II

106TH CONGRESS

2D SESSION S. 2013

To restore health care equity for Medicare-eligible uniformed services retirees,

and for other purposes.

IN THE SENATE OF THE UNITED STATES

JANUARY 27, 2000

Mr. LOTT (for Mr. MCCAIN) introduced the following bill; which was read

twice and referred to the Committee on Armed Services

A BILL

To restore health care equity for Medicare-eligible uniformed

services retirees, 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 ‘‘Honoring Health Care

5 Commitments to Servicemembers Past and Present Act of

6 2000’’.
2

•S 2013 IS

1 SEC. 2. SENSE OF SENATE ON HEALTH CARE FOR MEM2 BERS OF THE UNIFORMED SERVICES WHO

3 FIRST BECAME MEMBERS BEFORE JUNE 7,

4 1956, AND THEIR DEPENDENTS.

5 It is the sense of the Senate that—

6 (1) urgent priority should be given to the enact7 ment of legislation that provides health care cov8 erage for Medicare-eligible members and former

9 members of the uniformed services who first became

10 members of the uniformed services before June 7,

11 1956, and for their dependents, at no cost to such

12 members, former members, and dependents; and

13 (2) the bill proposing to provide the health care

14 coverage described in paragraph (1), which has been

15 introduced in the Senate, should—

16 (A) receive priority of consideration by the

17 committee of the Senate having jurisdiction

18 over the bill; and

19 (B) become the pending business of the

20 Senate immediately after its reporting to the

21 Senate by the committee of the Senate de22 scribed in paragraph (1).
3

•S 2013 IS

1 SEC. 3. PARTICIPATION OF MEDICARE-ELIGIBLE BENE2 FICIARIES IN CERTAIN DEPARTMENT OF DE3 FENSE PHARMACY PROGRAMS.

4 (a) IN GENERAL.—Not later than October 1, 2000,

5 the Secretary of Defense shall—

6 (1) expand and make permanent the dem7 onstration project for pharmaceuticals by mail estab8 lished under subsection (a) of section 702 of the Na9 tional Defense Authorization Act for Fiscal Year

10 1993 (10 U.S.C. 1079 note) in order to permit indi11 viduals described in subsection (b) worldwide to ob12 tain pharmaceuticals through the project; and

13 (2) modify each managed health care program

14 which includes a managed care network of commu15 nity retail pharmacies under subsection (b) of such

16 section 702 to supply prescription pharmaceuticals

17 to the individuals described in subsection (b) of this

18 section through such network in the area covered by

19 such program.

20 (b) ELIGIBLE INDIVIDUALS.—(1) Except as provided

21 in paragraph (2), an individual eligible to obtain pharma22 ceuticals under this section is a member or former member

23 of the uniformed services described in section 1074(b) of

24 title 10, United States Code, a dependent of a member

25 described in subsection (a)(2)(B) or (b) of section 1076

26 of that title, or a dependent of a member who died while
4

•S 2013 IS

1 on active duty for a period of more than 30 days, who

2 is entitled to hospital insurance benefits under part A of

3 title XVIII of the Social Security Act (42 U.S.C. 1395

4 et seq.).

5 (2) An individual described in paragraph (1) is not

6 eligible to obtain pharmaceuticals under this section if the

7 individual is covered by a health benefits plan offered

8 through the Federal Employees Health Benefits program,

9 whether as an employee under chapter 89 of title 5,

10 United States Code, or pursuant to section 1108 of title

11 10, United States Code.

12 (c) FEES AND CHARGES.—(1) Subject to paragraph

13 (2), the amount of the deductible, copayment, annual fee,

14 or other fee, if any, paid by an eligible individual described

15 in subsection (b) who obtains a pharmaceutical under this

16 section through the project referred to in subsection (a)(1)

17 or a retail pharmacy network referred to in subsection

18 (a)(2) shall not exceed the amount of the deductible copay19 ment, annual fee, or other fee paid by other persons for

20 such pharmaceutical through the project or the pharmacy

21 network, as the case may be.

