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(2) Establish standards of care for trauma 
services provided at military medical treatment fa-
cilities. 
(3) Coordinate the translation of research from 
the centers of excellence of the Department of De-
fense into standards of clinical trauma care. 
(4) Coordinate the incorporation of lessons 
learned from the trauma education and training 
partnerships pursuant to section 709 into clinical 
practice. 
(c) REVIEW.—Not later than 120 days after the date 
on which the Secretary submits to the Committees on 
Armed Services of the House of Representatives and the 
Senate the implementation plan under subsection (a)(1), 
the Comptroller General of the United States shall submit 
to such committees a review of such plan to determine if 
each element under subsection (b) is included in such plan. 
(d) REVIEW OF MILITARY TRAUMA SYSTEM.—In es-
tablishing a Joint Trauma System, the Secretary of De-
fense may seek to enter into an agreement with a non- 
governmental entity with subject matter experts to— 
(1) conduct a system-wide review of the military 
trauma system; and 
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(2) make publicly available a report containing 
such review and recommendations to establish a 
comprehensive trauma system for the Armed Forces. 
SEC. 709. JOINT TRAUMA EDUCATION AND TRAINING DI-
RECTORATE. 
(a) ESTABLISHMENT.—The Secretary of Defense 
shall establish a Joint Trauma Education and Training 
Directorate (in this section referred to as the ‘‘Direc-
torate’’) to ensure that the traumatologists of the Armed 
Forces maintain readiness and are able to be rapidly de-
ployed for future armed conflicts. The Secretary shall 
carry out this section in collaboration with the Secretaries 
of the military departments. 
(b) DUTIES.—The duties of the Directorate are as 
follows: 
(1) To enter into and coordinate the partner-
ships under subsection (c). 
(2) To establish the goals of such partnerships 
necessary for trauma combat casualty care teams led 
by traumatologists to maintain professional com-
petency in trauma care. 
(3) To establish metrics for measuring the per-
formance of such partnerships in achieving such 
goals. 
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(4) To develop methods of data collection and 
analysis for carrying out paragraph (3). 
(5) To communicate and coordinate lessons 
learned from such partnerships with the Joint Trau-
ma System established under section 708. 
(c) PARTNERSHIPS.— 
(1) IN
GENERAL.—The Secretary shall enter 
into partnerships with civilian academic medical cen-
ters and large metropolitan teaching hospitals that 
have level I civilian trauma centers. 
(2) 
TRAUMA
COMBAT
CASUALTY
CARE 
TEAMS.—Under the partnerships entered into with 
civilian academic medical centers and large metro-
politan teaching hospitals under paragraph (1), 
trauma combat casualty care teams of the Armed 
Forces led by traumatologists of the Armed Forces 
shall embed within the trauma centers of the med-
ical centers and hospitals on an enduring basis. 
(3) SELECTION.—The Secretary shall select ci-
vilian academic medical centers and large metropoli-
tan teaching hospitals to enter into partnerships 
under paragraph (1) based on patient volume, acu-
ity, and other factors the Secretary determines nec-
essary to ensure that the traumatologists of the 
Armed Forces and the associated clinical support 
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teams have adequate and continuous exposure to 
critically injured patients. 
(4) CONSIDERATION.—In entering into partner-
ships under paragraph (1), the Secretary may con-
sider the experiences and lessons learned by the mili-
tary departments that have entered into memoranda 
of understanding with civilian medical centers for 
trauma care. 
(d) ANALYSIS.—The Secretary of Defense shall con-
duct 
an 
analysis 
to 
determine 
the 
number 
of 
traumatologists of the Armed Forces, by specialty, that 
must be maintained within the Department of Defense to 
meet the requirements of the combatant commands. 
(e) IMPLEMENTATION PLAN.—Not later than July 1, 
2017, the Secretary shall submit to the Committees on 
Armed Services of the House of Representatives and the 
Senate an implementation plan for establishing the Joint 
Trauma Education and Training Directorate under sub-
section (a) and entering into partnerships under sub-
section (c). 
(f) LEVEL I CIVILIAN TRAUMA CENTER DEFINED.— 
In this section, the term ‘‘level I civilian trauma center’’ 
means a comprehensive regional resource that is a tertiary 
care facility central to the trauma system and is capable 
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of providing total care for every aspect of injury from pre-
vention through rehabilitation. 
SEC. 710. IMPROVEMENTS TO ACCESS TO HEALTH CARE IN 
MILITARY MEDICAL TREATMENT FACILITIES. 
(a) FIRST CALL RESOLUTION.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall implement standard processes to ensure that, 
in the case of a beneficiary contacting a military 
medical treatment facility over the telephone for, at 
a minimum, scheduling an appointment, requesting 
a prescription drug refill, and other matters deter-
mined appropriate by the Secretary, the needs of the 
beneficiary are met during the first such telephone 
call. 
