I

105TH CONGRESS

1ST SESSION H. R. 76

To amend title 10, United States Code, to permit covered beneficiaries under

the military health care system who are also entitled to Medicare to

enroll in the Federal Employees Health Benefits program.

IN THE HOUSE OF REPRESENTATIVES

JANUARY 7, 1997

Mr. MORAN of Virginia (for himself, Mr. WATTS of Oklahoma, Mr. HEFNER,

and Mr. DEAL of Georgia) introduced the following bill; which was referred to the Committee on National Security, and in addition to the

Committee on Government Reform and Oversight, 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 10, United States Code, to permit covered

beneficiaries under the military health care system who

are also entitled to Medicare to enroll in the Federal

Employees Health Benefits program.

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 ‘‘Health Care Commit5 ment Act’’.
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1 SEC. 2. INCLUSION OF MEDICARE-ELIGIBLE COVERED

2 BENEFICIARIES IN FEDERAL EMPLOYEES

3 HEALTH BENEFITS PROGRAM.

4 (a) FEHBP OPTION.—(1) Chapter 55 of title 10,

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

6 following new section:

7 ‘‘§ 1107. Health care coverage through Federal Em8 ployees Health Benefits program

9 ‘‘(a) FEHBP OPTION.—The Secretary of Defense,

10 after consulting with the other administering Secretaries,

11 shall enter into an agreement with the Office of Personnel

12 Management under which a Medicare-eligible covered ben13 eficiary described in subsection (b) will be offered an op14 portunity to enroll in a health benefits plan offered

15 through the Federal Employee Health Benefits program

16 under chapter 89 of title 5, in addition to receiving health

17 care services under this chapter through a treatment facil18 ity of the uniformed services, the Civilian Health and Med19 ical Program of the Uniformed Services, or the TRICARE

20 program. The agreement may provide for limitations on

21 enrollment of Medicare-eligible covered beneficiaries in the

22 Federal Employee Health Benefits program if the Office

23 of Personnel Management determines the limitations are

24 necessary to allow for adequate planning for access for

25 services under the Federal Employee Health Benefits pro26 gram.
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1 ‘‘(b) MEDICARE-ELIGIBLE COVERED BENEFICIARY

2 DESCRIBED.—A Medicare-eligible covered beneficiary re3 ferred to in subsection (a) is a covered beneficiary under

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

5 hospital insurance benefits under part A of title XVIII of

6 the Social Security Act (42 U.S.C. 1395c et seq.). The

7 covered beneficiary shall not be required to satisfy any eli8 gibility criteria specified in chapter 89 of title 5 as a condi9 tion for enrollment in a health benefits plan offered

10 through the Federal Employee Health Benefits program

11 pursuant to subsection (a).

12 ‘‘(c) CONTINUED PARTICIPATION IN UNIFORMED

13 SERVICES HEALTH SYSTEM.—A Medicare-eligible covered

14 beneficiary who enrolls in a health benefits plan offered

15 through the Federal Employee Health Benefits program

16 pursuant to subsection (a) may continue, after such enroll17 ment, to receive health care services through a treatment

18 facility of the uniformed services, the Civilian Health and

19 Medical Program of the Uniformed Services, or the

20 TRICARE program. Section 1095 of this title, relating

21 to collection from third-party payers, shall apply with re22 spect to the costs of health care services incurred by the

23 United States on behalf of an enrolled covered beneficiary

24 through a treatment facility of the uniformed services, the
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1 Civilian Health and Medical Program of the Uniformed

2 Services, or the TRICARE program.

3 ‘‘(d) CONTRIBUTIONS.—(1) In the case of a Medi4 care-eligible covered beneficiary who enrolls in a health

5 benefits plan offered through the Federal Employee

6 Health Benefits program pursuant to subsection (a), the

7 administering Secretary concerned shall be responsible for

8 Government contributions that the Office of Personnel

9 Management determines are necessary to cover all costs

10 in excess of beneficiary contributions under paragraph (2).

11 ‘‘(2) The contribution required from the enrolled cov12 ered beneficiary shall be equal to the amount that would

13 be withheld from the pay of a similarly situated Federal

14 employee who enrolls in a health benefits plan under chap15 ter 89 of title 5.

