards for timely access to such

care under the managed care option of the TRICARE program known as

TRICARE Prime.

(2) The Secretary of Defense shall enter into arrangements with

contractors under the TRICARE program or with other appropriate

contractors for the timely and efficient processing of claims under

this subsection.

(3) This subsection applies with respect to a dependent referred

to in subsection (a) who -

(A) is a dependent of a member of the uniformed services

referred to in section 1074(c)(3) of this title and is residing

with the member;

(B) is a dependent of a member who, after having served in a

duty assignment described in section 1074(c)(3) of this title,

has relocated without the dependent pursuant to orders for a

permanent change of duty station from a remote location described

in subparagraph (B)(ii) of such section where the member and the

dependent resided together while the member served in such

assignment, if the orders do not authorize dependents to

accompany the member to the new duty station at the expense of

the United States and the dependent continues to reside at the

same remote location, or

(C) is a dependent of a reserve component member ordered to

active duty for a period of more than 30 days and is residing

with the member, and the residence is located more than 50 miles,

or approximately one hour of driving time, from the nearest

military medical treatment facility adequate to provide the

needed care.

(4) The Secretary of Defense shall consult with the other

administering Secretaries in the administration of this subsection.

(q) Subject to subsection (a), a physician or other health care

practitioner who is eligible to receive reimbursement for services

provided under medicare (as defined in section 1086(d)(3)(C) of

this title) shall be considered approved to provide medical care

authorized under this section and section 1086 of this title unless

the administering Secretaries have information indicating medicare,

TRICARE, or other Federal health care program integrity violations

by the physician or other health care practitioner.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1448;

amended Pub. L. 89-614, Sec. 2(6), Sept. 30, 1966, 80 Stat. 863;

Pub. L. 92-58, Sec. 1, July 29, 1971, 85 Stat. 157; Pub. L. 95-485,

title VIII, Sec. 806(a)(1), Oct. 20, 1978, 92 Stat. 1622; Pub. L.

96-342, title VIII, Sec. 810(a), (b), Sept. 8, 1980, 94 Stat. 1097;

Pub. L. 96-513, title V, Sec. 501(13), 511(36), (38), Dec. 12,

1980, 94 Stat. 2908, 2923; Pub. L. 96-552, Dec. 19, 1980, 94 Stat.

3254; Pub. L. 97-22, Sec. 11(a)(2), July 10, 1981, 95 Stat. 137;

Pub. L. 97-86, title IX, Sec. 906(a)(1), Dec. 1, 1981, 95 Stat.

1117; Pub. L. 98-94, title IX, Sec. 931(a), title XII, Sec.

1268(4), Sept. 24, 1983, 97 Stat. 648, 705; Pub. L. 98-525, title

VI, Sec. 632(a)(1), title XIV, Sec. 1401(e)(4), 1405(23), Oct. 19,

1984, 98 Stat. 2543, 2617, 2623; Pub. L. 98-557, Sec. 19(7), Oct.

30, 1984, 98 Stat. 2869; Pub. L. 99-661, div. A, title VI, Sec.

652(d), title VII, Sec. 703, Nov. 14, 1986, 100 Stat. 3889, 3900;

Pub. L. 100-180, div. A, title VII, Sec. 721(a), 726(a), Dec. 4,

1987, 101 Stat. 1115, 1117; Pub. L. 100-456, div. A, title VI,

Sec. 646(a), Sept. 29, 1988, 102 Stat. 1989; Pub. L. 101-189, div.

A, title VII, Sec. 730(a), Nov. 29, 1989, 103 Stat. 1481; Pub. L.

101-510, div. A, title VII, Sec. 701(a), 702(a), 703(a), (b),

712(a), title XIV, Sec. 1484(g)(1), Nov. 5, 1990, 104 Stat. 1580,

1581, 1583, 1717; Pub. L. 102-25, title III, Sec. 316(b), Apr. 6,

1991, 105 Stat. 87; Pub. L. 102-190, div. A, title VII, Sec.

702(b), 711, 712(a), 713, Dec. 5, 1991, 105 Stat. 1400, 1402, 1403;

Pub. L. 102-484, div. A, title VII, Sec. 704, title X, Sec.

1052(13), 1053(3), Oct. 23, 1992, 106 Stat. 2432, 2499, 2501; Pub.

L. 103-35, title II, Sec. 202(a)(5), May 31, 1993, 107 Stat. 101;

Pub. L. 103-160, div. A, title VII, Sec. 711, 716(c), Nov. 30,

1993, 107 Stat. 1688, 1693; Pub. L. 103-337, div. A, title VII,

Sec. 702(a), 707(a), Oct. 5, 1994, 108 Stat. 2797, 2800; Pub. L.

104-106, div. A, title VII, Sec. 701, 731(a)-(d), Feb. 10, 1996,

110 Stat. 370, 380, 381; Pub. L. 104-201, div. A, title VII, Sec.

701(b)(2), 711, 731, 732, 735(c), Sept. 23, 1996, 110 Stat. 2587,

2590, 2597, 2599; Pub. L. 105-85, div. A, title VII, Sec. 735,

Nov. 18, 1997, 111 Stat. 1813; Pub. L. 106-398, Sec. 1 ((div. A),

title VII, Sec. 701(c)(1), 704(b), 722(b)(1), 757(a)), Oct. 30,

2000, 114 Stat. 1654, 1654A-172, 1654A-175, 1654A-185, 1654A-198;

Pub. L. 107-107, div. A, title VII, Sec. 701(b), (g)(2), 703(b),

707(a), (b), title X, Sec. 1048(c)(5), Dec. 28, 2001, 115 Stat.

1158, 1161-1163, 1226; Pub. L. 107-314, div. A, title VII, Sec.

701(a), Sec. 702, Sec. 705(a), Dec. 2, 2002, 116 Stat. 2583, 2584.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1079(a) 1079(b) 37:402(a)(2) (as June 7, 1956, ch.

applicable to 374, Sec. 102(a)(2)

37:411(a)). (as applicable to

37:411(a). Sec. 201(a)),

37:411(b). 37:414. 201(a), (b), 204,

70 Stat. 250, 252,

253.

-------------------------------

In subsection (a), the words ''appointed, enlisted, inducted or

called, ordered or conscripted in a uniformed service'', in

37:402(a)(2) are omitted as surplusage, since it does not matter

how a member became a member. The words ''active duty for a period

of more than 30 days'' are substituted for the words ''active duty

or active duty for training pursuant to a call or order that does

not specify a period of thirty days or less'', in 37:402(a)(2), to

reflect section 101(22) and (23) of this title. The words '',

under the authority of this section,'' are substituted for the

words ''pursuant to the provisions of this title'' to make clear

that the section provides independent procurement authority. The

words ''all'', ''by the hospital'', and ''a period of'', in

37:411(a), are omitted as surplusage.

In subsection (a)(1), the word ''rooms'', in 37:411(a), is

substituted for the word ''accommodations''.

In subsection (a)(5), the word ''services'' is substituted for

the word ''procedures'' and the word ''performed'' is substituted

for the word ''accomplished'', in 37: 411(a). The words ''or

surgeon'' are inserted for clarity.

In subsection (b), the word ''variances'' is substituted for the

words ''limitations, additions, exclusions''. The words ''or care

other than that provided for in sections 1076-1078 of this title''

are substituted for 37:414. The words ''definitions, and related

provisions'', in 37:411(b), are omitted as surplusage, since the

Secretary of an executive department has inherent authority to

interpret laws and issue regulations.

-REFTEXT-

REFERENCES IN TEXT

The Social Security Act, referred to in subsecs. (h)(1), (4)(A),

(B)(i), (i)(3)(B)(ii), (C), (j)(1), (2), and (o)(2), is act Aug.

13, 1935, ch. 531, 49 Stat. 620, as amended. Part B of title XI of

the Act is classified generally to part B (Sec. 1320c et seq.) of

subchapter XI of chapter 7 of Title 42, The Public Health and

Welfare. Titles XVIII and XIX of the Act are classified generally

to subchapters XVIII (Sec. 1395 et seq.) and XIX (Sec. 1396 et

seq.), respectively, of chapter 7 of Title 42. Parts A and B of

title XVIII of the Act are classified generally to part A (Sec.

1395c et seq.) and part B (Sec. 1395j et seq.), respectively, of

subchapter XVIII of chapter 7 of Title 42. Section 1861(m) of the

Act is classified to section 1395x(m) of Title 42. For complete

classification of this Act to the Code, see section 1305 of Title

42 and Tables.