(2) METRICS.—The Secretary shall— 
(A) develop metrics, collect data, and 
evaluate the performance of the processes im-
plemented under paragraph (1); and 
(B) carry out satisfaction surveys to mon-
itor the satisfaction of beneficiaries with such 
processes, including with respect to the satisfac-
tion regarding access to appointments and pa-
tient care. 
(b) APPOINTMENT SCHEDULING.— 
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(1) IN GENERAL.—The Secretary shall imple-
ment standard processes to schedule beneficiaries for 
appointments at military medical treatment facili-
ties. 
(2) ELEMENTS.—The standard processes imple-
mented under paragraph (1) shall include the fol-
lowing: 
(A) Requiring clinics at military medical 
treatment facilities to allow a beneficiary to 
schedule an appointment for wellness visits or 
follow-up appointments during the six-month or 
longer period beginning on the date of the re-
quest for the appointment. 
(B) A process to remind a beneficiary of 
future appointments in a manner that the bene-
ficiary prefers, which may include sending post-
cards to the beneficiary prior to appointments 
and making reminder telephone calls, emails, or 
cellular text messages to the beneficiary at 
specified intervals prior to appointments. 
(c) APPOINTMENT SUPPLY AND DEMAND.— 
(1) PRODUCTIVITY.—The Secretary shall imple-
ment standards for the productivity of health care 
providers at military medical treatment facilities. In 
developing such standards, the Secretary shall con-
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sider civilian benchmarks for measuring the produc-
tivity of health care providers, the optimal number 
of appointments (patient contact hours) required to 
maintain access according to the standards devel-
oped by the Secretary, and readiness requirements. 
(2) MANAGING USE OF FACE-TO-FACE APPOINT-
MENTS.—The Secretary shall implement strategies 
for managing the use of face-to-face appointments at 
military medical treatment facilities. Such strategies 
may include— 
(A) maximizing the use of telehealth and 
virtual appointments for beneficiaries at the 
discretion of the health care provider and the 
beneficiary; 
(B) the implementation of remote patient 
monitoring of chronic conditions to improve 
outcomes and reduce the number of follow-up 
appointments for beneficiaries; and 
(C) maximizing the use of secure mes-
saging between health care providers and bene-
ficiaries to improve the access of beneficiaries 
to health care and reduce the number of visits 
for health care needs. 
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(d) IMPLEMENTATION.—The Secretary shall imple-
ment subsections (a), (b), and (c) by not later than Feb-
ruary 1, 2017. 
(e) BRIEFING.—Not later than March 1, 2017, the 
Secretary shall provide the Committees on Armed Services 
of the House of Representatives and the Senate a briefing 
on the implementation of subsections (a), (b), and (c). 
(f) BENEFICIARIES DEFINED.—In this section, the 
term ‘‘beneficiaries’’ means members of the Armed Forces 
and covered beneficiaries (as defined in section 1072(5) 
of title 10, United States Code). 
SEC. 711. ADOPTION OF CORE QUALITY PERFORMANCE 
METRICS. 
(a) ADOPTION.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the Sec-
retary of Defense shall adopt the core quality per-
formance metrics agreed upon by the Core Quality 
Measures Collaborative for use by the military 
health system and in contracts awarded to carry out 
the TRICARE program. 
(2) CORE
MEASURES.—The core quality per-
formance metrics described in paragraph (1) shall 
include the following sets: 
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(A) Accountable care organizations, patient 
centered medical homes and primary care. 
(B) Cardiology. 
(C) Gastroenterology. 
(D) HIV and hepatitis C. 
(E) Medical oncology. 
(F) Obstetrics and gynecology. 
(G) Orthopedics. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘Core Quality Measures Collabo-
rative’’ means the collaboration between the Centers 
for Medicare & Medicaid Services, major health in-
surance companies, national physician organizations, 
and other entities to reach consensus on core per-
formance measures reported by health care pro-
viders. 
(2) The term ‘‘TRICARE program’’ has the 
meaning given that term in section 1072 of title 10, 
United States Code. 
SEC. 712. STUDY ON IMPROVING CONTINUITY OF HEALTH 
CARE 
COVERAGE 
FOR 
RESERVE 
COMPO-
NENTS. 
(a) STUDY.—The Secretary of Defense shall conduct 
a study of options for providing health care coverage that 
improves the continuity of health care provided to current 
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and former members of the Selected Reserve of the Ready 
Reserve who are not— 
(1) serving on active duty; 
(2) eligible for the Transitional Assistance Man-
agement Program under section 1145 of title 10, 
United States Code; or 
(3) eligible for the Federal Employees Health 
Benefit Program under chapter 89 of title 5. 
(b) ELEMENTS.—The study under subsection (a) 
shall address the following: 
(1) Whether to allow current and former mem-
bers of the Selected Reserve to participate in the 
Federal Employees Health Benefit Program under 
chapter 89 of title 5. 
(2) Whether to pay a stipend to current and 
former members to continue coverage in a health 
plan obtained by the member. 
(3) Whether to allow current and former mem-
bers to participate in the TRICARE program under 
section 1076d of title 10, United States Code. 
