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‘‘(2) the Secretary of Defense.’’. 
SEC. 712. SURVEYS ON CONTINUED VIABILITY OF TRICARE 
STANDARD AND TRICARE EXTRA. 
Section 711(b)(2) of the National Defense Authoriza-
tion Act for Fiscal Year 2008 (10 U.S.C. 1073 note) is 
amended in the matter preceding subparagraph (A)— 
(1) by striking ‘‘on a biennial basis’’; and 
(2) by striking ‘‘paragraph (1)’’ and inserting 
the following: ‘‘paragraph (1) during 2017 and 
2020, and at such others times as requested by such 
committees or as the Comptroller General deter-
mines appropriate’’. 
SEC. 713. LIMITATION ON TRANSFER OR ELIMINATION OF 
GRADUATE MEDICAL EDUCATION BILLETS. 
The Secretary of Defense may not transfer or elimi-
nate a graduate medical education billet from the military 
medical treatment facility to which the billet is assigned 
as of the date of the enactment of this Act unless the Sec-
retary— 
(1) conducts a Department-wide review of the 
implementation of the plan required by section 731 
of the National Defense Authorization Act for Fiscal 
Year 2013 (Public Law 112–239; 10 U.S.C. 1071 
note) that is based on not less than two years of car-
rying out such implementation; 
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(2) conducts an examination of the most suc-
cessful incentives for recruiting and retaining med-
ical professionals to participate in the graduate med-
ical education programs of the military departments; 
(3) determines the assignment of such billets 
based on the review and examination conducted 
under paragraphs (1) and (2), respectively; and 
(4) after the Secretary makes the determination 
under paragraph (3), certifies to the congressional 
defense committees that any proposed transfer or 
elimination of such billets— 
(A) meets the needs of the military depart-
ments and the patient population; and 
(B) takes into account the assignment in-
terests of the members of the Armed Forces 
who are participating (or who will participate) 
in the graduate medical education programs of 
the military departments. 
SEC. 714. REVIEW OF MILITARY HEALTH SYSTEM MOD-
ERNIZATION STUDY. 
(a) LIMITATION.— 
(1) IN
GENERAL.—The Secretary of Defense 
may not restructure or realign a military medical 
treatment facility until a 120-day period has elapsed 
following the date on which the Comptroller General 
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of the United States is required to submit to the 
congressional defense committees the report under 
subsection (b)(3). 
(2) REPORT.—The Secretary shall submit to 
the congressional defense committees a report that 
includes the following: 
(A) During the period from 2001 to 2012, 
for each military medical treatment facility con-
sidered under the modernization study directed 
by the Resource Management Decision of the 
Department of Defense numbered MP–D–01— 
(i) the average daily inpatient census; 
(ii) the average inpatient capacity; 
(iii) the top five inpatient admission 
diagnoses; 
(iv) each medical specialty available; 
(v) the average daily percent of staff-
ing available for each medical specialty; 
(vi) the beneficiary population within 
the catchment area; 
(vii) the budgeted funding level; 
(viii) whether the facility has a 
helipad capable of receiving medical evacu-
ation airlift patients arriving on the pri-
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mary evacuation aircraft platform for the 
military installation served; 
(ix) a determination of whether the ci-
vilian hospital system in which the facility 
resides is a Federally-designated under-
served medical community and the effect 
on such community from any reduction in 
staff or functions or downgrade of the fa-
cility; 
(x) if the facility serves a training 
center, a determination, made in consulta-
tion with the appropriate training direc-
torate, training and doctrine command, 
and forces command of each military de-
partment, of the risk with respect to high 
tempo, live-fire military operations, and the 
potential for a mass casualty event if the 
facility is downgraded to a clinic or re-
duced in personnel or capabilities; 
(xi) a site assessment by TRICARE 
to assess the network capabilities of 
TRICARE providers in the local area; 
(xii) the inpatient mental health avail-
ability; and 
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(xiii) the average annual inpatient 
care directed to civilian medical facilities. 
(B) For each military medical treatment 
facility considered under such modernization 
study— 
(i) the civilian capacity by medical 
specialty in each catchment area; 
(ii) the distance in miles to the near-
est civilian emergency care department; 
(iii) the distance in miles to the clos-
est civilian inpatient hospital, listed by 
level of care and whether the facility is 
designated a sole community hospital; 
(iv) the availability of ambulance serv-
ice on the military installation and the dis-
tance in miles to the nearest civilian ambu-
lance service, including the average re-
sponse time to the military installation; 
(v) an estimate of the cost to restruc-
ture or realign the military medical treat-
ment facility, including with respect to bed 
closures and civilian personnel reductions; 
and 
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(vi) if the military medical treatment 
facility is restructured or realigned, an es-
timate of— 
(I) the number of civilian per-
sonnel reductions, listed by series; 
(II) the number of local support 
contracts terminated; and 
(III) the increased cost of pur-
chased care. 
(C) The results of the study with respect 
to the recommendations of the Secretary to re-
structure or realign military medical treatment 
facilities. 
(b) COMPTROLLER GENERAL REVIEW.— 
(1) REVIEW.—The Comptroller General of the 
United States shall review the report under sub-
section (a)(2). 
(2) ELEMENTS.—The review under paragraph 
(1) shall include the following: 
(A) An assessment of the methodology 
used by the Secretary of Defense in conducting 
the study. 
(B) An assessment of the adequacy of the 
data used by the Secretary with respect to such 
study. 