-MISC2-

PRIOR PROVISIONS

Provisions similar to those in subsec. (a)(7) to (14) of this

section were contained in the following appropriation acts, with

the exception of the provisions similar to par. (14) which first

appeared in Pub. L. 96-154:

Pub. L. 98-473, title I, Sec. 101(h) (title VIII, Sec. 8031,

8032, 8045), Oct. 12, 1984, 98 Stat. 1904, 1929, 1931.

Pub. L. 98-212, title VII, Sec. 737, 738, 752, Dec. 8, 1983, 97

Stat. 1445, 1447.

Pub. L. 97-377, title I, Sec. 101(c) (title VII, Sec. 740, 741,

756), Dec. 21, 1982, 96 Stat. 1833, 1857, 1860.

Pub. L. 97-114, title VII, Sec. 741, 742, 759, Dec. 29, 1981, 95

Stat. 1585, 1588.

Pub. L. 96-527, title VII, Sec. 742, 743, 763, Dec. 15, 1980, 94

Stat. 3088, 3092.

Pub. L. 96-154, title VII, Sec. 744, 745, 769, Dec. 21, 1979, 93

Stat. 1159, 1163.

Pub. L. 95-457, title VIII, Sec. 844, 845, Oct. 13, 1978, 92

Stat. 1251.

Pub. L. 95-111, title VIII, Sec. 843, 844, Sept. 21, 1977, 91

Stat. 907.

Pub. L. 94-419, title VII, Sec. 742, 743, Sept. 22, 1976, 90

Stat. 1298.

Pub. L. 94-212, title VII, Sec. 750, 751, Feb. 9, 1976, 90 Stat.

176.

Provisions similar to those added to subsec. (h)(2) of this

section by section 1401(e)(4)(B) of Pub. L. 98-525 were contained

in the following prior appropriation acts:

Pub. L. 98-473, title I, Sec. 101(h) (title VIII, Sec. 8077),

Oct. 12, 1984, 98 Stat. 1904, 1938.

Pub. L. 98-212, title VII, Sec. 785, Dec. 8, 1983, 97 Stat. 1453.

A prior section 1079, act Aug. 10, 1956, ch. 1041, 70A Stat. 84,

related to establishment of right to vote, prior to repeal by Pub.

L. 85-861, Sec. 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded

by the Federal Voting Assistance Act of 1955 which is classified to

subchapter I-D (Sec. 1973cc et seq.) of chapter 20 of Title 42, The

Public Health and Welfare.

AMENDMENTS

2002 - Subsec. (i)(3). Pub. L. 107-314, Sec. 701(a), designated

existing provisions as subpar. (A), substituted ''Except as

provided in subparagraph (B),'' for ''Except in the case of an

emergency,'', and added subpars. (B) and (C).

Subsec. (p)(1). Pub. L. 107-314, Sec. 702(1), substituted

''dependents described in paragraph (3)'' for ''dependents referred

to in subsection (a) of a member of the uniformed services referred

to in section 1074(c)(3) of this title who are residing with the

member''.

Subsec. (p)(3), (4). Pub. L. 107-314, Sec. 702(2), (3), added

par. (3) and redesignated former par. (3) as (4).

Subsec. (q). Pub. L. 107-314, Sec. 705(a), added subsec. (q).

2001 - Subsec. (a)(5). Pub. L. 107-107, Sec. 703(b), amended par.

(5) generally. Prior to amendment, par. (5) read as follows:

''Durable equipment, such as wheelchairs, iron lungs and hospital

beds may be provided on a rental basis.''

Subsec. (a)(17). Pub. L. 107-107, Sec. 701(g)(2), struck out par.

(17) which read as follows:

''(17)(A) The Secretary of Defense may establish a program for

the individual case management of a person covered by this section

or section 1086 of this title who has extraordinary medical or

psychological disorders and, under such a program, may waive

benefit limitations contained in paragraphs (5) and (13) of this

subsection or section 1077(b)(1) of this title and authorize the

payment for comprehensive home health care services, supplies, and

equipment if the Secretary determines that such a waiver is

cost-effective and appropriate.

''(B) The total amount expended under subparagraph (A) for a

fiscal year may not exceed $100,000,000.''

Subsec. (d) to (f). Pub. L. 107-107, Sec. 701(b), added subsecs.

(d) to (f) and struck out former subsecs. (d) to (f) which related

to medical care provided for retarded or handicapped dependents,

the requirement of members sharing in cost of benefits provided,

and the requirement that members use public facilities to the

extent available and adequate, respectively.

Subsec. (h)(2). Pub. L. 107-107, Sec. 1048(c)(5), substituted

''February 10, 1996,'' for ''the date of the enactment of this

paragraph''.

Subsec. (h)(4). Pub. L. 107-107, Sec. 707(b), designated existing

provisions as subpar. (A) and added subpar. (B).

Subsec. (j)(2) to (4). Pub. L. 107-107, Sec. 707(a), designated

existing provisions of subpar. (A) of par. (2) as par. (2) and

substituted ''shall be determined under joint regulations'' for

''may be determined under joint regulations'', redesignated subpar.

(B) of par. (2) as par. (4) and substituted therein ''this

subsection,'' for ''subparagraph (A),'', and added par. (3).

2000 - Subsec. (a)(17). Pub. L. 106-398, Sec. 1 ((div. A), title

VII, Sec. 701(c)(1)), designated existing provisions as subpar. (A)

and added subpar. (B).

Subsec. (g). Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec.

704(b)), substituted ''three-year period'' for ''one-year period''.

Subsec. (h)(5). Pub. L. 106-398, Sec. 1 ((div. A), title VII,

Sec. 757(a)), added par. (5).

Subsec. (p). Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec.

722(b)(1)), added subsec. (p).

1997 - Subsec. (h)(1). Pub. L. 105-85, Sec. 735(a), added par.

(1) and struck out former par. (1) which read as follows: ''Payment

for a charge for services by an individual health care professional

(or other noninstitutional health care provider) for which a claim

is submitted under a plan contracted for under subsection (a) may

not exceed the lesser of -

''(A) the amount equivalent to the 80th percentile of billed

charges made for similar services in the same locality during the

base period; or

''(B) an amount determined to be appropriate, to the extent

practicable, in accordance with the same reimbursement rules as

apply to payments for similar services under title XVIII of the

Social Security Act (42 U.S.C. 1395 et seq.).''

Subsec. (h)(2). Pub. L. 105-85, Sec. 735(c)(2), redesignated par.

(4) as (2).

Pub. L. 105-85, Sec. 735(a), struck out par. (2) which read as

follows: ''For the purposes of paragraph (1)(A), the 80th

percentile of charges shall be determined by the Secretary of

Defense, in consultation with the other administering Secretaries,

and the base period shall be a period of twelve calendar months.

The Secretary of Defense shall adjust the base period as frequently

as he considers appropriate.''

Subsec. (h)(3). Pub. L. 105-85, Sec. 735(c)(2), redesignated par.

(5) as (3).

Pub. L. 105-85, Sec. 735(a), struck out par. (3) which read as

follows: ''For the purposes of paragraph (1)(B), the appropriate

payment amount shall be determined by the Secretary of Defense, in

consultation with the other administering Secretaries.''

Subsec. (h)(4). Pub. L. 105-85, Sec. 735(c)(2), redesignated par.

(4) as (2).

Subsec. (h)(5). Pub. L. 105-85, Sec. 735(c)(2), redesignated par.

(5) as (3).

Pub. L. 105-85, Sec. 735(b), (c)(1), substituted ''paragraph (2),

the Secretary of Defense'' for ''paragraph (4), the Secretary'' and

inserted at end ''With the consent of the health care provider, the

Secretary is also authorized to reduce the authorized payment for

certain health care services below the amount otherwise required by

the payment limitations under paragraph (1).''

Subsec. (h)(6). Pub. L. 105-85, Sec. 735(c)(2), redesignated par.

(6) as (4).

1996 - Subsec. (a). Pub. L. 104-201, Sec. 731(b)(1), substituted

''except as follows:'' for ''except that - '' in introductory

provisions.

Subsec. (a)(1). Pub. L. 104-201, Sec. 731(b)(2), (3), capitalized

first letter of first word and substituted a period for the

semicolon at end.

Subsec. (a)(2). Pub. L. 104-201, Sec. 731(b)(2), (3), capitalized

first letter of first word and substituted a period for the

semicolon at end.