22 (2) An eligible individual described in subsection (b)

23 shall not be charged an enrollment fee for participation

24 in the project or a retail pharmacy network under this sec25 tion.
5

•S 2013 IS

1 (3) The Secretary of Defense may not establish or

2 collect any new fee or charge under the project referred

3 to in subsection (a)(1), or any retail pharmacy network

4 referred to in subsection (a)(2), by reason of the participa5 tion of eligible individuals described in subsection (b) in

6 the project or network under this section.

7 SEC. 4. NATIONWIDE EXPANSION OF MEDICARE SUB8 VENTION.

9 (a) PARTICIPANTS.—Effective October 1, 2000, sub10 section (a)(4) of section 1896 of the Social Security Act

11 (42 U.S.C. 1395ggg) is amended by adding after subpara12 graph (D) the following new flush matter:

13 ‘‘Notwithstanding the first sentence of this subpara14 graph, the term does not include any individual who

15 is covered by a health benefits plan offered through

16 the Federal Employees Health Benefits program,

17 whether as an employee under chapter 89 of title 5,

18 United States Code, or pursuant to section 1108 of

19 title 10, United States Code.’’.

20 (b) REPEAL OF LIMITATION ON NUMBER OF

21 SITES.—Effective October 1, 2000, paragraph (2) of sec22 tion 1896(b) of such Act is amended to read as follows:

23 ‘‘(2) LOCATION OF SITES.—
6

•S 2013 IS

1 ‘‘(A) IN GENERAL.—The program shall be

2 conducted in any site designated jointly by the

3 administering Secretaries.

4 ‘‘(B) FEE-FOR-SERVICE.—If feasible, at

5 least 1 of the sites designated under subpara6 graph (A) shall be conducted using the fee-for7 service reimbursement method described in sub8 section (l)(1).

9 ‘‘(C) UNIFORMED SERVICES TREATMENT

10 FACILITIES.—If feasible, designated providers

11 covered by section 722 of the National Defense

12 Authorization Act for 1997 (Public Law 104–

13 201; 10 U.S.C. 1073 note) shall be included

14 among the sites designated by the admin15 istering Secretaries.’’.

16 (c) MAKING PROJECT PERMANENT; CHANGES IN

17 PROJECT REFERENCES.—

18 (1) ELIMINATION OF TIME LIMITATION.—Para19 graph (4) of section 1896(b) of such Act is repealed.

20 (2) CONFORMING CHANGES OF REFERENCES TO

21 DEMONSTRATION PROJECT.—Section 1896 of such

22 Act is further amended—

23 (A) in the heading, by striking ‘‘DEM24 ONSTRATION PROJECT’’ and inserting

25 ‘‘PROGRAM’’;
7

•S 2013 IS

1 (B) by amending subsection (a)(2) to read

2 as follows:

3 ‘‘(2) PROGRAM.—The term ‘program’ means

4 the program carried out under this section.’’;

5 (C) in the heading to subsection (b), by

6 striking ‘‘DEMONSTRATION PROJECT’’ and in7 serting ‘‘PROGRAM’’;

8 (D) by striking ‘‘demonstration project’’ or

9 ‘‘project’’ each place either appears and insert10 ing ‘‘program’’; and

11 (E) in subsection (k)(2)—

12 (i) in the heading, by striking ‘‘EX13 TENSION AND EXPANSION OF DEMONSTRA14 TION PROJECT’’ and inserting ‘‘PROGRAM’’;

15 and

16 (ii) by striking subparagraphs (A)

17 through (C) and inserting the following:

18 ‘‘(A) whether there is a cost to the health

19 care program under this title in conducting the

20 program under this section; and

21 ‘‘(B) whether the terms and conditions of

22 the program should be modified.’’.