16 ‘‘(e) MANAGEMENT OF PARTICIPATION.—If the en17 rolled covered beneficiary is a member or former member

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

19 this title, the authority responsible for approving retired

20 or retainer pay or equivalent pay for the member or

21 former member shall manage the participation of the en22 rolled member or former member in a health benefits plan

23 offered through the Federal Employee Health Benefits

24 program pursuant to subsection (a). If the enrolled cov25 ered beneficiary is a dependent of a member or former
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1 member, the authority that is, or would be, responsible

2 for approving retired or retainer pay or equivalent pay for

3 the member or former member shall manage the participa4 tion of the enrolled dependent in a health benefits plan

5 offered through the Federal Employee Health Benefits

6 program under subsection (a). The Office of Personnel

7 Management shall maintain separate risk pools for en8 rolled covered beneficiaries until such time as the Director

9 of the Office of Personnel Management determines that

10 complete inclusion of enrolled covered beneficiaries under

11 chapter 89 of title 5 will not adversely affect Federal em12 ployees and annuitants enrolled in health benefits plans

13 under such chapter.

14 ‘‘(f) EFFECT OF CANCELLATION.—The cancellation

15 by a Medicare-eligible covered beneficiary of coverage

16 under the Federal Employee Health Benefits program

17 shall be irrevocable for purposes of this section.

18 ‘‘(g) REPORTING REQUIREMENTS.—Not later than

19 November 1 of each year, the administering Secretaries

20 and the Director of the Office of Personnel Management

21 shall jointly submit a report to Congress describing the

22 provision of health care services to Medicare-eligible cov23 ered beneficiaries under this section during the preceding

24 fiscal year. The report shall address or contain the follow25 ing:
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1 ‘‘(1) The number of Medicare-eligible covered

2 beneficiaries enrolled in health benefits plans offered

3 through the Federal Employee Health Benefits pro4 gram pursuant to subsection (a), both in terms of

5 total number and as a percentage of all Medicare6 eligible covered beneficiaries receiving health care

7 through the health care system of the uniformed

8 services.

9 ‘‘(2) The out-of-pocket cost to enrolled covered

10 beneficiaries under such health benefits plans.

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

12 Department of Defense, the Department of Trans13 portation, and the Department of Health and

14 Human Services) of providing care under such

15 health benefits plans as a result of this section.

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

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

18 would have otherwise been incurred by the Govern19 ment and enrolled covered beneficiaries under alter20 native health care options available to the admin21 istering Secretaries.

22 ‘‘(5) The effect of this section on the cost, ac23 cess, and utilization rates of other health care op24 tions under the health care system of the uniformed

25 services.
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1 ‘‘(h) TIME FOR OPTION.—The Secretary of Defense

2 shall begin to offer the health benefits option under sub3 section (a) not later than January 1, 1998.’’.

4 (2) The table of sections at the beginning of such

5 chapter is amended by adding at the end the following

6 new item:

‘‘1107. Health care coverage through Federal Employees Health Benefits program.’’.

7 (b) CONFORMING AMENDMENTS.—Chapter 89 of

8 title 5, United States Code, is amended—

9 (1) in section 8905—

10 (A) by redesignating subsections (d)

11 through (f) as subsections (e) through (g), re12 spectively; and

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

14 following new subsection:

15 ‘‘(d) An individual whom an administering Secretary

16 described in section 1073 of title 10 determines is a medi17 care-eligible covered beneficiary under subsection (b) of

18 section 1107 of such title may enroll in a health benefits

19 plan under this chapter in accordance with the agreement

20 entered into under subsection (a) of such section between

21 the Secretary of Defense and the Office and in accordance

22 with applicable regulations under this chapter.’’;

23 (2) in section 8906(b)—
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1 (A) in paragraph (1), by striking ‘‘para2 graphs (2) and (3)’’ and inserting in lieu there3 of ‘‘paragraphs (2), (3), and (4)’’; and

4 (B) by adding at the end the following new

5 paragraph:

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

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

8 Government contribution shall be determined under sec9 tion 1107(d) of title 10.’’; and

10 (3) in section 8906(g)—

11 (A) in paragraph (1), by striking ‘‘para12 graph (2)’’ and inserting in lieu thereof ‘‘para13 graphs (2) and (3)’’; and

14 (B) by adding at the end the following new

15 paragraph:

16 ‘‘(3) The Government contribution described in sub17 section (b)(4) for beneficiaries who enroll in accordance

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

19 in section 1107(d) of title 10.’’.

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