Pub. L. 104-201, Sec. 701(b)(2), inserted ''the schedule and

method of colon and prostate cancer screenings,'' after ''pap

smears and mammograms,'' in introductory provisions and ''or colon

and prostate cancer screenings'' after ''pap smears and

mammograms'' in subpar. (B).

Pub. L. 104-106, Sec. 701, added par. (2) and struck out former

par. (2) which read as follows: ''routine physical examinations and

immunizations of dependents over two years of age may only be

provided when required in the case of dependents who are traveling

outside the United States as a result of a member's duty assignment

and such travel is being performed under orders issued by a

uniformed service, except that pap smears and mammograms may be

provided on a diagnostic or preventive basis;''.

Subsec. (a)(3) to (12). Pub. L. 104-201, Sec. 731(b)(2), (3),

capitalized first letter of first word and substituted a period for

the semicolon at end.

Subsec. (a)(13). Pub. L. 104-201, Sec. 731(a), (b)(2),

substituted ''Any service'' for ''any service'' and ''paragraph

(4).'' for ''paragraph (4);'' and inserted at end ''Pursuant to an

agreement with the Secretary of Health and Human Services and under

such regulations as the Secretary of Defense may prescribe, the

Secretary of Defense may waive the operation of this paragraph in

connection with clinical trials sponsored or approved by the

National Institutes of Health if the Secretary of Defense

determines that such a waiver will promote access by covered

beneficiaries to promising new treatments and contribute to the

development of such treatments.''

Subsec. (a)(14), (15). Pub. L. 104-201, Sec. 731(b)(2), (3),

capitalized first letter of first word and substituted a period for

the semicolon at end.

Subsec. (a)(16). Pub. L. 104-201, Sec. 731(b)(2), (4),

capitalized first letter of first word and substituted a period for

''; and'' at end.

Subsec. (a)(17). Pub. L. 104-201, Sec. 731(b)(2), capitalized

first letter of first word.

Subsec. (h)(1). Pub. L. 104-106, Sec. 731(a), added par. (1) and

struck out former par. (1) which read as follows: ''Payment for a

charge for services by an individual health-care professional (or

other noninstitutional health-care provider) for which a claim is

submitted under a plan contracted for under subsection (a) may be

denied only to the extent that the charge exceeds the amount

equivalent to the 80th percentile of billed charges made for

similar services in the same locality during the base period.''

Subsec. (h)(2). Pub. L. 104-106, Sec. 731(d), substituted

''paragraph (1)(A)'' for ''paragraph (1)''.

Subsec. (h)(3). Pub. L. 104-106, Sec. 731(b), added par. (3).

Subsec. (h)(4). Pub. L. 104-201, Sec. 711, struck out

''emergency'' before ''services from nonparticipating providers.''

Pub. L. 104-106, Sec. 731(c), added par. (4).

Subsec. (h)(5). Pub. L. 104-201, Sec. 732(2), added par. (5).

Former par. (5) redesignated (6).

Pub. L. 104-106, Sec. 731(c), added par. (5).

Subsec. (h)(6). Pub. L. 104-201, Sec. 732(1), redesignated par.

(5) as (6).

Subsec. (j)(1). Pub. L. 104-201, Sec. 735(c), inserted '',

including any plan offered by a third-party payer (as defined in

section 1095(h)(1) of this title),'' after ''or health plan''.

1994 - Subsec. (a). Pub. L. 103-337, Sec. 702(a)(1), substituted

''dependents, as described in subparagraphs (A), (D), and (I) of

section 1072(2) of this title,'' for ''spouses and children''.

Subsec. (d). Pub. L. 103-337, Sec. 702(a)(2), substituted ''as

described in subparagraph (A), (D), or (I) of section 1072(2)'' for

''as defined in section 1072(2)(A) or (D)''.

Subsec. (g). Pub. L. 103-337, Sec. 707(a), inserted at end ''In

addition, when a member dies while on active duty for a period of

more than 30 days, the member's dependents who are receiving

benefits under a plan covered by subsection (a) shall continue to

be eligible for such benefits during the one-year period beginning

on the date of the death of the member.''

1993 - Subsec. (a)(7). Pub. L. 103-160, Sec. 716(c), substituted

''except that those services may be provided in any case in which

another insurance plan or program provides primary coverage for

those services;'' for ''except that -

''(A) those services may be provided in any case in which

another insurance plan or program provides primary coverage for

those services; and

''(B) the Secretary of Defense may waive the 40-mile radius

restriction with regard to the provision of a particular service

before October 1, 1993, if the Secretary determines that the use

of a different geographical area restriction will result in a

more cost-effective provision of the service;''.

Subsec. (a)(15). Pub. L. 103-35 made technical amendment to

directory language of Pub. L. 102-484, Sec. 704(1). See 1992

Amendment note below.

Subsec. (o). Pub. L. 103-160, Sec. 711, added subsec. (o).

1992 - Subsec. (a)(15). Pub. L. 102-484, Sec. 1053(3), made

technical amendment to directory language of Pub. L. 102-190, Sec.

702(b)(1)(C). See 1991 Amendment note below.

Pub. L. 102-484, Sec. 704(1), as amended by Pub. L. 103-35,

struck out ''and'' at end of par. (15).

Subsec. (a)(16). Pub. L. 102-484, Sec. 704(2), substituted '';

and'' for period at end.

Subsec. (a)(17). Pub. L. 102-484, Sec. 704(3), added par. (17).

Subsec. (j)(2)(B). Pub. L. 102-484, Sec. 1052(13), inserted a

close parenthesis after ''1395x(dd)(2)''.

1991 - Subsec. (a)(6). Pub. L. 102-25, Sec. 316(b), revived par.

(6) as in effect on Feb. 14, 1991, thus negating amendment to par.

(6) by Pub. L. 101-510, Sec. 703(a), from its original effective

date (Feb. 15, 1991) to the effective date as amended (Oct. 1,

1991). See 1990 Amendment note and Effective Date of 1990 Amendment

note below.

Subsec. (a)(7). Pub. L. 102-190, Sec. 711, substituted ''except

that - '' and subpars. (A) and (B), for ''except that such services

may be provided in any case in which another insurance plan or

program provides primary coverage for the services;''.

Subsec. (a)(13). Pub. L. 102-190, Sec. 702(b)(1)(A), substituted

''paragraph (4)'' for ''clause (4)''.

Subsec. (a)(14). Pub. L. 102-190, Sec. 702(b)(1)(B), struck out

''and'' at end.

Subsec. (a)(15). Pub. L. 102-190, Sec. 702(b)(1)(C), as amended

by Pub. L. 102-484, Sec. 1053(3), substituted ''; and'' for period

at end.

Subsec. (a)(16). Pub. L. 102-190, Sec. 702(b)(1)(D), added par.

(16).

Subsec. (i). Pub. L. 102-25, Sec. 316(b), revived subsec. (i) as

in effect on Feb. 14, 1991, thus negating amendment to subsec. (i)

by Pub. L. 101-510, Sec. 703(b), from its original effective date

(Feb. 15, 1991) to the effective date as amended (Oct. 1, 1991).

See 1990 Amendment note and Effective Date of 1990 Amendment note

below.

Subsec. (j)(1). Pub. L. 102-190, Sec. 713, inserted '', or

covered by,'' after ''person enrolled in''.

Subsec. (j)(2)(B). Pub. L. 102-190, Sec. 702(b)(2), inserted

''hospice program (as defined in section 1861(dd)(2) of the Social

Security Act (42 U.S.C. 1395x(dd)(2)),''.

Subsec. (n). Pub. L. 102-190, Sec. 712(a), added subsec. (n).

1990 - Subsec. (a)(2). Pub. L. 101-510, Sec. 701(a), inserted

before the semicolon '', except that pap smears and mammograms may

be provided on a diagnostic or preventive basis''.

Subsec. (a)(6). Pub. L. 101-510, Sec. 703(a), substituted ''in

excess of - '' for ''in excess of 60 days in any year;'' and added

subpars. (A) to (C).

Subsec. (a)(8). Pub. L. 101-510, Sec. 702(a)(1), inserted

''(other than certified marriage and family therapists)'' after

''marital counselors'' and inserted before semicolon ''and services

of certified marriage and family therapists may be provided

consistent with such rules as may be prescribed by the Secretary of

Defense, including credentialing criteria and a requirement that

the therapists accept payment under this section as full payment

for all services provided''.

