Calendar No. 536

103D CONGRESS

2D SESSION S. 2343

A BILL

To state the sense of the Senate on the TRICARE

to certain medicare-eligible individuals.for the cost of care provided under the programauthorizing the reimbursement of the programcilitate the full implementation of the program byprogram of the Department of Defense and to faAUGUST 1 (legislative day, JULY 20), 1994

Placed on the calendar
II

Calendar No. 536

103D CONGRESS

2D SESSION S. 2343

To state the sense of the Senate on the TRICARE program of the Department of Defense and to facilitate the full implementation of the program

by authorizing the reimbursement of the program for the cost of care

provided under the program to certain medicare-eligible individuals.

IN THE SENATE OF THE UNITED STATES

AUGUST 1 (legislative day, JULY 20), 1994

Mr. NUNN, from the Committee on Armed Services, reported the following

original bill; which was read twice and placed on the calendar

A BILL

To state the sense of the Senate on the TRICARE program

of the Department of Defense and to facilitate the full

implementation of the program by authorizing the reimbursement of the program for the cost of care provided

under the program to certain medicare-eligible individuals.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. IMPLEMENTATION OF THE TRICARE PROGRAM

2 OF THE DEPARTMENT OF DEFENSE.

3 (a) SENSE OF SENATE.—It is the sense of the Senate

4 that—

5 (1) the health care program of the Department

6 of Defense, commonly known as TRICARE—

7 (A) reflects a commitment to cooperation

8 between the military departments; and

9 (B) integrates on a regional basis the pro10 vision of health care by the military medical

11 treatment facilities under chapter 55 of title 10,

12 United States Code;

13 (2) the full implementation of the TRICARE

14 program of the Department will result in the estab15 lishment of a system for the delivery of health care

16 by the Department that is cohesive, flexible, and

17 more capable of meeting the requirements of readi18 ness to provide health care in support of military op19 erations and of capacity to provide health care on a

20 routine basis;

21 (3) the full implementation of the TRICARE

22 program of the Department will also result in—

23 (A) improved access to health care for in24 dividuals eligible to participate in the system;

25 and
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1 (B) an enhancement of the capacities of

2 the Department of Defense medical facilities

3 through—

4 (i) control over contractor support of

5 such facilities;

6 (ii) sharing of resources and inter7 operability between the military depart8 ments in the operation of such facilities;

9 and

10 (iii) cost containment; and

11 (4) medicare reimbursement is essential if the

12 TRICARE program of the Department is to com13 pete effectively among providers of health care serv14 ices nationwide.

15 (b) REIMBURSEMENT BY MEDICARE FOR CARE PRO16 VIDED TO MEDICARE-ELIGIBLE INDIVIDUALS.—(1) In the

17 case of a person who is a medicare-eligible individual and

18 who is provided care in a facility of the uniformed services

19 that is certified under subsection (c), the Secretary of

20 Health and Human Services shall be responsible for mak21 ing payments to the certified facility under this section

22 on behalf of the person.

23 (2) The responsibilities of the Secretary of Health

24 and Human Services under this subsection shall be in the

25 same amounts and under similar terms and conditions
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1 under which that Secretary makes payments to eligible or2 ganizations with a risk-sharing contract under such sec3 tion 1876.

4 (3) Upon making payment under this subsection to

5 a certified facility on behalf of a person, the obligation

6 of the Secretary of Health and Human Services to provide

7 health care services to the person shall cease.

8 (c) CERTIFICATION OF FACILITIES.—(1) The Sec9 retary of Defense shall certify to the Secretary of Health

10 and Human Services each year—

11 (A) a list of all facilities of the uniformed serv12 ices that—

13 (i) meet or exceed medicare requirements

14 that apply to a public facility; or

15 (ii) fully comply with requirements estab16 lished by the administering Secretaries that are

17 intended to achieve the same or similar pur18 poses as the requirements referred to in clause

19 (i) and that are no less stringent than such re20 quirements; and

21 (B) a list of all health plans conducted by the

22 Secretary of Defense that—

23 (i) meet or exceed medicare HMO require24 ments that apply to the health plan of a public

25 entity; or
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1 (ii) fully comply with requirements estab2 lished by the administering Secretaries that are

3 intended to achieve the same or similar pur4 poses as the requirements referred to in clause

5 (i) and that are no less stringent than such re6 quirements.

7 (2) For purposes of the medicare program—

8 (A) a Department health care facility for which

9 there is a certification in effect under paragraph

10 (1)(A) and which provides care to medicare-eligible

11 individuals shall be deemed to be a medicare pro12 vider; and

13 (B) a health plan for which there is a certifi14 cation in effect under paragraph (1)(B) and which

15 provides care to medicare-eligible individuals shall be

16 deemed to be a medicare HMO.

17 (d) DEFINITIONS.—In this section:

18 (1) The term ‘‘administering Secretaries’’ has

19 the meaning given such term in section 1072(3) of

20 title 10, United States Code.

21 (2) The term ‘‘medicare program’’ means the

22 health insurance program under title XVIII of the

23 Social Security Act (42 U.S.C. 1395 et seq.).
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1 (3) The term ‘‘medicare-eligible individual’’

2 means an individual who is entitled to benefits under

3 part A of the medicare program.

4 (4) The term ‘‘medicare HMO’’ means an eligi5 ble organization under section 1876 of the Social Se6 curity Act (42 U.S.C. 1395mm).

7 (5) The term ‘‘medicare provider’’ means an in8 dividual or entity furnishing items or services for

9 which payments may be made under the medicare

10 program.

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