23 (3) REPEAL OF OBSOLETE REPORTING RE24 QUIREMENT.—Paragraph (5) of section 1896(b) of

25 such Act is repealed.
8

•S 2013 IS

1 (d) CORRECTION OF REFERENCE TO MEDICARE-ELI2 GIBLE RETIREES.—Section 1896 of such Act is further

3 amended—

4 (1) in the heading, by striking ‘‘MILITARY

5 RETIREES’’ and inserting ‘‘UNIFORMED SERV6 ICES RETIREES’’;

7 (2) in paragraph (4) of subsection (a)—

8 (A) in the caption, by striking ‘‘MILITARY

9 RETIREE’’ and inserting ‘‘UNIFORMED SERV10 ICES RETIREE’’; and

11 (B) by striking ‘‘military retiree’’ and in12 serting ‘‘uniformed services retiree’’; and

13 (3) by striking ‘‘military retirees’’ each place it

14 appears and inserting ‘‘uniformed services retirees’’.

15 (e) PERMITTING PAYMENT ON A FEE-FOR-SERVICE

16 BASIS.—

17 (1) IN GENERAL.—Section 1896 of the Social

18 Security Act is further amended by adding at the

19 end the following new subsection:

20 ‘‘(l) REIMBURSEMENT ON FEE-FOR-SERVICE

21 BASIS.—

22 ‘‘(1) REIMBURSEMENT AT DESIGNATED

23 SITES.—In the case of a Medicare health care serv24 ice provided at a site, if any, designated for oper25 ation under the fee-for-service model under sub-
9

•S 2013 IS

1 section (b)(2)(B), the Secretary shall reimburse the

2 Secretary of Defense at a rate equal to 95 percent

3 of the amount that otherwise would be payable

4 under this title on a noncapitated basis for the serv5 ice if the site were not part of the program under

6 this section.

7 ‘‘(2) REIMBURSEMENT FOR UNENROLLED INDI8 VIDUALS.—Notwithstanding subsection (i), in the

9 case of Medicare-eligible uniformed services retirees

10 or dependents who are not enrolled in the program

11 under this section, the Secretary may reimburse the

12 Secretary of Defense for Medicare health care serv13 ices provided to such retirees or dependents at a

14 military treatment facility under the program at a

15 rate that does not exceed the rate of payment that

16 would otherwise be made under this title for such

17 services.

18 ‘‘(3) INAPPLICABILITY OF LIMITATIONS ON

19 FEDERAL PAYMENTS.—Sections 1814(c) and

20 1835(d), and paragraphs (2) and (3) of section

21 1862(a), do not apply to the making of payments

22 under this subsection.’’.

23 (2) CONFORMING AMENDMENTS.—Such section

24 is further amended—
10

•S 2013 IS

1 (A) in subsections (b)(1)(B)(v) and

2 (b)(1)(B)(viii)(I), by inserting ‘‘or subsection

3 (l)’’ after ‘‘subsection (i)’’;

4 (B) in subsection (d)(1)(A), by inserting

5 ‘‘(insofar as it provides for the enrollment of in6 dividuals and payment on the basis described in

7 subsection (i))’’ before ‘‘shall meet’’;

8 (C) in subsection (d)(1)(A), by inserting

9 ‘‘and the program (insofar as it provides for

10 payment for Medicare health care services pro11 vided at a military treatment facility on the

12 basis described in subsection (l)) shall meet all

13 requirements that are applicable to facilities

14 that provide such services under this title’’ after

15 ‘‘Medicare payments’’;

16 (D) in subsection (d)(2), by inserting ‘‘, in17 sofar as it provides for the enrollment of indi18 viduals and payment on the basis described in

19 subsection (i),’’ before ‘‘shall comply’’;

20 (E) in subsection (g)(1), by inserting ‘‘in21 sofar as it provides for the enrollment of indi22 viduals and payment on the basis described in

23 subsection (i),’’ before ‘‘the Secretary of De24 fense’’;
11

•S 2013 IS

1 (F) in subsection (i)(1), by inserting ‘‘and

2 subsection (l)’’ after ‘‘of this subsection’’;

3 (G) in subsection (i)(4), by inserting ‘‘and

4 subsection (l)’’ after ‘‘under this subsection’’;

5 and

6 (H) in subsection (j)(2)(B)(ii), by inserting

7 ‘‘or subsection (l)’’ after ‘‘subsection (i)(1)’’.