(4) Whether to allow members of the National 
Guard assigned to Homeland Response Force Units 
mobilized for a State emergency pursuant to chapter 
9 of title 32, United States Code, to remain eligible 
for the TRICARE program. 
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(5) Any other options for providing health care 
coverage to current and former members of the Se-
lected Reserve the Secretary considers appropriate. 
(c) CONSULTATION.—In carrying out the study under 
subsection (a), the Secretary shall consult with, and obtain 
the opinions of, current and former members of the Se-
lected Reserve, including the leadership of the Selected 
Reserve. 
(d) SUBMISSION.— 
(1) REPORT.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary 
shall submit to the congressional defense committees 
a report on the study under subsection (a). 
(2) MATTERS
INCLUDED.—The report under 
paragraph (1) shall include the following: 
(A) A description of the health care cov-
erage options addressed by the Secretary under 
subsection (b). 
(B) Identification of such health care cov-
erage option that the Secretary recommends as 
the best option. 
(C) The justifications for such rec-
ommended best option. 
(D) The number and proportion of the cur-
rent and former members of the Selected Re-
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serve projected to participate in such rec-
ommended best option. 
(E) A determination of the appropriate 
cost sharing for such recommended best option 
with respect to the percentage contribution as a 
monthly premium for current members of the 
Selected Reserve. 
(F) An estimate of the cost of imple-
menting such recommended best option. 
(G) Any legislative language required to 
implement such recommended best option. 
Subtitle B—Other Health Care 
Benefits 
SEC. 721. PROVISION OF HEARING AIDS TO DEPENDENTS 
OF RETIRED MEMBERS. 
Section 1077 of title 10, United States Code, is 
amended— 
(1) in subsection (a)(16), by striking ‘‘A hear-
ing aid’’ and inserting ‘‘Except as provided by sub-
section (g), a hearing aid’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(g) In addition to the authority to provide a hearing 
aid under subsection (a)(16), hearing aids may be sold 
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under this section to dependents of former members of 
the uniformed services at cost to the United States.’’. 
SEC. 722. EXTENDED TRICARE PROGRAM COVERAGE FOR 
CERTAIN 
MEMBERS 
OF 
THE 
NATIONAL 
GUARD AND DEPENDENTS DURING CERTAIN 
DISASTER RESPONSE DUTY. 
(a) IN GENERAL.—Chapter 55 of title 10, United 
States Code, is amended by inserting after section 1076e 
the following new section: 
‘‘§ 1076f. TRICARE program: extension of coverage 
for certain members of the National 
Guard and dependents during certain 
disaster response duty 
‘‘(a) EXTENDED COVERAGE.—During a period in 
which a member of the National Guard is performing dis-
aster response duty, the member shall be treated as being 
on active duty for a period of more than 30 days for pur-
poses of the eligibility of the member and dependents of 
the member for health care benefits under the TRICARE 
program if such period immediately follows a period in 
which the member served on full-time National Guard 
duty under section 502(f) of title 32, including pursuant 
to chapter 9 of such title, unless the Governor of the State 
(or, with respect to the District of Columbia, the mayor 
of the District of Columbia) determines that such ex-
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tended eligibility is not in the best interest of the member 
or the State. 
‘‘(b) CONTRIBUTION BY STATE.—(1) The Secretary 
may charge a State for the costs of providing coverage 
under the TRICARE program to members of the National 
Guard of the State and the dependents of the members 
pursuant to subsection (a). Such charges shall be paid 
from the funds of the State or from any other non-Federal 
funds. 
‘‘(2) Any amounts received by the Secretary under 
paragraph (1) shall be credited to the appropriation avail-
able for the Defense Health Program Account under sec-
tion 1100 of this title, shall be merged with sums in such 
Account that are available for the fiscal year in which col-
lected, and shall be available under subsection (b) of such 
section, including to carry out subsection (a) of this sec-
tion. 
‘‘(c) DEFINITIONS.—In this section: 
‘‘(1) The term ‘disaster response duty’ means 
duty performed by a member of the National Guard 
in State status pursuant to an emergency declara-
tion by the Governor of the State (or, with respect 
to the District of Columbia, the mayor of the Dis-
trict of Columbia) in response to a disaster or in 
preparation for an imminent disaster. 
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‘‘(2) The term ‘State’ means each of the several 
States, the District of Columbia, the Commonwealth 
of Puerto Rico, and any territory or possession of 
the United States.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
at the beginning of such chapter is amended by inserting 
after the item relating to section 1076e the following new 
item: 
‘‘1076f. TRICARE program: extension of coverage for certain members of the 
National Guard and dependents during certain disaster re-
sponse duty.’’. 
Subtitle C—Health Care 
Administration 
SEC. 731. PROSPECTIVE PAYMENT OF FUNDS NECESSARY 
TO PROVIDE MEDICAL CARE FOR THE COAST 
GUARD. 