Subsec. (a)(13). Pub. L. 101-510, Sec. 702(a)(2), inserted

''certified marriage and family therapist,'' after

''psychologist,''.

Subsec. (b)(2). Pub. L. 101-510, Sec. 712(a)(1), substituted

''$150'' for ''$50'' and inserted at end ''Notwithstanding the

preceding sentence, in the case of a dependent of an enlisted

member in a pay grade below E-5, the initial deductible each fiscal

year under this paragraph shall be limited to $50.''

Subsec. (b)(3). Pub. L. 101-510, Sec. 712(a)(2), substituted

''$300 (or in the case of the family group of an enlisted member in

a pay grade below E-5, the first $100)'' for ''$100''.

Subsec. (i). Pub. L. 101-510, Sec. 703(b), amended subsec. (i)

generally. Prior to amendment, subsec. (i) read as follows: ''The

limitation in subsection (a)(6) does not apply in the case of

inpatient mental health services -

''(1) provided under the program for the handicapped under

subsection (d);

''(2) provided as residential treatment care;

''(3) provided as partial hospital care; or

''(4) provided pursuant to a waiver authorized by the Secretary

of Defense because of extraordinary medical or psychological

circumstances that are confirmed by review by a non-Federal

health professional pursuant to regulations prescribed by the

Secretary of Defense.''

Subsec. (j)(2)(B). Pub. L. 101-510, Sec. 1484(g)(1), inserted

''the term'' after ''In subparagraph (A),''.

1989 - Subsec. (h)(1), (2). Pub. L. 101-189 substituted ''80th

percentile'' for ''90th percentile''.

1988 - Subsec. (b)(1). Pub. L. 100-456, Sec. 646(a)(1), inserted

provisions authorizing Secretary of Defense to exempt a patient

from paying such amount if the hospital to which the patient is

admitted does not impose a legal obligation on any of its patients

to pay for inpatient care.

Subsec. (m). Pub. L. 100-456, Sec. 646(a)(2), added subsec. (m).

1987 - Subsec. (a)(15). Pub. L. 100-180, Sec. 726(a), added par.

(15).

Subsec. (b)(5). Pub. L. 100-180, Sec. 721(a), added par. (5).

1986 - Subsec. (a)(7). Pub. L. 99-661, Sec. 703, substituted

''provides primary coverage for the services'' for ''pays for at

least 75 percent of the services''.

Subsec. (l). Pub. L. 99-661, Sec. 652(d), added subsec. (l).

1984 - Subsec. (a). Pub. L. 98-557, Sec. 19(7)(B), substituted

reference to other administering Secretaries for reference to

Secretary of Health and Human Services in provisions preceding cl.

(1).

Subsec. (a)(3). Pub. L. 98-525, Sec. 632(a)(1), substituted ''not

more than one eye examination may be provided to a patient in any

calendar year'' for ''eye examinations may not be provided''.

Subsec. (a)(4). Pub. L. 98-557, Sec. 19(7)(A), substituted

reference to the administering Secretaries for reference to the

Secretary of Defense and the Secretary of Health and Human

Services.

Subsec. (a)(7) to (14). Pub. L. 98-525, Sec. 1401(e)(4)(A), added

cls. (7) to (14).

Subsecs. (b)(4), (c), (d). Pub. L. 98-557, Sec. 19(7)(A),

substituted reference to the administering Secretaries for

reference to the Secretary of Defense and the Secretary of Health

and Human Services.

Subsec. (e). Pub. L. 98-525, Sec. 1405(23), substituted ''under

subsection (d) as follows:'' for ''under subsection (d).'' in

provisions preceding cl. (1).

Subsecs. (e)(1), (f). Pub. L. 98-557, Sec. 19(7)(A), substituted

reference to the administering Secretaries for reference to the

Secretary of Defense and the Secretary of Health and Human

Services.

Subsec. (h)(2). Pub. L. 98-557, Sec. 19(7)(B), substituted

reference to other administering Secretaries for reference to

Secretary of Health and Human Services.

Pub. L. 98-525, Sec. 1401(e)(4)(B), substituted ''The Secretary

of Defense shall adjust the base period as frequently as he

considers appropriate'' for ''The base period shall be adjusted at

least once a year''.

Subsec. (j)(2)(A). Pub. L. 98-557, Sec. 19(7)(A), substituted

reference to the administering Secretaries for reference to the

Secretary of Defense and the Secretary of Health and Human

Services.

Subsec. (k)(1), (2). Pub. L. 98-557, Sec. 19(7)(B), substituted

reference to other administering Secretaries for reference to

Secretary of Health and Human Services.

1983 - Subsec. (a). Pub. L. 98-94, Sec. 1268(4)(A), substituted

''30'' for ''thirty'' in provisions preceding par. (1).

Subsec. (a)(6). Pub. L. 98-94, Sec. 931(a)(1), added par. (6).

Subsec. (d). Pub. L. 98-94, Sec. 1268(4)(A), substituted ''30''

for ''thirty''.

Subsec. (g). Pub. L. 98-94, Sec. 1268(4)(B), struck out ''of this

section'' after ''subsection (d)''.

Subsecs. (i) to (k). Pub. L. 98-94, Sec. 931(a)(2), added

subsecs. (i) to (k).

1981 - Subsec. (b)(4). Pub. L. 97-22 substituted ''Secretary of

Health and Human Services'' for ''Secretary of Health, Education,

and Welfare''.

Subsec. (h). Pub. L. 97-86 substituted reference to services of

individual health-care professionals for former reference to

physician services, struck out provisions that had used the concept

of a predetermined charge level based upon customary charges, and

inserted provisions requiring a readjustment of the base period at

least once a year.

1980 - Subsec. (a). Pub. L. 96-513, Sec. 511(36), (38)(A),

substituted ''Secretary of Health and Human Services'' for

''Secretary of Health, Education, and Welfare'' wherever appearing,

and ''that - '' for ''that:''.

Subsec. (a)(2). Pub. L. 96-342, Sec. 810(a)(1), inserted ''of

dependents over two years of age'' after ''immunizations''.

Subsec. (a)(3). Pub. L. 96-342, Sec. 810(a)(2), struck out

''routine care of the newborn, well-baby care, and'' after ''(3)''.

Subsec. (b)(4). Pub. L. 96-552 added par. (4).

Pub. L. 96-513, Sec. 511(38)(B), substituted ''percent'' for

''per centum'' wherever appearing.

Subsec. (c). Pub. L. 96-513, Sec. 511(36), substituted

''Secretary of Health and Human Services'' for ''Secretary of

Health, Education, and Welfare''.

Subsec. (d). Pub. L. 96-513, Sec. 501(13), 511(36), substituted

''section 1072(2)(A) or (D) of this title'' for ''section

1072(2)(A), (C), or (E) of this title'', and ''Secretary of Health

and Human Services'' for ''Secretary of Health, Education, and

Welfare''.

Subsec. (e). Pub. L. 96-513, Sec. 511(36), (38)(C), substituted

''Secretary of Health and Human Services'' for ''Secretary of

Health, Education, and Welfare'', and ''(d) as follows:'' for

''(d).''.

Subsec. (e)(2). Pub. L. 96-342, Sec. 810(b), substituted

''$1,000'' for ''$350''.

Subsec. (f). Pub. L. 96-513, Sec. 511(36), substituted

''Secretary of Health and Human Services'' for ''Secretary of

Health, Education, and Welfare''.

Subsec. (g). Pub. L. 96-513, Sec. 511(38)(D), struck out '',

United States Code,'' after ''37''.

Subsec. (h). Pub. L. 96-513, Sec. 511(36), substituted

''Secretary of Health and Human Services'' for ''Secretary of

Health, Education, and Welfare''.

1978 - Subsec. (h). Pub. L. 95-485 added subsec. (h).

1971 - Subsec. (g). Pub. L. 92-58 added subsec. (g).

1966 - Subsec. (a). Pub. L. 89-614 struck out ''dependent''

before ''spouses and children'' and substituted sentence providing

that ''The types of health care authorized under this section,

shall be the same as those provided under section 1076 of this

title'', enumerating exceptions in pars. (1) to (5) for former

provisions which required the insurance, medical service, or health

plans to include (1) hospitalization in semiprivate rooms for not

more than 365 days for each admission, (2) medical and surgical

care incident to hospitalization, (3) obstetrical and maternity

service, including prenatal and postnatal care, (4) services of

physician or surgeon before or after hospitalization for bodily

injury or surgical operation, (5) diagnostic tests and services

incident to hospitalization, and (6) payments by patient of

hospital expenses, now incorporated in subsec. (b)(1).

