I
105TH CONGRESS
1ST SESSION
H. R. 1356
To amend title 10, United States Code, to permit beneficiaries of the military
health care system to enroll in Federal employees health benefits plans;
to improve health care benefits under CHAMPUS and TRICARE Stand-
ard, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
APRIL 16, 1997
Mr. WATTS of Oklahoma (for himself, Mr. ENGLISH of Pennsylvania, Mr.
WOLF, Mr. CONDIT, and Mr. NORWOOD) introduced the following bill;
which was referred to the Committee on National Security, and in addi-
tion to the Committee on Government Reform and Oversight, for a period
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee
concerned.
A BILL
To amend title 10, United States Code, to permit bene-
ficiaries of the military health care system to enroll in
Federal employees health benefits plans; to improve
health care benefits under CHAMPUS and TRICARE
Standard, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. INCLUSION OF CERTAIN COVERED BENE-
FICIARIES IN FEDERAL EMPLOYEES HEALTH
BENEFITS PROGRAM.
(a) FEHBP OPTION.—Chapter 55 of title 10, United
States Code, is amended by inserting after section 1079a
the following new section:
‘‘§ 1079b. Health care coverage through Federal Em-
ployees Health Benefits program
‘‘(a) FEHBP OPTION.—(1) Covered beneficiaries de-
scribed in subsection (b) shall be afforded an opportunity
to enroll in any health benefits plan under the Federal
Employee Health Benefits program offering medical and
dental care that is comparable to the care authorized by
section 1077 of this title to be provided under section
1076 of this title.
‘‘(2) The Secretary of Defense and the other admin-
istering Secretaries shall jointly enter into an agreement
with the Director of the Office of Personnel Management
to carry out paragraph (1).
‘‘(b) ELIGIBLE COVERED BENEFICIARIES.—(1) A
covered beneficiary referred to in subsection (a) is a mem-
ber or former member of the uniformed services described
in section 1074(b) of this title, and any dependent of the
member described in section 1076(b) of this title, who, as
determined pursuant to standards and procedures pro-
vided in the agreement entered into pursuant to subsection
(a)(2)—
‘‘(A) 
is 
not 
guaranteed 
access 
under
CHAMPUS or TRICARE Standard to health and
dental care that is comparable to the highest level of
health and dental care benefits provided under the
service benefit plan offered under the Federal Em-
ployee Health Benefits program;
‘‘(B) is eligible to enroll in the TRICARE pro-
gram but is not enrolled because of the location of
the beneficiary, a limitation on the total enrollment,
or any other reason; or
‘‘(C) is entitled to hospital insurance benefits
under part A of title XVIII of the Social Security
Act (42 U.S.C. 1395c et seq.).
‘‘(2) A covered beneficiary shall not be required to
satisfy any eligibility criteria specified in chapter 89 of
title 5 as a condition for enrollment in a health benefits
plan of the Federal Employee Health Benefits program
under this section.
‘‘(c) CONTRIBUTIONS.—(1) Contributions shall be
made for an enrollment of a covered beneficiary in a plan
of the Federal Employee Health Benefits program under
this section as if the beneficiary were an employee of the
Federal Government.
‘‘(2) The administering Secretary concerned shall be
responsible for the Government contributions that the Di-
rector of the Office of Personnel Management determines
would be payable by the Secretary under section 8906 of
title 5 for an enrolled covered beneficiary if the beneficiary
were an employee of the Secretary.
‘‘(3) Each covered beneficiary enrolled in a health
benefits plan under this section shall be required to con-
tribute the amount that would be withheld from the pay
of a similarly situated Federal employee who is enrolled
in the same health benefits plan under chapter 89 of title
5.
‘‘(d) MANAGEMENT OF PARTICIPATION.—The Direc-
tor of the Office of Personnel Management shall manage
the participation of a covered beneficiary in a health bene-
fits plan of the Federal Employee Health Benefits pro-
gram pursuant to an enrollment under this section. The
Director shall maintain separate risk pools for participat-
ing covered beneficiaries until such time as the Director
determines that a complete inclusion of participating cov-
ered beneficiaries under chapter 89 of title 5 will not ad-
versely affect Federal employees and annuitants enrolled
in health benefits plans under such chapter.
‘‘(e) REPORTING REQUIREMENTS.—Not later than
November 1 of each year, the Secretary of Defense and
the Director of the Office of Personnel Management shall
jointly submit to Congress a report describing the provi-
sion of health and dental care services to covered bene-
ficiaries under this section during the preceding fiscal
year. The report shall address or contain the following:
‘‘(1) The number of covered beneficiaries who
are participating in health benefits plans of the Fed-
eral Employee Health Benefits program pursuant to
an enrollment under this section, both in terms of
total number and as a percentage of all covered
beneficiaries who are receiving health care through
the health care system of the uniformed services.
‘‘(2) The extent to which covered beneficiaries
use the health and dental care services available to
the beneficiaries under health benefits plans pursu-
ant to enrollments under this section.
‘‘(3) The cost to covered beneficiaries for health
and dental care under such health benefits plans.