(a) IN GENERAL.—Chapter 13 of title 14, United 
States Code, is amended by adding at the end the fol-
lowing: 
‘‘§ 519. Prospective payment of funds necessary to 
provide medical care 
‘‘(a) PROSPECTIVE PAYMENT REQUIRED.—In lieu of 
the reimbursement required under section 1085 of title 10, 
the Secretary of Homeland Security shall make a prospec-
tive payment to the Secretary of Defense of an amount 
that represents the actuarial valuation of treatment or 
care— 
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‘‘(1) that the Department of Defense shall pro-
vide to members of the Coast Guard, former mem-
bers of the Coast Guard, and dependents of such 
members and former members (other than former 
members and dependents of former members who 
are a Medicare-eligible beneficiary or for whom the 
payment for treatment or care is made from the 
Medicare-Eligible Retiree Health Care Fund) at fa-
cilities under the jurisdiction of the Department of 
Defense or a military department; and 
‘‘(2) for which a reimbursement would other-
wise be made under section 1085. 
‘‘(b) AMOUNT.—The amount of the prospective pay-
ment under subsection (a) shall be— 
‘‘(1) in the case of treatment or care to be pro-
vided to members of the Coast Guard and their de-
pendents, derived from amounts appropriated for the 
operating expenses of the Coast Guard; 
‘‘(2) in the case of treatment or care to be pro-
vided former members of the Coast Guard and their 
dependents, derived from amounts appropriated for 
retired pay; 
‘‘(3) determined under procedures established 
by the Secretary of Defense; 
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‘‘(4) paid during the fiscal year in which treat-
ment or care is provided; and 
‘‘(5) subject to adjustment or reconciliation as 
the Secretaries determine appropriate during or 
promptly after such fiscal year in cases in which the 
prospective payment is determined excessive or in-
sufficient based on the services actually provided. 
‘‘(c) NO PROSPECTIVE PAYMENT WHEN SERVICE IN 
NAVY.—No prospective payment shall be made under this 
section for any period during which the Coast Guard oper-
ates as a service in the Navy. 
‘‘(d) RELATIONSHIP
TO TRICARE.—This section 
shall not be construed to require a payment for, or the 
prospective payment of an amount that represents the 
value of, treatment or care provided under any TRICARE 
program.’’. 
(b) CLERICAL AMENDMENT.—The analysis for chap-
ter 13 of title 14, United States Code, is amended by add-
ing at the end the following: 
‘‘519. Prospective payment of funds necessary to provide medical care.’’. 
(c) REPEAL.—Section 217 of the Coast Guard Au-
thorization Act of 2016 (Public Law 114–120), as amend-
ed by section 3504, and the item relating to that section 
in the table of contents in section 2 of such Act, are re-
pealed. 
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SEC. 732. REQUIREMENT TO REVIEW AND MONITOR PRE-
SCRIBING PRACTICES AT MILITARY TREAT-
MENT 
FACILITIES 
OF 
PHARMACEUTICAL 
AGENTS FOR TREATMENT OF POST-TRAU-
MATIC STRESS. 
(a) IN GENERAL.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary of Defense 
shall— 
(1) conduct a comprehensive review of the pre-
scribing practices at military treatment facilities of 
pharmaceutical agents for the treatment of post- 
traumatic stress; 
(2) implement a process or processes to monitor 
the prescribing practices at military treatment facili-
ties of pharmaceutical agents that are discouraged 
from use under the VA/DOD Clinical Practice 
Guideline 
for 
Management 
of 
Post-Traumatic 
Stress; and 
(3) implement a plan to address any deviations 
from such guideline in prescribing practices of phar-
maceutical agents for management of post-traumatic 
stress at such facilities. 
(b) PHARMACEUTICAL AGENT DEFINED.—In this 
section, the term ‘‘pharmaceutical agent’’ has the meaning 
given that term in section 1074g(g) of title 10, United 
States Code. 
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SEC. 733. USE OF MEFLOQUINE FOR MALARIA. 
(a) MEFLOQUINE.—In providing health care to mem-
bers of the Armed Forces, the Secretary of Defense shall 
require— 
(1) that the use of mefloquine for the prophy-
laxis of malaria be limited to members with intoler-
ance or contraindications to other chemoprophylaxis; 
(2) that mefloquine be prescribed by a licensed 
medical provider on an individual basis, and 
(3) that members prescribed mefloquine for ma-
laria prophylaxis be counseled by the medical pro-
vider about the potential side effects of the drug and 
be provided the Food and Drug Administration-re-
quired patient information handouts. 
(b) PROCESS AND REVIEW.— 
(1) PROCESS.—Not later than 180 days after 
the date of the enactment of this Act, in providing 
health care to members of the Armed Forces, the 
Secretary shall develop a standardized process to 
document the screening for contraindications and 
patient education, including a prior authorization 
form, to be used by all medical providers prescribing 
mefloquine for malaria prophylaxis. 
(2) ANNUAL REVIEW.—The Secretary shall con-
duct an annual review of each mefloquine prescrip-
tion at all military medical treatment facilities to 
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evaluate the documentation of the assessment for 
contraindications, justification for not using other 
chemoprophylaxis, and patient education for the safe 
use of mefloquine and its side effects. 