8 (3) EFFECTIVE DATE.—The amendments made

9 by this subsection take effect on October 1, 2000,

10 and apply to services furnished on or after such

11 date.

12 (f) ELIMINATION OF RESTRICTION ON ELIGI13 BILITY.—Section 1896(b)(1) of such Act is amended by

14 adding at the end the following new subparagraph:

15 ‘‘(C) ELIMINATION OF RESTRICTIVE POL16 ICY.—If the enrollment capacity in the program

17 has been reached at a particular site designated

18 under paragraph (2) and the Secretary there19 fore limits enrollment at the site to medicare20 eligible uniformed services retirees and depend21 ents who are enrolled in TRICARE Prime (as

22 defined for purposes of chapter 55 of title 10,

23 United States Code) at the site immediately be24 fore attaining 65 years of age, participation in

25 the program by a retiree or dependent at such
12

•S 2013 IS

1 site shall not be restricted based on whether the

2 retiree or dependent has a civilian primary care

3 manager instead of a military primary care

4 manager.’’.

5 (g) MEDIGAP PROTECTION FOR ENROLLEES.—Sec6 tion 1896 of such Act is further amended by adding at

7 the end the following new subsection:

8 ‘‘(m) MEDIGAP PROTECTION FOR ENROLLEES.—

9 ‘‘(1) IN GENERAL.—Subject to paragraph (2),

10 the provisions of section 1882(s)(3) (other than

11 clauses (i) through (iv) of subparagraph (B)) and

12 section 1882(s)(4) shall apply to any enrollment

13 (and termination of enrollment) in the program (for

14 which payment is made on the basis described in

15 subsection (i)) in the same manner as they apply to

16 enrollment (and termination of enrollment) with a

17 Medicare+Choice organization in a

18 Medicare+Choice plan.

19 ‘‘(2) RULE OF CONSTRUCTION.—In applying

20 paragraph (1)—

21 ‘‘(A) in the case of enrollments occurring

22 before October 1, 2000, any reference in clause

23 (v) or (vi) of section 1882(s)(3)(B) to 12

24 months is deemed a reference to the period end25 ing on September 30, 2001; and
13

•S 2013 IS

1 ‘‘(B) the notification required under sec2 tion 1882(s)(3)(D) shall be provided in a man3 ner specified by the Secretary of Defense in

4 consultation with the Secretary.’’.

5 SEC. 5. INCLUSION OF MEDICARE-ELIGIBLE UNIFORMED

6 SERVICES BENEFICIARIES IN FEDERAL EM7 PLOYEES HEALTH BENEFITS PROGRAM.

8 (a) FEHBP OPTION.—(1) Section 1108 of title 10,

9 United States Code, is amended to read as follows:

10 ‘‘§ 1108. Health care coverage through Federal Em11 ployees Health Benefits program

12 ‘‘(a) FEHBP OPTION.—(1) The Secretary of De13 fense, after consulting with the other administering Secre14 taries, shall enter into an agreement with the Office of

15 Personnel Management under which a Medicare-eligible

16 covered beneficiary described in subsection (b) will be of17 fered an opportunity to enroll in a health benefits plan

18 offered through the Federal Employees Health Benefits

19 program under chapter 89 of title 5.

20 ‘‘(2) The agreement may provide for limitations on

21 enrollment of Medicare-eligible covered beneficiaries in the

22 Federal Employees Health Benefits program if the Office

23 of Personnel Management determines the limitations are

24 necessary to allow for adequate planning for access for
14

•S 2013 IS

1 services under the Federal Employees Health Benefits

2 program.

3 ‘‘(b) MEDICARE-ELIGIBLE COVERED BENEFICIARY

4 DESCRIBED.—A Medicare-eligible covered beneficiary re5 ferred to in subsection (a) is a covered beneficiary under

6 this chapter who for any reason is or becomes entitled to

7 hospital insurance benefits under part A of title XVIII of

8 the Social Security Act (42 U.S.C. 1395 et seq.). The cov9 ered beneficiary shall not be required to satisfy any eligi10 bility criteria specified in chapter 89 of title 5 as a condi11 tion for enrollment in a health benefits plan offered

12 through the Federal Employees Health Benefits program

13 pursuant to subsection (a).