‘‘(4) The cost to the Department of Defense,
the Department of Transportation, the Department
of Health and Human Services, and any other de-
partments and agencies of the Federal Government
of providing care to covered beneficiaries pursuant
to enrollments in such health benefits plans under
this section.
‘‘(5) A comparison of the costs determined
under paragraphs (3) and (4) and the costs that
would otherwise have been incurred by the United
States and enrollees under alternative health care
options available to the administering Secretaries.
‘‘(6) The effects of the exercise of authority
under this section on the cost, access, and utilization
rates of other health care options under the health
care system of the uniformed services.’’.
(b) CONFORMING AMENDMENTS.—(1) Section 8905
of title 5, United States Code, is amended—
(A) by redesignating subsections (d), (e), and
(f) as subsections (e), (f), and (g), respectively; and
(B) by inserting after subsection (c) the follow-
ing new subsection (d):
‘‘(d) An individual whom the Secretary of Defense de-
termines is an eligible covered beneficiary under sub-
section (b) of section 1079b of title 10 may enroll in a
health benefits plan under this chapter in accordance with
the agreement entered into under subsection (a) of such
section between the Secretary and the Office and with ap-
plicable regulations under this chapter.’’.
(2) Section 8906 of title 5, United States Code, is
amended—
(A) in subsection (b)—
(i) in paragraph (1), by striking ‘‘para-
graphs (2) and (3)’’ and inserting in lieu there-
of ‘‘paragraphs (2), (3), and (4)’’; and
(ii) by adding at the end the following new
paragraph:
‘‘(4) In the case of individuals who enroll in a health
plan under section 8905(d) of this title, the Government
contribution shall be determined under section 1079b(c)
of title 10.’’; and
(B) in subsection (g)—
(i) in paragraph (1), by striking ‘‘para-
graph (2)’’ and inserting in lieu thereof ‘‘para-
graphs (2) and (3)’’; and
(ii) by adding at the end the following new
paragraph:
‘‘(3) The Government contribution described in sub-
section (b)(4) for beneficiaries who enroll under section
8905(d) of this title shall be paid as provided in section
1079b(c) of title 10.’’.
SEC. 2. IMPROVED BENEFITS UNDER CHAMPUS AND
TRICARE STANDARD.
Chapter 55 of title 10, United States Code, as
amended by section 1(a), is further amended by inserting
after section 1079b the following new section:
‘‘§ 1079c. CHAMPUS and TRICARE Standard benefits:
comparability with service benefit plan
of the Federal Employees Health Benefits
program
‘‘(a) BENEFITS.—The health and dental care benefits
provided under CHAMPUS and TRICARE Standard
shall be comparable to the highest level of benefits pro-
vided under the service benefit plan of the Federal Em-
ployees Health Benefits program.
‘‘(b) PROVIDER
REIMBURSEMENT
RATES.—The
rates prescribed for the reimbursement of health and den-
tal care providers under CHAMPUS and TRICARE
Standard shall be the same as those provided for the high-
est level of benefits under the service benefit plan of the
Federal Employees Health Benefits program.’’.
SEC. 3. DEFINITIONS.
Section 1072 of title 10, United States Code, is
amended—
(1) in paragraph (4), by striking out ‘‘The term
‘Civilian Health and Medical Program of the Uni-
formed Services’ means’’ and inserting in lieu there-
of ‘‘The terms ‘Civilian Health and Medical Pro-
gram of the Uniformed Services’ and ‘CHAMPUS’
mean’’; and
(2) by adding at the end the following:
‘‘(7) The term ‘TRICARE program’ means the
managed health care program that is established by
the Secretary of Defense under the authority of this
chapter, principally section 1097 of this title, and in-
cludes the competitive selection of contractors to fi-
nancially underwrite the delivery of health care serv-
ices under CHAMPUS.
‘‘(8) The term ‘TRICARE Standard’ means a
CHAMPUS health care benefits option that, subject
to the deductibles and cost-sharing requirements
under CHAMPUS, pays a share of the cost of cov-
ered health care services that are provided by health
care providers outside the Federal Government who
are not part of the CHAMPUS network of health
care providers.
‘‘(9) The term ‘Federal Employee Health Bene-
fits program’ means the Federal Employee Health
Benefits program under chapter 89 of title 5.’’.
SEC. 4. IMPLEMENTATION.
The Secretary of Defense shall begin to offer the
health benefits option under section 1079b(a) of title 10,
United States Code (as added by section 1(a)), and the
improved benefits under section 1079c of such title (as
added by section 3) not later than November 1, 1997.
SEC. 5. CLERICAL AMENDMENT.
The table of sections at the beginning of chapter 55
of title 10, United States Code, is amended by inserting
after the item relating to section 1079a the following:
‘‘1079b. Health care coverage through Federal Employees Health Benefits pro-
gram.
‘‘1079c. CHAMPUS and TRICARE Standard benefits: comparability with serv-
ice benefit plan of the Federal Employees Health Benefits pro-
gram.’’.
Æ