(c) ADVERSE HEALTH EFFECTS OF MEFLOQUINE.— 
The Secretary of Defense shall expand the missions of the 
Hearing Center of Excellence, the Vision Center of Excel-
lence, the Defense Centers of Excellence for Psychological 
Health and Traumatic Brain Injury (including the De-
ployment Health Clinical Center), and the Center for De-
ployment Health Research to include, as appropriate, im-
proving the clinical evaluation, diagnosis, management, 
and epidemiological study of adverse health effects among 
members of the Armed Forces following exposure to 
mefloquine. 
SEC. 734. APPLIED BEHAVIOR ANALYSIS. 
(a) RATES OF REIMBURSEMENT.— 
(1) IN GENERAL.—In furnishing applied behav-
ior analysis under the TRICARE program to indi-
viduals described in paragraph (2) during the period 
beginning on the date of the enactment of this Act, 
and ending on December 31, 2018, the Secretary of 
Defense shall ensure that the reimbursement rates 
for providers of applied behavior analysis are not 
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less than the rates that were in effect on March 31, 
2016. 
(2) INDIVIDUALS DESCRIBED.—Individuals de-
scribed in this paragraph are individuals who are 
covered beneficiaries (as defined in section 1072 of 
title 10, United States Code) by reason of being a 
member or former member of the Army, Navy, Air 
Force, or Marine Corps, including the reserve com-
ponents thereof, or a dependent of such a member 
or former member. 
(b) ANALYSIS.— 
(1) IN GENERAL.—Upon the completion of the 
Department of Defense Comprehensive Autism Care 
Demonstration, the Assistant Secretary of Defense 
for Health Affairs shall conduct an analysis to— 
(A) use data gathered during the dem-
onstration to set future reimbursement rates for 
providers of applied behavior analysis under the 
TRICARE program; and 
(B) review comparative commercial insur-
ance claims for purposes of setting such future 
rates, including by— 
(i) conducting an analysis of the com-
parative total of commercial insurance 
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claims billed for applied behavior analysis; 
and 
(ii) reviewing any covered beneficiary 
limitations on access to applied behavior 
analysis services at various military instal-
lations throughout the United States. 
(2) SUBMISSION.—The Assistant Secretary 
shall submit to the congressional defense committees 
the analysis conducted under paragraph (1). 
(c) FUNDING.— 
(1) INCREASE.—Notwithstanding the amounts 
set forth in the funding tables in division D, the 
amount authorized to be appropriated in section 
1405 for the Defense Health Program, as specified 
in the corresponding funding table in section 4501, 
for Private Sector Care is hereby increased by 
$32,000,000. 
(2) OFFSET.—Notwithstanding the amounts set 
forth in the funding tables in division D, the amount 
authorized to be appropriated in section 4301 for 
operation and maintenance, as specified in the cor-
responding funding table in section 4301, for the Of-
fice of the Secretary of Defense (Line 300) is hereby 
reduced by $32,000,000. 
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(d) SENSE OF CONGRESS.—It is the sense of Con-
gress that amounts should be appropriated for behavioral 
health treatment of TRICARE beneficiaries, including 
pursuant to this section, in a manner to ensure the appro-
priate and equitable access to such treatment by all such 
beneficiaries. 
Subtitle D—Reports and Other 
Matters 
SEC. 741. MENTAL HEALTH RESOURCES FOR MEMBERS OF 
THE MILITARY SERVICES AT HIGH RISK OF 
SUICIDE. 
(a) IN GENERAL.—The Secretary of Defense shall 
develop a methodology that identifies which members and 
units of the military services are at high risk of suicide. 
(b) MENTAL HEALTH RESOURCES.— 
(1) HIGH
RISK
MEMBERS
OF
THE
MILITARY 
SERVICES.—The Secretary of Defense shall use the 
results under subsection (c) to— 
(A) identify which units have a dispropor-
tionately high rate of suicide and suicide at-
tempts; and 
(B) provide additional preventative and 
treatment resources for mental health for mem-
bers of the military services who were deployed 
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with the units identified under subparagraph 
(A). 
(2) PREVENTATIVE MENTAL HEALTH CARE.— 
The Secretary of Defense shall use the results under 
subsection (c) to— 
(A) identify the circumstances of deploy-
ments associated with increased vulnerability to 
suicide, including the length of deployment, the 
region and area of deployment, and the nature 
and extent to which there was contact with 
enemy forces; and 
(B) provide additional preventative mental 
health care to units who currently are, or will 
be, deployed under circumstances similar to 
those of subparagraph (A). 
(3) HIGH RISK VETERANS.—The Secretary of 
Veterans Affairs shall use the results under sub-
section (c) to provide outreach regarding the avail-
able preventative and treatment resources for mental 
health for enrolled veterans who were deployed with 
the units identified under this subsection. 