14 ‘‘(c) LIMITATIONS ON ENROLLMENT.—The number

15 of Medicare-eligible covered beneficiaries enrolled in the

16 Federal Employees Health Benefits program under this

17 section shall not exceed 275,000.

18 ‘‘(d) CONTINUED PARTICIPATION IN UNIFORMED

19 SERVICES HEALTH SYSTEM.—(1) A Medicare-eligible cov20 ered beneficiary who enrolls in the Federal Employees

21 Health Benefits program under this section shall not be

22 eligible to receive health care under section 1086 or 1097

23 of this title.

24 ‘‘(2)(A) Subject to such limitations as the Secretary

25 of Defense, after consultation with the other administering
15

•S 2013 IS

1 Secretaries, a Medicare-eligible covered beneficiary de2 scribed in paragraph (1) may continue to receive health

3 care in a military medical treatment facility on a space

4 available basis.

5 ‘‘(B) A treatment facility providing care under sub6 paragraph (A) shall be reimbursed by the Federal Em7 ployees Health Benefits program for the cost of such care

8 at rates not to exceed the rates of reimbursement for such

9 care under the program if such care had been provided

10 by a health care provider other than the treatment facility.

11 ‘‘(e) LIMITATIONS ON OTHER HEALTH CARE COV12 ERAGE.—(1) A Medicare-eligible covered beneficiary who

13 is covered by a health benefits plan through the Federal

14 Employees Health Benefits program under subsection (a)

15 may not, during a period of coverage under such plan

16 under this section—

17 ‘‘(A) be enrolled in a health benefits plan under

18 the Federal Employees Health Benefits program as

19 an employee under chapter 89 of title 5;

20 ‘‘(B) be enrolled in the Medicare subvention

21 program for military retirees under section 1896 of

22 the Social Security Act (42 U.S.C. 1395ggg);

23 ‘‘(C) otherwise obtain pharmaceuticals by mail

24 under section 702(a) of Public Law 102–484 (10

25 U.S.C. 1079 note) pursuant to section 3(a)(1) of the
16

•S 2013 IS

1 Honoring Health Care Commitments to

2 Servicemembers Past and Present Act of 2000; or

3 ‘‘(D) otherwise obtain pharmaceuticals through

4 a network of retail pharmacies under section 702(b)

5 of Public Law 102–484 pursuant to section 3(a)(2)

6 of the Honoring Health Care Commitments to

7 Servicemembers Past and Present Act of 2000.

8 ‘‘(2) A Medicare-eligible covered beneficiary who is

9 also eligible for participation in the Federal Employees

10 Health Benefits program as an employee under chapter

11 89 of title 5 shall participate in the program, if at all,

12 under that chapter.

13 ‘‘(f) CONTRIBUTIONS.—(1) In the case of a Medicare14 eligible covered beneficiary who enrolls in a health benefits

15 plan offered through the Federal Employees Health Bene16 fits program pursuant to subsection (a), the administering

17 Secretary concerned shall be responsible for Government

18 contributions that the Office of Personnel Management

19 determines are necessary to cover all costs in excess of

20 beneficiary contributions under paragraph (2).

