I 

114TH CONGRESS 

2D SESSION H. R. 6076 

To require the Administrator of the National Aeronautics and Space Administration to establish a program for the medical monitoring, diagnosis, 

and treatment of astronauts, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 20, 2016 

Mr. BABIN (for himself, Ms. EDWARDS, Mr. SMITH of Texas, Ms. EDDIE

BERNICE JOHNSON of Texas, Mr. POSEY, Mr. BRIDENSTINE, and Mr. 

ABRAHAM) introduced the following bill; which was referred to the Committee on Science, Space, and Technology 

A BILL 

To require the Administrator of the National Aeronautics 

and Space Administration to establish a program for 

the medical monitoring, diagnosis, and treatment of astronauts, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘To Research, Evaluate, 

5 Assess, and Treat Astronauts Act’’ or the ‘‘TREAT Astro6 nauts Act’’. 


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1 SEC. 2. DEFINITIONS. 

2 In this Act: 

3 (1) ADMINISTRATOR.—The term ‘‘Adminis4 trator’’ means the Administrator of NASA. 

5 (2) CREWMEMBER.—The term ‘‘crewmember’’ 

6 means an individual certified by the Administrator 

7 to be— 

8 (A) a former NASA astronaut or payload 

9 specialist who has flown on at least one orbital 

10 space mission; or 

11 (B) a management NASA astronaut who 

12 has flown on at least one orbital space mission 

13 and is currently employed by the Federal Gov14 ernment. 

15 (3) NASA.—The term ‘‘NASA’’ means the Na16 tional Aeronautics and Space Administration. 

17 (4) PROGRAM.—The term ‘‘Program’’ means 

18 the medical monitoring, diagnosis, and treatment 

19 program established under section 3. 

20 (5) SPACE FLIGHT-ASSOCIATED MEDICAL CON21 DITION.—The term ‘‘space flight-associated medical 

22 condition’’ means— 

23 (A) for purposes of medical monitoring or 

24 diagnosis under the Program, a psychological or 

25 medical condition that the Administrator deterVerDate Sep 11 2014 22:34 Sep 21, 2016 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6076.IH H6076

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1 mines is potentially associated with human 

2 space flight; and 

3 (B) for purposes of medical treatment 

4 under the Program, a psychological or medical 

5 condition that the Administrator determines is 

6 associated with human space flight. 

7 SEC. 3. PROGRAM FOR THE MEDICAL MONITORING, DIAG8 NOSIS, AND TREATMENT OF ASTRONAUTS. 

9 (a) ESTABLISHMENT OF PROGRAM.—The Adminis10 trator shall, subject to section 6 and subsections (a)(2) 

11 and (b)(3) of section 4, establish a program that satisfies 

12 the requirements described in subsection (b) to provide for 

13 the medical monitoring, diagnosis, and treatment of crew14 members for space flight-associated medical conditions. 

15 (b) PROGRAM REQUIREMENTS.—The requirements 

16 described in this subsection are the following: 

17 (1) NO COST SHARING.—Medical monitoring, 

18 diagnosis, and treatment shall be provided under the 

19 Program without any deductibles, copayments, or 

20 other cost sharing obligation for crewmembers par21 ticipating in the Program. 

22 (2) ACCESS TO LOCAL SERVICES.—The Admin23 istrator shall design the Program to facilitate rea24 sonable access of a crewmember to medical moniVerDate Sep 11 2014 22:34 Sep 21, 2016 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6076.IH H6076

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1 toring, diagnosis, and treatment under the Program, 

2 including, at the option of the crewmember— 

3 (A) directly through NASA; or 

4 (B) from a health care provider who the 

5 crewmember selects and who enters into an 

6 agreement with the Administrator, with respect 

7 to the provision by the provider of medical mon8 itoring, diagnosis, and treatment services, as 

9 applicable, to such crewmember under the Pro10 gram, under which— 

11 (i) the provider agrees to comply with 

12 the protocols issued under subsection (c) 

13 with respect to such provision of such serv14 ices to such crewmember; 

15 (ii) the provider agrees to submit data 

16 with respect to such provision of such serv17 ices to such crewmember, as required by 

18 the Administrator for purposes of sub19 section (d); 

20 (iii) the provider agrees to receive 

21 such training as the Administrator may re22 quire with respect to such medical moni23 toring, treatment, and diagnosis; and 

24 (iv) the Administrator agrees to pro25 vide payment to such provider for the proVerDate Sep 11 2014 22:34 Sep 21, 2016 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H6076.IH H6076

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1 vision of such services to such crewmember 

2 in accordance with payment rates estab3 lished by the Administrator under the Pro4 gram, which shall be not less than the rea5 sonable costs of such services. 