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(3) REPORT.—Not later than 180 days after 
the date on which the Secretary submits the report 
under subsection (a)(2), the Comptroller General 
shall submit to the congressional defense committees 
a report on the review under paragraph (1). 
SEC. 715. PROVISION OF WRITTEN NOTICE OF CHANGE TO 
TRICARE BENEFITS. 
(a) IN GENERAL.—Chapter 55 of title 10, United 
States Code, is amended by inserting after section 1097c 
the following new section: 
‘‘§ 1097d. TRICARE program: notice of change to ben-
efits 
‘‘(a) PROVISION OF NOTICE.—(1) If the Secretary 
makes a significant change to any benefits provided by the 
TRICARE program to covered beneficiaries, the Secretary 
shall provide individuals described in paragraph (2) with 
written notice explaining such changes. 
‘‘(2) The individuals described by this paragraph are 
covered beneficiaries and providers participating in the 
TRICARE program who may be affected by a significant 
change covered by a notification under paragraph (1). 
‘‘(3) The Secretary shall provide notice under para-
graph (1) through electronic means. 
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‘‘(b) TIMING OF NOTICE.—The Secretary shall pro-
vide notice under paragraph (1) of subsection (a) by the 
earlier of the following dates: 
‘‘(1) The date that the Secretary determines 
would afford individuals described in paragraph (2) 
of such subsection adequate time to understand the 
change covered by the notification. 
‘‘(2) The date that is 90 days before the date 
on which the change covered by the notification be-
comes effective. 
‘‘(3) The effective date of a significant change 
that is required by law. 
‘‘(c) SIGNIFICANT CHANGE DEFINED.—In this sec-
tion, the term ‘significant change’ means a system-wide 
change— 
‘‘(1) in policy regarding services provided under 
the TRICARE program (not including the addition 
of new services or benefits); or 
‘‘(2) in payment rates of more than 20 per-
cent.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 1097c the following new 
item: 
‘‘1097d. TRICARE program: notice of change to benefits.’’. 
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Subtitle C—Reports and Other 
Matters 
SEC. 721. EXTENSION OF AUTHORITY FOR JOINT DEPART-
MENT OF DEFENSE-DEPARTMENT OF VET-
ERANS AFFAIRS MEDICAL FACILITY DEM-
ONSTRATION FUND. 
Section 1704(e) of the National Defense Authoriza-
tion Act for Fiscal Year 2010 (Public Law 111–84; 123 
Stat. 2573) is amended by striking ‘‘September 30, 2015’’ 
and inserting ‘‘September 30, 2016’’. 
SEC. 722. DESIGNATION AND RESPONSIBILITIES OF SENIOR 
MEDICAL ADVISOR FOR ARMED FORCES RE-
TIREMENT HOME. 
(a) DESIGNATION OF SENIOR MEDICAL ADVISOR.— 
Subsection (a) of section 1513A of the Armed Forces Re-
tirement Home Act of 1991 (24 U.S.C. 413a) is amend-
ed— 
(1) in paragraph (1), by striking ‘‘Deputy Di-
rector of the TRICARE Management Activity’’ and 
inserting ‘‘Deputy Director of the Defense Health 
Agency’’; and 
(2) in paragraph (2), by striking ‘‘Deputy Di-
rector of the TRICARE Management Activity’’ both 
places it appears and inserting ‘‘Deputy Director of 
the Defense Health Agency’’. 
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(b) CLARIFICATION OF RESPONSIBILITIES AND DU-
TIES OF SENIOR MEDICAL ADVISOR.—Subsection (c)(2) 
of such section is amended by striking ‘‘health care stand-
ards of the Department of Veterans Affairs’’ and inserting 
‘‘nationally recognized health care standards and require-
ments’’. 
SEC. 723. RESEARCH REGARDING ALZHEIMER’S DISEASE. 
The Secretary of Defense may carry out research, de-
velopment, test, and evaluation activities with respect to 
Alzheimer’s disease. 
SEC. 724. ACQUISITION STRATEGY FOR HEALTH CARE PRO-
FESSIONAL STAFFING SERVICES. 
(a) ACQUISITION STRATEGY.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall develop and carry out an acquisition strategy 
with respect to entering into contracts for the serv-
ices of health care professional staff at military med-
ical treatment facilities. 
(2) 
ELEMENTS.—The 
acquisition 
strategy 
under paragraph (1) shall include the following: 
(A) Identification of the responsibilities of 
the military departments and elements of the 
Department of Defense in carrying out such 
strategy. 
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(B) Methods to analyze, using reliable and 
detailed data covering the entire Department, 
the amount of funds expended on contracts for 
the services of health care professional staff. 
(C) Methods to identify opportunities to 
consolidate requirements for such services and 
reduce cost. 
(D) Methods to measure cost savings that 
are realized by using such contracts instead of 
purchased care. 
(E) Metrics to determine the effectiveness 
of such strategy. 
(b) REPORT.—Not later than April 1, 2015, the Sec-
retary shall submit to the congressional defense commit-
tees a report on the status of implementing the acquisition 
strategy under paragraph (1) of subsection (a), including 
how each element under subparagraphs (A) through (E) 
of paragraph (2) of such subsection are being carried out. 
SEC. 725. PILOT PROGRAM ON MEDICATION THERAPY MAN-
AGEMENT UNDER TRICARE PROGRAM. 
(a) ESTABLISHMENT.—In accordance with section 
1092 of title 10, United States Code, the Secretary of De-
fense shall carry out a pilot program to evaluate the feasi-
bility and desirability of including medication therapy 
management as part of the TRICARE program. 
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