21 ‘‘(2) The contribution required from the enrolled

22 Medicare-eligible covered beneficiary shall be equal to the

23 amount that would be withheld from the pay of a similarly

24 situated Federal employee who enrolls in a health benefits

25 plan under chapter 89 of title 5.
17

•S 2013 IS

1 ‘‘(g) MANAGEMENT OF PARTICIPATION.—(1) If an

2 enrolled Medicare-eligible covered beneficiary is a member

3 or former member of the uniformed services described in

4 section 1074(b) of this title, the authority responsible for

5 approving retired or retainer pay or equivalent pay for the

6 member or former member shall manage the participation

7 of the enrolled member or former member in a health ben8 efits plan offered through the Federal Employees Health

9 Benefits program pursuant to subsection (a).

10 ‘‘(2) If an enrolled Medicare-eligible covered bene11 ficiary is a dependent of a member or former member, the

12 authority that is, or would be, responsible for approving

13 retired or retainer pay or equivalent pay for the member

14 or former member shall manage the participation of the

15 dependent in a health benefits plan offered through the

16 Federal Employees Health Benefits program under sub17 section (a).

18 ‘‘(3) The Office of Personnel Management shall

19 maintain separate risk pools for enrolled Medicare-eligible

20 covered beneficiaries until such time as the Director of the

21 Office of Personnel Management determines that complete

22 inclusion of enrolled Medicare-eligible covered beneficiaries

23 under chapter 89 of title 5 will not adversely affect Fed24 eral employees and annuitants enrolled in health benefits

25 plans under such chapter.
18

•S 2013 IS

1 ‘‘(h) EFFECT OF CANCELLATION.—The cancellation

2 by a Medicare-eligible covered beneficiary of coverage

3 under the Federal Employees Health Benefits program

4 under this section shall be irrevocable for purposes of this

5 section.

6 ‘‘(i) REPORTING REQUIREMENTS.—Not later than

7 November 1 of each year, the administering Secretaries

8 and the Director of the Office of Personnel Management

9 shall jointly submit to Congress a report describing the

10 provision of health care services to Medicare-eligible cov11 ered beneficiaries under this section during the preceding

12 fiscal year. The report shall address or contain the fol13 lowing:

14 ‘‘(1) The number of Medicare-eligible covered

15 beneficiaries enrolled in health benefits plans offered

16 through the Federal Employees Health Benefits pro17 gram pursuant to subsection (a), both in terms of

18 total number and as a percentage of all Medicare19 eligible covered beneficiaries receiving health care

20 through the health care system of the uniformed

21 services.

22 ‘‘(2) The out-of-pocket cost to enrolled Medi23 care-eligible covered beneficiaries under such health

24 benefits plans.
19

•S 2013 IS

1 ‘‘(3) The cost to the Government (including the

2 Department of Defense, the Department of Trans3 portation, and the Department of Health and

4 Human Services) of providing care under such

5 health benefits plans as a result of this section.

6 ‘‘(4) A comparison of the costs determined

7 under paragraphs (2) and (3) and the costs that

8 would have otherwise been incurred by the Govern9 ment and enrolled Medicare-eligible covered bene10 ficiaries under alternative health care options avail11 able to the administering Secretaries.

12 ‘‘(5) The effect of this section on the cost, ac13 cess, and utilization rates of other health care op14 tions under the health care system of the uniformed

15 services.

16 ‘‘(j) TIME FOR OPTION.—The Secretary of Defense

17 shall begin to offer the health benefits option under sub18 section (a) on January 1, 2001, with an initial open enroll19 ment period conducted in the fall of 2000.’’.

20 (2) The item relating to section 1108 in the table of

21 sections at the beginning of such chapter is amended to

22 read as follows:

‘‘1108. Health care coverage through Federal Employees Health Benefits program.’’.

23 (b) CONFORMING AMENDMENTS.—Chapter 89 of

24 title 5, United States Code, is amended—
20

•S 2013 IS

1 (1) in section 8905—

2 (A) by redesignating subsections (d)

3 through (f) as subsections (e) through (g), re4 spectively; and

5 (B) by inserting after subsection (c) the

6 following:

7 ‘‘(d) Subject to subsection (e) of section 1108 of title

8 10, an individual whom an administering Secretary (as de9 fined in section 1073 of such title) determines is a Medi10 care-eligible covered beneficiary under subsection (b) of

11 such section 1108 may enroll in a health benefits plan

12 under this chapter in accordance with the agreement en13 tered into under subsection (a) of such section 1108 be14 tween the Secretary of Defense and the Office and in ac15 cordance with applicable regulations under this chapter.’’;