(c) METHODOLOGY.—Not later than 180 days after 
the date of the enactment of this Act, the Secretary of 
Defense shall develop a methodology to assess the rate of 
suicide and suicide attempts of members of the military 
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services of units that have been deployed in support of 
a contingency operation after September 11, 2001. 
(d) REPORTS.—Not later than September 30, 2017, 
the Secretary of Defense and the Secretary of Veterans 
Affairs shall submit to the Committee on Armed Services 
and the Committee on Veterans’ Affairs of the House of 
Representatives and the Committee on Armed Services 
and the Committee on Veterans’ Affairs of the Senate a 
report on the activities carried out under this section and 
the effectiveness of such activities. 
(e) RESTRICTION ON USE OF INFORMATION.—Infor-
mation disclosed or obtained pursuant to the provisions 
of this section may be used by officers, employees, and 
contractors of the Department of Defense only for the 
purposes of, and to the extent necessary in, carrying out 
this section. 
(f) DEFINITIONS.—In this section: 
(1) MILITARY SERVICES.—The term ‘‘military 
services’’ means the Army, Navy, Air Force, and the 
Marine Corps, including the reserve components 
thereof. 
(2) ENROLLED VETERAN.—The term ‘‘enrolled 
veteran’’ means a veteran enrolled in the health care 
system of the Department of Veterans Affairs. 
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SEC. 
742. 
RESEARCH 
OF 
CHRONIC 
TRAUMATIC 
ENCEPHALOPATHY. 
Of the funds authorized to be appropriated by this 
Act or otherwise made available for fiscal year 2017 for 
advanced development for research, development, test, and 
evaluation for the Defense Health Program, not more than 
$25,000,000 may be used to award grants to medical re-
searchers and universities to support research into early 
detection of chronic traumatic encephalopathy. 
SEC. 743. ACTIVE OSCILLATING NEGATIVE PRESSURE 
TREATMENT. 
In furnishing health care and medical treatment to 
members of the Armed Forces who have incurred injuries 
from improvised explosive devices and other blast-related 
events, the Secretary of Defense shall consider using non- 
invasive technologies that increase blood flow to areas of 
reduced circulation, including through the use of active os-
cillating negative pressure treatment. 
SEC. 744. LONG-TERM STUDY ON HEALTH OF HELICOPTER 
AND TILTROTOR PILOTS. 
(a) STUDY REQUIRED.—The Secretary of Defense 
shall carry out a long-term study of career helicopter and 
tiltrotor pilots to assess potential links between the oper-
ation of helicopter and tiltrotor aircraft and acute and 
chronic medical conditions experienced by such pilots. 
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(b) ELEMENTS.—The study under subsection (a) 
shall include the following: 
(1) A study of career helicopter and tiltrotor pi-
lots compared to a control population that— 
(A) takes into account the amount of time 
such pilots operated aircraft; 
(B) examines the severity and rates of 
acute and chronic injuries experienced by such 
pilots; and 
(C) determines whether such pilots experi-
ence a higher degree of acute and chronic med-
ical conditions than the control population. 
(2) If a higher degree of acute and chronic 
medical conditions is observed among such pilots, an 
explanation of— 
(A) the specific causes of the conditions 
(such as whole body vibration, seat and cockpit 
ergonomics, landing loads, hard impacts, and 
pilot-worn gear); and 
(B) any costs associated with treating the 
conditions if the causes are not mitigated. 
(3) A review of relevant scientific literature and 
prior research. 
(4) Such other information as the Secretary de-
termines to be appropriate. 
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(c) DURATION.—The duration of the study under 
subsection (a) shall be not more than 2 years. 
(d) BRIEFING.—Not later than June 6, 2017, the 
Secretary shall provide to the Committees on Armed Serv-
ices of the Senate and House of Representatives (and 
other congressional defense committees on request) a 
briefing on the progress of the Secretary in carrying out 
the study under subsection (a). 
SEC. 745. PILOT PROGRAM FOR PRESCRIPTION DRUG AC-
QUISITION COST PARITY IN THE TRICARE 
PHARMACY BENEFITS PROGRAM. 
(a) AUTHORITY TO ESTABLISH PILOT PROGRAM.— 
The Secretary of Defense may conduct a pilot program 
to evaluate whether, in carrying out the TRICARE phar-
macy benefits program under section 1074g of title 10, 
United States Code, extending additional discounts for 
prescription drugs filled at retail pharmacies will maintain 
or reduce prescription drug costs for the Department of 
Defense. 
(b) ELEMENTS OF PILOT PROGRAM.—In carrying 
out the pilot program under subsection (a), the Secretary 
shall require that for prescription medications, including 
but not limited to non-generic maintenance medications, 
that are dispensed to retired TRICARE beneficiaries that 
are not Medicare eligible, through any TRICARE partici-
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pating retail pharmacy, including small business phar-
macies, manufacturers shall pay rebates such that those 
medications are available to the Department at the lowest 
rate available. In addition to utilizing the authority under 
section 1074g(f) of title 10, United States Code, the Sec-
retary shall have the authority to enter into a purchase 
blanket agreement with prescription drug manufactures 
for supplemental discounts for prescription drugs dis-
pensed in the pilot to be paid in the form of manufactures 
rebates. 
