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104TH CONGRESS

1ST SESSION H. R. 580

To amend title XVIII of the Social Security Act and title 10, United States

Code, to allow the Secretary of Health and Human Services to reimburse

the Military Health Services System for care provided to Medicareeligible military retirees and their spouses in the Military Health Services

System.

IN THE HOUSE OF REPRESENTATIVES

JANUARY 19, 1995

Mr. HEFLEY (for himself, Mr. PETE GEREN of Texas, Mr. BARTON of Texas,

Mr. CONDIT, and Mr. SAM JOHNSON of Texas) introduced the following

bill; which was referred to the Committee on Commerce and, in addition,

to the Committees on Ways and Means and National Security, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend title XVIII of the Social Security Act and title

10, United States Code, to allow the Secretary of Health

and Human Services to reimburse the Military Health

Services System for care provided to Medicare-eligible

military retirees and their spouses in the Military Health

Services System.

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. MEDICARE PROGRAM PAYMENTS FOR HEALTH

2 CARE SERVICES PROVIDED IN THE MILITARY

3 HEALTH SERVICES SYSTEM.

4 (a) PAYMENTS UNDER MEDICARE RISK CONTRACTS

5 PROGRAM.—Section 1876 of the Social Security Act (42

6 U.S.C. 1395mm) is amended by adding at the end the

7 following new subsection:

8 ‘‘(k) Notwithstanding any other provision of this sec9 tion, a managed health care plan established by the Sec10 retary of Defense under chapter 55 of title 10, United

11 States Code, shall be considered an eligible organization

12 under this section, and the Secretary shall make payments

13 to such a managed health care plan during a year on be14 half of any individuals entitled to benefits under this title

15 who are enrolled in such a managed health care plan dur16 ing the year. Such payments shall be made in the same

17 amounts and under similar terms and conditions under

18 which the Secretary makes payments to other eligible

19 organizations with risk sharing contracts under this

20 section.’’.

21 (b) TEMPORARY PROVISION FOR WAIVER OF PART

22 B PREMIUM PENALTY.—Section 1839 of the Social Secu23 rity Act (42 U.S.C. 1395r) is amended by adding at the

24 end the following new subsection:

25 ‘‘(h) The premium increase required by subsection

26 (b) shall not apply with respect to a person who is enrolled
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1 with a managed care plan that is established by the Sec2 retary of Defense under chapter 55 of title 10, United

3 States Code, and is recognized as an eligible organization

4 pursuant to section 1876(k), if such person first enrolled

5 in such plan prior to January 1, 1998.’’.

6 (c) PAYMENTS UNDER PART A OF MEDICARE.—Sec7 tion 1814(c) of the Social Security Act (42 U.S.C.

8 1395f(c)) is amended—

9 (1) by redesignating the current matter as

10 paragraph (1); and

11 (2) by adding at the end the following new

12 paragraph:

13 ‘‘(2) Paragraph (1) shall not apply to services

14 provided by facilities of the uniformed services pur15 suant to chapter 55 of title 10, United States Code,

16 and subject to the provisions of section 1095 of such

17 title. With respect to such services, payments under

18 this title shall be made without regard to whether

19 the beneficiary under this title has paid the deduct20 ible and copayments amounts generally required by

21 this title.’’.

22 (d) PAYMENTS UNDER PART B OF MEDICARE.—Sec23 tion 1835(d) of the Social Security Act (42 U.S.C.

24 1395n(d)) is amended—
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1 (1) by redesignating the current matter as

2 paragraph (1); and

3 (2) by adding at the end the following new

4 paragraph:

5 ‘‘(2) Paragraph (1) shall not apply to services pro6 vided by facilities of the uniformed services pursuant to

7 chapter 55 of title 10, United States Code, and subject

8 to the provisions of section 1095 of such title. With respect

9 to such services, payments under this title shall be made

10 without regard to whether the beneficiary under this title

11 has paid the deductible and copayments amounts generally

12 required by this title.’’.

13 (e) CONFORMING AMENDMENTS TO THE THIRD

14 PARTY COLLECTION PROGRAM FOR MILITARY MEDICAL

15 FACILITIES.—(1) Section 1095(d) of title 10, United

16 States Code, is amended—

17 (A) by striking ‘‘XVIII or’’; and

18 (B) by striking ‘‘1395’’ and inserting ‘‘1396’’.

19 (2) Section 1095(h)(2) of such title is amended by

20 inserting after ‘‘includes’’ the following: ‘‘plans adminis21 tered under title XVIII of the Social Security Act (42

22 U.S.C. 1395 et seq.),’’.
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1 (f) EFFECTIVE DATE.—The amendments made by

2 this section shall take effect at the end of the 30-day pe3 riod beginning on the date of the enactment of this Act.

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