6 (3) SECONDARY PAYER.— 

7 (A) IN GENERAL.—Subject to subpara8 graph (B), payment or reimbursement for (or 

9 the provision of) medical monitoring, diagnosis, 

10 or treatment under the Program shall be sec11 ondary to any obligation of the United States 

12 or any third party (including any State or local 

13 governmental entity, private insurance carrier, 

14 or employer) under any other provision of law 

15 or contractual agreement to pay for or provide 

16 such medical monitoring, diagnosis, or treat17 ment. Any costs for items and services covered 

18 under the Program that are not paid for or pro19 vided under such other provision of law or con20 tractual agreement, due to the application of 

21 deductibles, copayments, coinsurance, other cost 

22 sharing, or otherwise, are reimbursable under 

23 the Program to the extent that they are covered 

24 under the Program. 


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1 (B) CONDITIONAL PAYMENT.—The Admin2 istrator may, under the Program, provide for 

3 conditional payments for (or provide) medical 

4 monitoring, diagnosis, or treatment services 

5 that is obliged to be paid for or provided by the 

6 United States or any third party described in 

7 subparagraph (A) under any other provision of 

8 law or contractual agreement if— 

9 (i) payment for (or the provision of) 

10 such medical monitoring, diagnosis, or 

11 treatment services has not been made (or 

12 provided) or cannot reasonably be expected 

13 to be made (or provided) promptly by the 

14 United States or such third party, respec15 tively; and 

16 (ii) such payment (or such provision 

17 of services) by the Administrator under the 

18 Program is conditioned on reimbursement 

19 by the United States or such third party, 

20 respectively, for such medical monitoring, 

21 diagnosis, or treatment. 

22 (C) CONSULTATION.—In carrying out this 

23 paragraph, the Administrator may consult with 

24 other Federal officials with experience coordiVerDate Sep 11 2014 22:34 Sep 21, 2016 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H6076.IH H6076

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1 nating health care payments with third-party 

2 payers. 

3 (4) VOLUNTARY PARTICIPATION IN PROGRAM.— 

4 (A) IN GENERAL.—Participation by a 

5 crewmember under the Program, including with 

6 respect to the provision of medical monitoring, 

7 diagnosis, and treatment to such crewmember, 

8 shall be voluntary and pursuant to the written 

9 consent of such crewmember. Such consent pro10 vided by a crewmember shall constitute consent 

11 of the crewmember for the Administrator to use 

12 or disclose data acquired in the course of med13 ical monitoring, diagnosis, and treatment of 

14 such crewmember under the Program in accord15 ance with subsection (d). 

16 (B) CONSENT NOT A CONDITION FOR EM17 PLOYMENT OR BENEFITS.—Providing any con18 sent under subparagraph (A) shall not be a 

19 condition for— 

20 (i) employment with NASA; or 

21 (ii) receiving any salary or benefits, 

22 either for current or former crewmembers. 

23 For purposes of clause (ii), medical monitoring, 

24 diagnosis, and treatment under the Program 

25 shall not be considered a benefit. 


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1 (c) PROTOCOLS.—The Administrator shall issue such 

2 uniform protocols for the provision of medical monitoring, 

3 diagnosis, and treatment furnished under the Program. 

4 (d) DATA COLLECTION, USAGE, AND DISCLOSURES; 

5 PRIVACY PROTECTIONS.— 

6 (1) UNIFORM DATA COLLECTION.—Under the 

7 Program, subject to paragraph (3), the Adminis8 trator shall provide— 

9 (A) for the uniform collection of data, in10 cluding data on space flight-associated medical 

11 conditions and the identification of new space 

12 flight-associated conditions; 

13 (B) that such data shall be collected with 

14 respect to all crewmembers provided medical 

15 monitoring, diagnosis, or treatment under the 

16 Program for such conditions; 

17 (C) for the integration of such data into 

18 the medical monitoring, diagnosis, and treat19 ment activities under the Program; 

20 (D) for the analysis of, and regular reports 

21 to the Administrator on, such data; and 

22 (E) notwithstanding section 7(a), that the 

23 Administrator may retain access to such data. 

24 (2) USES AND DISCLOSURES OF INFORMA25 TION.—The Administrator may, subject to paraVerDate Sep 11 2014 22:34 Sep 21, 2016 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H6076.IH H6076

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1 graph (3), use or disclose data acquired in the 

2 course of medical monitoring, diagnosis, and treat3 ment of any crewmember under the Program for the 

4 following purposes: 

5 (A) The medical monitoring, diagnosis, 

6 and treatment of such crewmember under the 

7 Program. 

8 (B) Other medical monitoring, diagnosis, 

9 or treatment under the Program. 

10 (C) Other scientific and research purposes. 

11 (D) For purposes of analysis and reports 

12 under section 4. 