(c) CONSULTATION.—The Secretary shall develop the 
pilot program in consultation with— 
(1) the Secretaries of the military departments, 
including Army, Navy and Air Force; 
(2) the Chief, Pharmacy Operations Division, of 
the Defense Health Agency; and 
(3) stakeholders, including TRICARE bene-
ficiaries and retail pharmacies. 
(d) DURATION OF PILOT PROGRAM.—If the Sec-
retary carries out the pilot program under subsection (a), 
the Secretary shall commence such pilot program no later 
than October 1, 2017, and may terminate such program 
no later than September 30, 2018. 
(e) REPORTS.—If the Secretary carries out the pilot 
program under subsection (a), the Secretary of Defense 
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shall submit to the congressional defense committees, in-
cluding the House and Senate Committees on Armed 
Services, reports on the pilot program as follows: 
(1) Not later than 90 days after the date of the 
enactment of this Act, a report containing an imple-
mentation plan for the pilot program. 
(2) Not later than 180 days after the date on 
which the pilot program commences, an interim re-
port on the pilot program. 
(3) Not later than 90 days after the date on 
which the pilot program terminates, a final report 
describing the results of the pilot program, including 
any recommendations of the Secretary to expand 
such program. The final report will include— 
(A) an analysis of the changes in prescrip-
tion drug costs for the Department related to 
the pilot program; 
(B) an analysis of the impact on bene-
ficiary access to prescription drugs; 
(C) a survey of beneficiary satisfaction 
with the pilot program; 
(D) a summary of any fraud and abuse ac-
tivities related to the pilot and actions taken in 
response by the Department; and 
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(E) a comparison of immunization rates 
for beneficiaries participating in the pilot and 
those outside of the pilot. 
SEC. 746. STUDY ON DISPLAY OF WAIT TIMES AT URGENT 
CARE CLINICS, PHARMACIES, AND EMER-
GENCY 
ROOMS 
OF 
MILITARY 
MEDICAL 
TREATMENT FACILITIES. 
(a) STUDY.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall conduct a study on the feasibility of placing in 
a conspicuous location at each urgent care clinic of 
a military medical treatment facility, pharmacy of 
such a facility, and emergency room of such a facil-
ity an electronic sign that displays the current aver-
age wait time for a patient to be seen by a qualified 
medical professional or to receive a filled prescrip-
tion, as the case may be. 
(2) 
DETERMINATION
OF
CERTAIN
WAIT 
TIMES.—For purposes of conducting the study under 
paragraph (1) with respect to urgent care clinics and 
emergency rooms, the average wait time that would 
be displayed shall be— 
(A) determined by calculating, for the 
four-hour period preceding the calculation, the 
average length of time beginning at the time of 
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the arrival of a patient and ending at the time 
at which the patient is first seen by a doctor of 
medicine, a doctor of osteopathy, a physician 
assistant, or an advanced registered nurse prac-
titioner; and 
(B) updated every 30 minutes. 
(b) REPORT.—Not later than March 1, 2017, the 
Secretary shall submit to the Committees on Armed Serv-
ices of the House of Representatives and the Senate a re-
port on the study conducted under subsection (a)(1), in-
cluding the estimated costs for displaying the wait times 
as described in such subsection. 
SEC. 747. REPORT ON FEASIBILITY OF INCLUDING ACU-
PUNCTURE AND CHIROPRACTIC SERVICES 
FOR RETIREES UNDER TRICARE PROGRAM. 
Not later than November 1, 2016, the Secretary of 
Defense shall submit to the congressional defense commit-
tees a report on the feasibility of furnishing acupuncture 
services and chiropractic services under the TRICARE 
program to beneficiaries who are retired members of the 
uniformed services (not including any dependent of such 
a retired member). 
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SEC. 748. CLARIFICATION OF SUBMISSION OF REPORTS ON 
LONGITUDINAL 
STUDY 
ON 
TRAUMATIC 
BRAIN INJURY. 
Section 1080 of the National Defense Authorization 
Act for Fiscal Year 2016 (Public Law 114–92; 129 Stat. 
1000; 10 U.S.C. 111 note) shall not apply to reports sub-
mitted by the Secretary of Defense to Congress under sec-
tion 721 of the John Warner National Defense Authoriza-
tion Act for Fiscal Year 2007 (Public Law 109–364; 120 
Stat. 2294). 
SEC. 749. INCREASED COLLABORATION WITH NIH TO COM-
BAT TRIPLE NEGATIVE BREAST CANCER. 
The Office of Health of the Department of Defense 
shall work in collaboration with the National Institutes of 
Health to— 
(1) identify specific genetic and molecular tar-
gets and biomarkers for triple negative breast can-
cer; and 
(2) provide information useful in biomarker se-
lection, drug discovery, and clinical trials design that 
will enable both— 
(A) triple negative breast cancer patients 
to be identified earlier in the progression of 
their disease; and 
(B) the development of multiple targeted 
therapies for the disease. 