16 (2) in section 8906(b), by striking paragraph

17 (4) and inserting the following new paragraph (4):

18 ‘‘(4) In the case of individuals who enroll in a health

19 plan in accordance with section 8905(d) of this title, the

20 Government contribution shall be determined under sec21 tion 1108(f) of title 10.’’; and

22 (3) in section 8906(g), by striking paragraph

23 (3) and inserting the following new paragraph (3):

24 ‘‘(3) The Government contribution described in sub25 section (b)(4) for beneficiaries who enroll in accordance
21

•S 2013 IS

1 with section 8905(d) of this title shall be paid as provided

2 in section 1108(f) of title 10.’’.

3 SEC. 6. ELIMINATION OF COPAYMENTS, DEDUCTIBLES, AND

4 OTHER FEES FOR CARE FOR DEPENDENTS

5 UNDER TRICARE PRIME.

6 (a) ELIMINATION.—Section 1097a of title 10, United

7 States Code, is amended—

8 (1) by redesignating subsections (d) and (e) as

9 subsections (e) and (f), respectively; and

10 (2) by inserting after subsection (c) the fol11 lowing new subsection (d):

12 ‘‘(d) PROHIBITION ON COPAYMENTS AND OTHER

13 FEES FOR CARE FOR DEPENDENTS.—No copayment, de14 ductible, annual fee, or other fee may be collected for or

15 with respect to any medical care provided a dependent (as

16 described in subparagraph (A), (D), or (I) of section

17 1072(2) of this title) of a member of the uniformed serv18 ices who is enrolled in TRICARE Prime.’’.

19 (b) CONFORMING AND CLERICAL AMENDMENTS.—

20 (1) The section heading of such section is amended by

21 adding at the end the following: ‘‘; prohibition on

22 fees for certain beneficiaries’’.

23 (2) The item relating to such section at the beginning

24 of chapter 55 of such title is amended by inserting before
22

•S 2013 IS

1 the period the following: ‘‘; prohibition on fees for certain

2 beneficiaries’’.

3 SEC. 7. HEALTH CARE COVERAGE OF IMMEDIATE FAMILY

4 MEMBERS UNDER PROGRAM FOR MEMBERS

5 ASSIGNED TO CERTAIN DUTY LOCATIONS

6 FAR FROM CARE.

7 Section 1079 of title 10, United States Code, is

8 amended by adding at the end the following:

9 ‘‘(p)(1)(A) Subject to such exceptions as the Sec10 retary of Defense considers necessary, coverage for med11 ical care under this section for the dependents referred

12 to in subsection (a) of a member of the armed forces cov13 ered by section 1074(c) of this title who are residing with

14 the member, and standards with respect to timely access

15 to such care, shall be comparable to coverage for medical

16 care and standards for timely access to such care under

17 the managed care option of the TRICARE program known

18 as TRICARE Prime.

19 ‘‘(B) No copayment, deductible, or annual fee may

20 be collected for or with respect to any medical care pro21 vided a dependent under subparagraph (A).

22 ‘‘(2) The Secretary of Defense shall enter into ar23 rangements with contractors under the TRICARE pro24 gram or with other appropriate contractors for the timely

25 and efficient processing of claims under this subsection.
23

•S 2013 IS

1 ‘‘(3) The Secretary of Defense may not require de2 pendents referred to in subsection (a) of a member of the

3 armed forces described in section 1074(c)(3)(B) of this

4 title to receive routine primary medical care at a military

5 medical treatment facility.’’.

6 SEC. 8. UNIFORMED SERVICES RETIREE HEALTH CARE AC7 COUNT.

8 (a) ESTABLISHMENT.—Chapter 55 of title 10,

9 United States Code, is amended by adding at the end the

10 following new section:

11 ‘‘§ 1110. Uniformed Services Retiree Health Care Ac12 count

13 ‘‘(a) ESTABLISHMENT.—There is established in the

14 Treasury an account to be known as ‘Uniformed Services

15 Retiree Health Care Account’ (in this section referred to

16 as the ‘Account’).