13 (E) Any other purpose deemed appropriate 

14 by the Administrator. 

15 (3) PRIVACY PROTECTIONS.—The data collec16 tion, analysis, integration, use, disclosure, and reten17 tion under this subsection shall be conducted (and 

18 such data maintained) in a manner that protects the 

19 confidentiality of individually identifiable health in20 formation consistent with applicable Federal law, in21 cluding regulations. 

22 SEC. 4. REPORTS AND COST ESTIMATE. 

23 (a) ANNUAL REPORTS.— 

24 (1) REQUIREMENT.—Consistent with applicable 

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1 ulations, for each fiscal year of the Program, the 

2 Administrator shall prepare and publish a report on 

3 activities conducted under the Program, as well as 

4 plans for activities to be conducted under the Pro5 gram during the subsequent fiscal year. Each such 

6 report shall include detailed cost accounting of such 

7 activities and five-year budget estimates. Each re8 port for a fiscal year shall be submitted, not later 

9 than the date of submission of the President’s an10 nual budget request for such fiscal year, to the Com11 mittee on Science, Space, and Technology of the 

12 House of Representatives and the Committee on 

13 Commerce, Science, and Transportation of the Sen14 ate. 

15 (2) FAILURE TO SUBMIT REPORT.— 

16 (A) IN GENERAL.—Subject to subpara17 graph (B), no funds are authorized to be appro18 priated for a fiscal year to carry out the Pro19 gram unless the Administrator has submitted 

20 the report required under paragraph (1) for 

21 that fiscal year by the deadline established 

22 under such paragraph. 

23 (B) TREATMENT OF ONGOING PROCE24 DURES.—In the case of a fiscal year (after the 

25 first fiscal year for which the Program has been 


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1 implemented) with respect to which no funds 

2 would be authorized to carry out the Program 

3 pursuant to subparagraph (A), notwithstanding 

4 subparagraph (A), there are authorized to be 

5 appropriated, subject to section 6, for such fis6 cal year such sums as may be necessary to pro7 vide that any crewmember receiving under the 

8 Program diagnosis services or a course of treat9 ment that began on a date prior to the first day 

10 of such fiscal year shall continue to be provided 

11 such diagnosis services or course of treatment, 

12 respectively (and payment under the Program 

13 for such diagnosis services or course of treat14 ment, respectively, shall continue) after such 

15 date until completion of such diagnosis services 

16 or course of treatment, respectively. 

17 (b) COST ESTIMATE.— 

18 (1) REQUIREMENT.—Not later than 90 days 

19 after the date of enactment of this Act, the Adminis20 trator shall enter into an arrangement with an inde21 pendent external organization to undertake an inde22 pendent cost estimate of the cost to NASA and the 

23 Federal Government to implement and administer 

24 the Program. The independent external organization 


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1 may not be a NASA entity, such as the Office of 

2 Safety and Mission Assurance. 

3 (2) SUBMITTAL TO CONGRESS.—Not later than 

4 one year after the date of the enactment of this Act, 

5 the Administrator shall submit the independent cost 

6 estimate undertaken pursuant to paragraph (1) to 

7 the Committee on Science, Space, and Technology of 

8 the House of Representatives and the Committee on 

9 Commerce, Science, and Transportation of the Sen10 ate. 

11 (3) PROVISION OF SERVICES.—The Adminis12 trator may not implement the Program until the 

13 date that is 90 days after the date of submission of 

14 the independent cost estimate under paragraph (2). 

15 SEC. 5. INSPECTOR GENERAL AUDIT. 

16 The Inspector General of NASA shall conduct, as ap17 propriate, periodic audits or reviews of the Program as 

18 is necessary to prevent waste, fraud, and abuse. 

19 SEC. 6. FUNDING. 

20 The Program shall be carried out, to the extent and 

21 in such amounts as are provided in advance by appropria22 tion Acts, using existing funding available for Agency 

23 Management and Operations in the ‘‘Safety, Security and 

24 Mission Services’’ account of the National Aeronautics 

25 and Space Administration. 


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1 SEC. 7. SUNSET. 

2 (a) IN GENERAL.—Subject to subsection (b), the 

3 Program shall terminate on the date that is 10 years after 

4 the date of implementation of the Program. 

5 (b) GRANDFATHER.—In the case of a crewmember 

6 receiving under the Program diagnosis services or treat7 ment services that began on a date prior to the date of 

8 termination described in subsection (a), the Administrator 

9 shall provide that such diagnosis services or course of 

10 treatment, respectively, for such crewmember (and pay11 ment for such diagnosis services or course of treatment, 

12 respectively) may, subject to section 6, continue after such 

13 date until completion of such diagnosis services or course 

14 of treatment, respectively. 

Æ 


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