Subsec. (b). Pub. L. 89-614 incorporated existing provisions of

subsec. (a)(6) in par. (1) and added pars. (2) and (3). Former

subsec. (b) authorized the Secretary of Defense to make variances

from subsec. (a) requirements as appropriate other than outpatient

care or care other than provided for in sections 1076 to 1078 of

this title.

Subsecs. (c) to (f). Pub. L. 89-614 added subsecs. (c) to (f).

EFFECTIVE DATE OF 2002 AMENDMENT

Pub. L. 107-314, div. A, title VII, Sec. 701(b), Dec. 2, 2002,

116 Stat. 2583, provided that: ''The amendments made by subsection

(a) (amending this section) shall take effect October 1, 2003.''

Pub. L. 107-314, div. A, title VII, Sec. 705(b), Dec. 2, 2002,

116 Stat. 2585, provided that: ''The amendment made by subsection

(a) (amending this section) shall apply with respect to any

contract under the TRICARE program entered into on or after the

date of the enactment of this Act (Dec. 2, 2002).''

EFFECTIVE DATE OF 2001 AMENDMENT

Pub. L. 107-107, div. A, title VII, Sec. 707(c), Dec. 28, 2001,

115 Stat. 1164, provided that: ''The amendments made by this

section (amending this section) shall take effect on the date that

is 90 days after the date of the enactment of this Act (Dec. 28,

2001).''

EFFECTIVE DATE OF 2000 AMENDMENT

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 701(c)(3)),

Oct. 30, 2000, 114 Stat. 1654, 1654A-172, provided that: ''The

amendments made by paragraphs (1) and (2) (amending this section

and provisions set out as a note under section 1077 of this title)

shall apply to fiscal years after fiscal year 1999.''

Amendment by section 1 ((div. A), title VII, Sec. 722(b)(1)) of

Pub. L. 106-398 effective Oct. 1, 2001, see section 1 ((div. A),

title VII, Sec. 722(c)(1)) of Pub. L. 106-398, set out as a note

under section 1074 of this title.

EFFECTIVE DATE OF 1994 AMENDMENT

Pub. L. 103-337, div. A, title VII, Sec. 707(c), Oct. 5, 1994,

108 Stat. 2801, provided that: ''The amendments made by subsections

(a) and (b) (amending this section and section 1076a of this title)

shall apply with respect to the dependents described in such

amendments of a member of a uniformed service who dies on or after

October 1, 1993, while on active duty for a period of more than 30

days.''

EFFECTIVE DATE OF 1993 AMENDMENT

Amendment by Pub. L. 103-35 applicable as if included in the

enactment of Pub. L. 102-484, see section 202(b) of Pub. L. 103-35,

set out as a note under section 155 of this title.

EFFECTIVE DATE OF 1992 AMENDMENT

Section 1053(3) of Pub. L. 102-484 provided that the amendment

made by that section is effective Dec. 5, 1991.

EFFECTIVE DATE OF 1991 AMENDMENT

Section 316(b) of Pub. L. 102-25 provided that the amendment made

by that section is effective Feb. 15, 1991.

EFFECTIVE DATE OF 1990 AMENDMENT

Section 701(b) of Pub. L. 101-510 provided that: ''The amendment

made by subsection (a) (amending this section) shall apply to the

provision of pap smears and mammograms under section 1079 or 1086

of title 10, United States Code, on or after the date of the

enactment of this Act (Nov. 5, 1990).''

Section 702(b) of Pub. L. 101-510 provided that: ''The amendments

made by subsection (a) (amending this section) shall apply with

respect to the services of certified marriage and family therapists

provided under section 1079 or 1086 of title 10, United States

Code, on or after the date of the enactment of this Act (Nov. 5,

1990).''

Section 703(d) of Pub. L. 101-510, as amended by Pub. L. 102-25,

title III, Sec. 316(a)(1), Apr. 6, 1991, 105 Stat. 87, provided

that: ''This section and the amendments made by this section

(amending this section) shall take effect on October 1, 1991, and

shall apply with respect to mental health services provided under

section 1079 or 1086 of title 10, United States Code, on or after

that date.''

Section 712(c) of Pub. L. 101-510 provided that: ''The amendments

made by this section (amending this section and section 1086 of

this title) shall apply with respect to health care provided under

sections 1079 and 1086 of title 10, United States Code, on or after

April 1, 1991.''

EFFECTIVE DATE OF 1989 AMENDMENT

Section 730(b) of Pub. L. 101-189 provided that: ''The amendment

made by subsection (a) (amending this section) shall apply to

services provided on or after October 1, 1989.''

EFFECTIVE DATE OF 1988 AMENDMENT

Section 646(c) of Pub. L. 100-456 provided that: ''The amendments

made by subsections (a) and (b) (amending this section and section

1086 of this title) shall apply with respect to medical care

received after September 30, 1988.''

EFFECTIVE DATE OF 1987 AMENDMENT

Section 721(c) of Pub. L. 100-180 provided that: ''Paragraph (5)

of section 1079(b) of title 10, United States Code, as added by

subsection (a), and paragraph (4) of section 1086(b) of such title,

as added by subsection (b), shall apply with respect to fiscal

years beginning after September 30, 1987.''

Section 726(b) of Pub. L. 100-180 provided that: ''Paragraph (15)

of section 1079(a) of such title, as added by subsection (a), shall

apply with respect to costs incurred for home monitoring equipment

after the date of the enactment of this Act (Dec. 4, 1987).''

EFFECTIVE DATE OF 1986 AMENDMENT

Section 652(e)(4) of Pub. L. 99-661 provided that: ''The

amendment made by subsection (d) (amending this section) shall

apply only with respect to care furnished under section 1079 of

title 10, United States Code, on or after the date of the enactment

of this Act (Nov. 14, 1986).''

EFFECTIVE DATE OF 1984 AMENDMENT

Section 632(a)(3) of Pub. L. 98-525 provided that: ''The

amendments made by this subsection (amending this section and

section 1086 of this title) shall apply only to health care

furnished after September 30, 1984.''

Amendment by section 1401(e)(4) of Pub. L. 98-525 effective Oct.

1, 1985, see section 1404 of Pub. L. 98-525, set out as an

Effective Date note under section 520b of this title.

EFFECTIVE DATE OF 1983 AMENDMENT

Section 931(c) of Pub. L. 98-94 provided that: ''The amendments

made by this section (amending this section and section 1086 of

this title) shall take effect on October 1, 1983, except that -

''(1) clause (6) of section 1079(a) of title 10, United States

Code, as added by subsection (a)(1), shall not apply in the case

of inpatient mental health services provided to a patient

admitted before January 1, 1983, for so long as that patient

remains continuously in inpatient status for medically or

psychologically necessary reasons; and

''(2) subsection (k) of section 1079 of such title, as added by

subsection (a)(1), shall apply with respect to liver transplant

operations performed on or after July 1, 1983.''

EFFECTIVE DATE OF 1981 AMENDMENT

Section 906(b) of Pub. L. 97-86 provided that: ''The amendments

made by subsection (a) (amending this section and section 1086 of

this title) shall apply with respect to claims submitted for

payment for services provided after the end of the 30-day period

beginning on the date of the enactment of this Act (Dec. 1,

1981).''

EFFECTIVE DATE OF 1980 AMENDMENTS

Amendment by section 501(13) of Pub. L. 96-513 effective Sept.

15, 1981, see section 701 of Pub. L. 96-513, set out as a note

under section 101 of this title.

Amendment by section 511 of Pub. L. 96-513 effective Dec. 12,

1980, see section 701(b)(3) of Pub. L. 96-513.

Section 810(c) of Pub. L. 96-342 provided that: ''The amendments

made by this section (amending this section) shall apply to medical

care provided after September 30, 1980.''

EFFECTIVE DATE OF 1978 AMENDMENT

Section 806(b) of Pub. L. 95-485 provided that: ''the amendments

made by subsection (a) (amending this section and section 1086 of

this title) shall apply with respect to claims submitted for

payment for services provided on or after the first day of the

first calendar year beginning after the date of enactment of this

Act (Oct. 20, 1978).''