17 ‘‘(b) TRANSFERS TO ACCOUNT.—There shall be

18 transferred to the Account any unexpired funds (as deter19 mined by the Secretary of Defense, after consultation with

20 the other administering Secretaries) in the Defense Health

21 Program account that, as a result of economies, effi22 ciencies, and other savings achieved in the medical care

23 and health care programs of the Department of Defense,

24 are excess to the requirements of such programs.
24

•S 2013 IS

1 ‘‘(c) USE OF FUNDS.—(1) Amounts in the Account

2 may be used for purposes of covering the costs incurred

3 by the Secretary of Defense and the other administering

4 Secretaries in administering section 1108 of this title and

5 the provisions of the Honoring Health Care Commitments

6 to Servicemembers Past and Present Act of 2000 (includ7 ing the amendments made by that Act).

8 ‘‘(2) Notwithstanding any other provision of law,

9 amounts in the Account shall remain available until ex10 pended.

11 ‘‘(d) UNEXPIRED FUNDS DEFINED.—In this section,

12 the term ‘unexpired funds’ means funds appropriated for

13 a definite period of time that remain available for obliga14 tion.’’.

15 (b) CLERICAL AMENDMENT.—The table of sections

16 at the beginning of such chapter is amended by adding

17 at the end the following new item:

‘‘1110. Uniformed Services Retiree Health Care Account.’’.

18 SEC. 9. CONTRACT AUTHORITY FOR RECOVERY OF OVER19 PAYMENTS UNDER THE TRICARE PROGRAM.

20 Section 1097b of title 10, United States Code, is

21 amended by adding at the end the following new sub22 section:

23 ‘‘(d) CONTRACT AUTHORITY FOR RECOVERY OF

24 OVERPAYMENTS.—The Secretary of Defense may enter

25 into contracts with appropriate private entities for pur-
25

•S 2013 IS

1 poses of recovering amounts of overpayments to health

2 care providers under the TRICARE program. Services

3 under contracts under this subsection may include audit

4 services and such other services as the Secretary of De5 fense considers appropriate.’’.

6 SEC. 10. ENHANCEMENT OF EFFICIENCY OF ADMINISTRA7 TION OF MILITARY HEALTH CARE SYSTEM.

8 (a) IN GENERAL.—The Secretary of Defense, after

9 consultation with the other administering Secretaries,

10 shall take appropriate actions—

11 (1) to enhance the efficiency of administration

12 of the provision of health care services under chapter

13 55 of title 10, United States Code, including the

14 TRICARE program, in matters relating to mar15 keting, beneficiary enrollment, beneficiary and pro16 vider education, claims processing, and the sched17 uling of appointments; and

18 (2) otherwise to improve the quality of service

19 provided under that chapter.

20 (b) PARTICULAR ACTIONS.—The actions taken by the

21 Secretary of Defense under subsection (a) shall include the

22 following:

23 (1) Simplification of administrative processes.

24 (2) Use of the Internet for critical administra25 tive processes.
26

•S 2013 IS

1 (c) DEFINITIONS.—In this section the terms ‘‘admin2 istering Secretaries’’ and ‘‘TRICARE program’’ shall have

3 the meanings given such terms in section 1072 of title 10,

4 United States Code.

5 SEC. 11. NATIONWIDE ENROLLMENT CARD UNDER THE

6 TRICARE PROGRAM.

7 (a) REQUIREMENT.—The Secretary of Defense, after

8 consultation with the other administering Secretaries,

9 shall issue to covered beneficiaries under the TRICARE

10 program an enrollment card which shall serve as an enroll11 ment card for participation in the TRICARE program na12 tionwide. The purpose of the enrollment card is to facili13 tate the ready portability of benefits under the TRICARE

14 program.

15 (b) DEFINITIONS.—In this section the terms ‘‘admin16 istering Secretaries’’ and ‘‘TRICARE program’’ shall have

17 the meanings given such terms in section 1072 of title 10,

18 United States Code.

Æ