Legislación
US (United States) Code. Title 10. Subtitle A. Part II. Chapter 55: Medical and dental care
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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
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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 Repealed.)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 Repealed.)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.
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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.)
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Historical and Revision Notes
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Revised section Source (U.S. Code) Source (Statutes at
Large)
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1071 37:401. June 7, 1956, ch.
374, Sec. 101, 70
Stat. 250.
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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
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''(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)
---------------------------------------------------------------------
1083 37:423. June 7, 1956, ch.
374, Sec. 303, 70
Stat. 254.
-------------------------------
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
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| Enviado por: | El remitente no desea revelar su nombre |
| Idioma: | inglés |
| País: | Estados Unidos |
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