EFFECTIVE DATE OF 1971 AMENDMENT

Section 2 of Pub. L. 92-58 provided that: ''This Act (amending

this section) becomes effective as of January 1, 1967. However, no

person is entitled to any benefits because of this Act for any

period before the date of enactment (July 29, 1971).''

EFFECTIVE DATE OF 1966 AMENDMENT

For effective date of amendment by Pub. L. 89-614, see section 3

of Pub. L. 89-614, set out as a note under section 1071 of this

title.

REPORT ON ACTIONS TO ESTABLISH SPECIAL REIMBURSEMENT RATES

Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 757(b)(1)),

Oct. 30, 2000, 114 Stat. 1654, 1654A-199, provided that: ''Not

later than March 31, 2001, the Secretary of Defense shall submit to

the Committees on Armed Services of the Senate and the House of

Representatives and the General Accounting Office a report on

actions taken to carry out section 1079(h)(5) of title 10, United

States Code (as added by subsection (a)) and section 1097b of such

title.''

PROGRAMS RELATING TO SALE OF PHARMACEUTICALS

Section 702 of Pub. L. 102-484, as amended by Pub. L. 103-160,

div. A, title VII, Sec. 721, Nov. 30, 1993, 107 Stat. 1695; Pub.

L. 103-337, div. A, title VII, Sec. 706, Oct. 5, 1994, 108 Stat.

2800; Pub. L. 106-398, Sec. 1 ((div. A), title VII, Sec. 711(b)),

Oct. 30, 2000, 114 Stat. 1654, 1654A-176, provided that:

''(a) Demonstration Project for Pharmaceuticals by Mail. - Not

later than 18 months after the date of the enactment of this Act

(Oct. 23, 1992), the Secretary of Defense, in consultation with the

administering Secretaries, shall -

''(1) establish a demonstration project that permits eligible

persons described in subsection (c) to obtain prescription

pharmaceuticals by mail in connection with medical care furnished

to such persons under chapter 55 of title 10, United States Code;

and

''(2) conduct the demonstration project in two or more regions

selected by the Secretary, each of which consists of two or more

States.

''(b) Retail Pharmacy Network. - To the maximum extent

practicable, the Secretary of Defense shall include in each managed

health care program initiated, awarded, or renewed by the Secretary

after January 1, 1993, a program to supply prescription

pharmaceuticals to eligible persons described in subsection (c)

through a managed care network of community retail pharmacies in

the area covered by the managed health care program.

''(c) Eligible Persons. - A person eligible to obtain

pharmaceuticals under the demonstration project established under

subsection (a) or the retail pharmacy network included in a managed

health care program under subsection (b) is any person living in

the area covered by the demonstration project or managed health

care program -

''(1) who is eligible for medical care under a contract for

medical care entered into by the Secretary of Defense under

section 1079 or 1086 of title 10, United States Code; or

''(2) who -

''(A) would be eligible for medical care under a contract for

medical care entered into under section 1086 of such title

except for operation of subsection (d)(1) of such section; and

''(B) either -

''(i) resides in an area that is adversely affected (as

determined by the Secretary) by the closure of a health care

facility of the uniformed services as a result of the closure

or realignment of the military installation at which such

facility is located; or

''(ii) can demonstrate to the satisfaction of the Secretary

that the person relied upon a health care facility referred

to in clause (i) before the closure of the facility to obtain

the person's pharmaceuticals.

''(d) Pharmaceuticals Offered; Purchase Fees. - (1) The Secretary

of Defense, in consultation with the administering Secretaries,

shall -

''(A) determine the pharmaceuticals that may be obtained by

eligible persons under the demonstration project established

under subsection (a) or the retail pharmacy network included in a

managed health care program under subsection (b); and

''(B) establish an appropriate fee, charge, or copayment to be

paid by such persons for pharmaceuticals obtained under the

demonstration project or managed health care program.

''(2) In the case of persons eligible to participate in the

demonstration project for pharmaceuticals or the retail pharmacy

network by reason of clause (ii) of subsection (c)(2)(B), the

Secretary of Defense may increase the fees, charges, and copayments

established under paragraph (1)(B) and otherwise applicable to such

persons by an amount necessary to cover any additional costs

incurred by the administering Secretaries as a result of making

pharmaceuticals available to such persons under this section.

''(e) Report Regarding Demonstration Project. - Not later than

two years after the establishment of the demonstration project

under subsection (a), the Secretary of Defense shall submit to

Congress a report -

''(1) describing the results of the demonstration project

required by subsection (a);

''(2) containing such recommendations for revision of the

demonstration project as the Secretary considers to be necessary;

and

''(3) containing a plan (including a schedule) for implementing

the demonstration project throughout the United States.

''(f) Additional Report Regarding Programs. - Not later than

January 1, 1994, the Secretary of Defense shall submit to Congress

a report containing -

''(1) an evaluation of the feasibility and advisability of

increasing the size of those areas determined by the Secretary

under subsection (c)(2) to be adversely affected by the closure

of a health care facility of the uniformed services in order to

increase the number of persons described in such subsection who

will be eligible to participate in the demonstration project for

pharmaceuticals by mail or in the retail pharmacy network under

this section;

''(2) an evaluation of the feasibility and advisability of

expanding the demonstration project and the retail pharmacy

network under this section to include all covered beneficiaries

under chapter 55 of title 10, United States Code, including those

persons currently excluded from participation in the Civilian

Health and Medical Program of the Uniformed Services by operation

of section 1086(d)(1) of such title;

''(3) an estimation of the costs that would be incurred, and

any savings that would be achieved by improving efficiencies of

operation, as a result of undertaking the increase or expansion

described in paragraph (1) or (2); and

''(4) such recommendations as the Secretary considers to be

appropriate.

''(g) Definitions. - In this section, the terms 'uniformed

services' and 'administering Secretaries' have the meanings given

those terms in section 1072 of title 10, United States Code.

''(h) Termination. - This section shall cease to apply to the

Secretary of Defense on the date after the implementation of

section 711 of the Floyd D. Spence National Defense Authorization

Act for Fiscal Year 2001 (section 1 ((div. A), title VII, Sec. 711)

of Pub. L. 106-398, amending this note and provisions set out as a

note under section 1073 of this title) that the Secretary

determines appropriate, with a view to minimizing instability with

respect to the provision of pharmacy benefits, but in no case later

than the date that is one year after the date of the enactment of

such Act (Oct. 30, 2000).''

CORRECTION OF OMISSION IN DELAY OF INCREASE OF CHAMPUS DEDUCTIBLES

RELATED TO OPERATION DESERT STORM

Section 721 of Pub. L. 102-484 provided that:

''(a) Lower CHAMPUS Annual Deductible. - In the case of health

care provided under section 1079 or 1086 of title 10, United States

Code, during the period beginning on April 1, 1991, and ending on

September 30, 1991, to a CHAMPUS beneficiary described in

subsection (b), the annual deductibles specified in such sections

applicable to that care may not exceed the annual deductibles in

effect under such sections on November 4, 1990.

''(b) Eligible CHAMPUS Beneficiaries. - A CHAMPUS beneficiary

referred to in subsection (a) is a covered beneficiary of the

Civilian Health and Medical Program of the Uniformed Services who,

during any portion of the period specified in that subsection -

''(1) was a member or former member of a uniformed service

entitled to retired or retainer pay and served on active duty in

the Persian Gulf theater of operations in connection with

Operation Desert Storm; or

''(2) was a dependent of a member of a uniformed service who

served on active duty in the Persian Gulf theater of operations

in connection with Operation Desert Storm.

''(c) Credit or Reimbursement of Excess. - Subject to the

availability of appropriated funds to the Secretary of Defense, the

Secretary shall provide -

''(1) for the reimbursement of the amount of any deductible

paid under section 1079 or 1086 of title 10, United States Code,

during the period specified in subsection (a) in excess of the

amount required to be paid by operation of that subsection; or

''(2) for a credit against the annual deductible required under

such sections for a fiscal year equal to the amount of the excess

deductible paid.

''(d) Definitions. - For purposes of this section, the term

'Operation Desert Storm' has the meaning given that term in section

3(1) of the Persian Gulf Conflict Supplemental Authorization and

Personnel Benefits Act of 1991 (Public Law 102-25; 10 U.S.C. 101

note).''

TEMPORARY CHAMPUS PROVISIONS FOR DEPENDENTS OF OPERATION DESERT

SHIELD/DESERT STORM ACTIVE DUTY PERSONNEL

Pub. L. 102-172, title VIII, Sec. 8085, Nov. 26, 1991, 105 Stat.

1192, provided that: ''Any CHAMPUS (Civilian Health and Medical

Program of the Uniformed Services) health care provider may

voluntarily waive the patient copayment for medical services

provided from August 2, 1990, until the termination of Operation

Desert Shield/Desert Storm for dependents of active duty personnel:

Provided, That the Government's share of medical services is not

increased during the specified time period.''

Similar provisions were contained in Pub. L. 102-28, Sec. 105,

Apr. 10, 1991, 105 Stat. 165.

Section 312 of Pub. L. 102-25 provided that:

''(a) Delay in the Increase of Annual Deductibles under CHAMPUS.

- The annual deductibles specified in subsection (b) of section

1079 of title 10, United States Code (as in effect on November 4,

1990), shall apply until October 1, 1991, in the case of health

care provided under that section to the dependents of a member of

the uniformed services who serves or served on active duty in the

Persian Gulf theater of operations in connection with Operation

Desert Storm.

''(b) Waiver of Copayment Requirements. - (1) Any civilian health

care provider furnishing health care pursuant to a plan contracted

for under the authority of section 1079 or 1086 of title 10, United

States Code, may waive, in whole or in part, any requirement for

payment under subsection (b) of that section by a patient described

in paragraph (2) for health care furnished the patient by such

health care provider during the Persian Gulf conflict.

''(2) A patient referred to in paragraph (1) is a dependent of a

member of the uniformed services who serves on active duty in the

Persian Gulf theater of operations in connection with Operation

Desert Storm.

''(3) If a health care provider waives a payment for health care

under paragraph (1), the health care provider shall certify to the

Secretary of Defense that the amount charged the Federal Government

for such health care was not increased above the amount that the

health care provider would have charged the Federal Government for

such health care had the payment not been waived. The Secretary of

Defense may require a health care provider to provide information

to the Secretary to show the compliance of the health care provider

with this paragraph.''

TRANSITIONAL HEALTH CARE FOR MEMBERS, OR DEPENDENTS OF MEMBERS,

UPON RELEASE OF MEMBER FROM ACTIVE DUTY IN CONNECTION WITH

OPERATION DESERT STORM

For provision authorizing transitional health care, including

health benefits contracted for under subsec. (a) of this section,

for members, or dependents of members, upon release of member from

active duty in connection with Operation Desert Storm, see section

313 of Pub. L. 102-25, set out as a note under section 1076 of this

title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1072, 1074g, 1074j, 1077,

1080, 1081, 1082, 1083, 1086, 1086a, 1095, 1096, 1097b, 1098, 1100,

1104, 1105, 1145 of this title; title 42 sections 300e-1, 1395cc.

-CITE-

10 USC Sec. 1079a 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1079a. CHAMPUS: treatment of refunds and other amounts

collected

-STATUTE-

All refunds and other amounts collected in the administration of

the Civilian Health and Medical Program of the Uniformed Services

shall be credited to the appropriation available for that program

for the fiscal year in which the refund or amount is collected.

-SOURCE-

(Added Pub. L. 104-201, div. A, title VII, Sec. 733(a)(1), Sept.

23, 1996, 110 Stat. 2597.)

-MISC1-

PRIOR PROVISIONS

Provisions similar to those in this section were contained in the

following appropriations acts:

Pub. L. 104-61, title VIII, Sec. 8094, Dec. 1, 1995, 109 Stat.

671.

Pub. L. 103-335, title VIII, Sec. 8144, Sept. 30, 1994, 108 Stat.

2656.

-CITE-

10 USC Sec. 1079b 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1079b. Procedures for charging fees for care provided to

civilians; retention and use of fees collected

-STATUTE-

(a) Requirement To Implement Procedures. - The Secretary of

Defense shall implement procedures under which a military medical

treatment facility may charge civilians who are not covered

beneficiaries (or their insurers) fees representing the costs, as

determined by the Secretary, of trauma and other medical care

provided to such civilians.

(b) Use of Fees Collected. - A military medical treatment

facility may retain and use the amounts collected under subsection

(a) for -

(1) trauma consortium activities;

(2) administrative, operating, and equipment costs; and

(3) readiness training.

-SOURCE-

(Added Pub. L. 107-107, div. A, title VII, Sec. 732(a)(1), Dec.

28, 2001, 115 Stat. 1169.)

-MISC1-

DEADLINE FOR IMPLEMENTATION

Pub. L. 107-107, div. A, title VII, Sec. 732(b), Dec. 28, 2001,

115 Stat. 1170, provided that: ''The Secretary of Defense shall

begin to implement the procedures required by section 1079b(a) of

title 10, United States Code (as added by subsection (a)), not

later than one year after the date of the enactment of this Act

(Dec. 28, 2001).''

-CITE-

10 USC Sec. 1080 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1080. Contracts for medical care for spouses and children:

election of facilities

-STATUTE-

(a) Election. - A dependent covered by section 1079 of this title

may elect to receive inpatient medical care either in (1) the

facilities of the uniformed services, under the conditions

prescribed by sections 1076-1078 of this title, or (2) the

facilities provided under a plan contracted for under section 1079

of this title. However, under such regulations as the Secretary of

Defense, after consulting the other administering Secretaries, may

prescribe, the right to make this election may be limited for

dependents residing in the area where the member concerned is

assigned, if adequate medical facilities of the uniformed services

are available in that area for those dependents.

(b) Issuance of Nonavailability-of-Health-Care Statements. - In

determining whether to issue a nonavailability-of-health-care

statement for a dependent described in subsection (a), the

commanding officer of a facility of the uniformed services may

consider the availability of health care services for the dependent

pursuant to any contract or agreement entered into under this

chapter for the provision of health care services. Notwithstanding

any other provision of law, with respect to obstetrics and

gynecological care for beneficiaries not enrolled in a managed care

plan offered pursuant to any contract or agreement under this

chapter, a nonavailability-of-health-care statement shall be

required for receipt of health care services related to outpatient

prenatal, outpatient or inpatient delivery, and outpatient

post-partum care subsequent to the visit which confirms the

pregnancy.

(c) Waivers and Exceptions to Requirements. - (1) A covered

beneficiary enrolled in a managed care plan offered pursuant to any

contract or agreement under this chapter for the provision of

health care services shall not be required to obtain a

nonavailability-of-health-care statement as a condition for the

receipt of health care.

(2) The Secretary of Defense may waive the requirement to obtain

nonavailability-of-health-care statements following an evaluation

of the effectiveness of such statements in optimizing the use of

facilities of the uniformed services.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1449;

amended Pub. L. 96-513, title V, Sec. 511(36), Dec. 12, 1980, 94

Stat. 2923; Pub. L. 98-557, Sec. 19(8), Oct. 30, 1984, 98 Stat.

2870; Pub. L. 103-160, div. A, title VII, Sec. 716(b)(1), Nov. 30,

1993, 107 Stat. 1692; Pub. L. 104-201, div. A, title VII, Sec.

734(a)(1), (b)(1), (c), Sept. 23, 1996, 110 Stat. 2598; Pub. L.

106-65, div. A, title VII, Sec. 712(c), Oct. 5, 1999, 113 Stat.

687.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1080 37:411(c). June 7, 1956, ch.

374, Sec. 201(c),

70 Stat. 252.

-------------------------------

The words ''a plan contracted for under section 1079 of this

title'' are substituted for the words ''such insurance, medical

service, or health plan or plans as may be provided by the

authority contained in this section''. The words ''under the terms

of this chapter'' are omitted as surplusage.

PRIOR PROVISIONS

A prior section 1080, act Aug. 10, 1956, ch. 1041, 70A Stat. 85,

related to style and marking of envelopes, inserts, return

envelopes, and to weight of ballots, prior to repeal by Pub. L.

85-861, Sec. 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by

the Federal Voting Assistance Act of 1955 which is classified to

subchapter I-D (Sec. 1973cc et seq.) of chapter 20 of Title 42, The

Public Health and Welfare.

AMENDMENTS

1999 - Subsec. (b). Pub. L. 106-65 inserted at end

''Notwithstanding any other provision of law, with respect to

obstetrics and gynecological care for beneficiaries not enrolled in

a managed care plan offered pursuant to any contract or agreement

under this chapter, a nonavailability-of-health-care statement

shall be required for receipt of health care services related to

outpatient prenatal, outpatient or inpatient delivery, and

outpatient post-partum care subsequent to the visit which confirms

the pregnancy.''

1996 - Subsec. (a). Pub. L. 104-201, Sec. 734(a)(1), inserted

''inpatient'' before ''medical care'' in first sentence.

Subsec. (b). Pub. L. 104-201, Sec. 734(c), substituted

''Nonavailability-of-Health-Care Statements'' for ''Nonavailability

of Health Care Statements'' in heading and

''nonavailability-of-health-care statement'' for ''nonavailability

of health care statement'' in text.

Subsec. (c). Pub. L. 104-201, Sec. 734(b)(1), added subsec. (c).

1993 - Pub. L. 103-160 designated existing provisions as subsec.

(a), inserted heading, and added subsec. (b).

1984 - Pub. L. 98-557 substituted reference to administering

Secretaries for reference to Secretary of Health and Human

Services.

1980 - Pub. L. 96-513 substituted ''Secretary of Health and Human

Services'' for ''Secretary of Health, Education, and Welfare''.

EFFECTIVE DATE OF 1980 AMENDMENT

Amendment by Pub. L. 96-513 effective Dec. 12, 1980, see section

701(b)(3) of Pub. L. 96-513, set out as a note under section 101 of

this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1082, 1086 of this title.

-CITE-

10 USC Sec. 1081 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1081. Contracts for medical care for spouses and children:

review and adjustment of payments

-STATUTE-

Each plan under section 1079 of this title shall provide for a

review, and if necessary an adjustment of payments, by the

appropriate administering Secretary, not later than 120 days after

the close of each year the plan is in effect.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1449;

amended Pub. L. 96-513, title V, Sec. 511(36), Dec. 12, 1980, 94

Stat. 2923; Pub. L. 97-375, title I, Sec. 104(a), Dec. 21, 1982, 96

Stat. 1819; Pub. L. 98-94, title XII, Sec. 1268(5)(A), Sept. 24,

1983, 97 Stat. 706; Pub. L. 98-557, Sec. 19(9), Oct. 30, 1984, 98

Stat. 2870.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1081 37:412. June 7, 1956, ch.

374, Sec. 202, 70

Stat. 253.

-------------------------------

The words ''Each plan under section 1079 of this title'' are

substituted for the words ''Any insurance, medical service, or

health plan or plans which may be entered into by the Secretary of

Defense with respect to medical care under the provisions of this

chapter''. The words ''after the close of each year the plan is in

effect'' are substituted for the words ''after the first year the

plan or plans have been in effect and each year thereafter''. The

words ''Not later than'' are substituted for the word ''within''.

PRIOR PROVISIONS

A prior section 1081, act Aug. 10, 1956, ch. 1041, 70A Stat. 86,

related to notification of elections, prior to repeal by Pub. L.

85-861, Sec. 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by

the Federal Voting Assistance Act of 1955 which is classified to

subchapter I-D (Sec. 1973cc et seq.) of chapter 20 of Title 42, The

Public Health and Welfare.

AMENDMENTS

1984 - Pub. L. 98-557 substituted reference to appropriate

administering Secretary for reference to Secretary of Defense and

Secretary of Health and Human Services.

1983 - Pub. L. 98-94 struck out ''; reports'' after ''adjustment

of payments'' in section catchline.

1982 - Pub. L. 97-375 struck out requirement that the Secretary

of Defense report to the Committees on Armed Services of the

Congress amounts paid and adjustments made during the year covered

by the review not later than 90 days after such review.

1980 - Pub. L. 96-513 substituted ''Secretary of Health and Human

Services'' for ''Secretary of Health, Education, and Welfare''.

EFFECTIVE DATE OF 1980 AMENDMENT

Amendment by Pub. L. 96-513 effective Dec. 12, 1980, see section

701(b)(3) of Pub. L. 96-513, set out as a note under section 101 of

this title.

-SECREF-

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 1082 of this title.

-CITE-

10 USC Sec. 1082 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1082. Contracts for health care: advisory committees

-STATUTE-

To carry out sections 1079-1081 and 1086 of this title, the

Secretary of Defense may establish advisory committees on

insurance, medical service, and health plans, to advise and make

recommendations to him. He shall prescribe regulations defining

their scope, activities, and procedures. Each committee shall

consist of the Secretary, or his designee, as chairman, and such

other persons as the Secretary may select. So far as possible, the

members shall be representative of the organizations in the field

of insurance, medical service, and health plans. They shall serve

without compensation but may be allowed transportation and a per

diem payment in place of subsistence and other expenses.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1449;

amended Pub. L. 89-614, Sec. 2(8), Sept. 30, 1966, 80 Stat. 866.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

---------------------------------------------------------------------

1082 37:413. June 7, 1956, ch.

374, Sec. 203, 70

Stat. 253.

-------------------------------

The word ''organizations'' is inserted for clarity. The words

''consult'' and ''or plans'' are omitted as surplusage.

PRIOR PROVISIONS

A prior section 1082, act Aug. 10, 1956, ch. 1041, 70A Stat. 87,

related to extension of time limit for making ballots available,

prior to repeal by Pub. L. 85-861, Sec. 36B(5), Sept. 2, 1958, 72

Stat. 1570, as superseded by the Federal Voting Assistance Act of

1955 which is classified to subchapter I-D (Sec. 1973cc et seq.) of

chapter 20 of Title 42, The Public Health and Welfare.

AMENDMENTS

1966 - Pub. L. 89-614 substituted ''Contracts for health care''

for ''Contracts for medical care for spouses and children'' in

section catchline and included reference to section 1086 in text.

EFFECTIVE DATE OF 1966 AMENDMENT

For effective date of amendment by Pub. L. 89-614, see section 3

of Pub. L. 89-614, set out as a note under section 1071 of this

title.

TERMINATION OF ADVISORY COMMITTEES

Advisory committees in existence on Jan. 5, 1973, to terminate

not later than the expiration of the 2-year period following Jan.

5, 1973, unless, in the case of a committee established by the

President or an officer of the Federal Government, such committee

is renewed by appropriate action prior to the expiration of such

2-year period, or in the case of a committee established by the

Congress, its duration is otherwise provided for by law. See

sections 3(2) and 14 of Pub. L. 92-463, Oct. 6, 1972, 86 Stat. 770,

776, set out in the Appendix to Title 5, Government Organization

and Employees.

-CITE-

10 USC Sec. 1083 01/06/03

-EXPCITE-

TITLE 10 - ARMED FORCES

Subtitle A - General Military Law

PART II - PERSONNEL

CHAPTER 55 - MEDICAL AND DENTAL CARE

-HEAD-

Sec. 1083. Contracts for medical care for spouses and children:

additional hospitalization

-STATUTE-

If a dependent covered by a plan under section 1079 of this title

needs hospitalization beyond the time limits in that plan, and if

the hospitalization is authorized in medical facilities of the

uniformed services, he may be transferred to such a facility for

additional hospitalization. If transfer is not feasible, the

expenses of additional hospitalization in the civilian facility may

be paid under such regulations as the Secretary of Defense may

prescribe after consulting the other administering Secretaries.

-SOURCE-

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1449;

amended Pub. L. 96-513, title V, Sec. 511(36), Dec. 12, 1980, 94

Stat. 2923; Pub. L. 98-557, Sec. 19(10), Oct. 30, 1984, 98 Stat.

2870.)

-MISC1-

Historical and Revision Notes

---------------------------------------------------------------------

Revised section Source (U.S. Code) Source (Statutes at

Large)

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1083 37:423. June 7, 1956, ch.

374, Sec. 303, 70

Stat. 254.

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The words ''dependent covered by a plan under section 1079 of

this title'' are substituted for the words ''person who is covered

under an insurance, medical service, or health plan or plans, as

provided in this chapter''. The words ''period of'', ''or plans'',

and ''required by such person in a civilian facility'' are omitted

as surplusage.

PRIOR PROVISIONS

A prior section 1083, act Aug. 10, 1956, ch. 1041, 70A Stat. 87,

related to transmission, delivery, and return of post cards,

ballots, etc., prior to repeal by Pub. L. 85-861, Sec. 36B(5),

Sept. 2, 1958, 72 Stat. 1570, as superseded by the Federal Voting

Assistance Act of 1955 which is classified to subchapter I-D (Sec.

1973cc et seq.) of chapter 20 of Title 42, The Public Health and

Welfare.

AMENDMENTS

1984 - Pub. L. 98-557 substituted reference to other

administe