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SEC. 750. DEPARTMENT OF DEFENSE STUDIES ON PRE-
VENTING THE DIVERSION OF OPIOID MEDI-
CATIONS. 
(a) STUDIES.—With respect to programs of the De-
partment of Defense that dispense drugs to patients, the 
Secretary of Defense (referred to in this section as the 
‘‘Secretary’’) shall study the feasibility, the effectiveness 
in preventing the diversion of opioid medications, and the 
cost-effectiveness of— 
(1) requiring that such programs, in appro-
priate cases, dispense opioid medications in vials 
using affordable technologies designed to prevent ac-
cess to the medications by anyone other than the in-
tended patient, such as a vial with a locking-cap clo-
sure mechanism; and 
(2) the Secretary providing education on the 
risks of opioid medications to individuals for whom 
such medications are prescribed, and to their fami-
lies, with special consideration given to raising 
awareness among adolescents on such risks. 
(b) FEEDBACK.—In conducting the studies under 
subsection (a), the Secretary shall seek feedback (on a 
confidential basis when appropriate) from the individuals 
and entities involved in the studies. 
(c) REPORT TO CONGRESS.—Not later than one year 
after the date of the enactment of this Act, the Secretary 
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shall submit to the Congress a report on the results of 
the studies conducted under subsection (a). 
TITLE VIII—ACQUISITION POL-
ICY, ACQUISITION MANAGE-
MENT, AND RELATED MAT-
TERS 
Subtitle A—Amendments to Gen-
eral 
Contracting 
Authorities, 
Procedures, and Limitations 
SEC. 801. REVISION TO AUTHORITIES RELATING TO DE-
PARTMENT OF DEFENSE TEST RESOURCE 
MANAGEMENT CENTER. 
Section 196 of title 10, United States Code, is 
amended— 
(1) in subsection (c)(1)(B), by striking ‘‘of the 
Major Range and Test Facility Base, including with 
respect to the expansion, divestment, consolidation, 
or curtailment of activities,’’ and inserting the fol-
lowing: ‘‘that comprise the Major Range and Test 
Facility Base and other facilities and resources used 
to support the acquisition programs of the Depart-
ment of Defense’’; 
(2) in subsection (d)(2)(E)— 
(A) by striking ‘‘plans and business case 
analyses supporting any significant modification 
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of’’ and inserting ‘‘implementation plans and 
analyses supporting any significant change to’’; 
and 
(B) by striking ‘‘including with respect to 
the expansion, divestment, consolidation, or cur-
tailment of activities’’; 
(3) in subsection (f)— 
(A) in the subsection heading, by striking 
‘‘MODIFICATIONS’’ and inserting ‘‘CHANGES’’; 
(B) in paragraph (1)— 
(i) in the matter preceding subpara-
graph (A), by striking ‘‘modification of the 
test’’ and all that follows through ‘‘activi-
ties,’’ and inserting ‘‘change of the test 
and evaluation facilities and resources that 
comprise the Major Range and Test Facil-
ity Base and other facilities and resources 
used to support the acquisition programs 
of the Department of Defense’’; 
(ii) in subparagraph (A), by striking 
‘‘a business case analysis for such modi-
fication’’ and inserting ‘‘an implementation 
plan and analysis, including an analysis of 
cost considerations, that supports such a 
change’’; and 
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(iii) in subparagraph (B), by striking 
‘‘analysis and approves such modification’’ 
and inserts ‘‘plan and analysis and ap-
proves such change’’; and 
(C) in paragraph (2), by striking ‘‘business 
case’’ and inserting ‘‘implementation plan and’’; 
and 
(4) in subsection (i)— 
(A) by striking ‘‘In this section, the term’’ 
and inserting ‘‘In this section: 
‘‘(1) The term’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(2) The term ‘significant change’ means— 
‘‘(A) any action that will limit or preclude 
a test and evaluation capability from fully per-
forming its intended purpose; 
‘‘(B) any action that affects the ability of 
the Department of Defense to conduct test and 
evaluation in a timely or cost-effective manner; 
or 
‘‘(C) any expansion or addition that devel-
ops a new significant test capability.’’. 
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SEC. 
802. 
AMENDMENTS 
TO 
RESTRICTIONS 
ON 
UNDEFINITIZED CONTRACTUAL ACTIONS. 
(a) ALLOWABLE PROFIT.—Section 2326(e) of title 
10, United States Code, is amended— 
(1) by redesignating paragraphs (1) and (2) as 
subparagraphs (A) and (B); 
(2) by inserting ‘‘(1)’’ before ‘‘The head’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(2) If a contractor submits a qualifying proposal to 
definitize an undefinitized contractual action and the con-
tracting officer for such action definitized the contract 
after the end of the 180-day period beginning on the date 
on which the contractor submitted the qualifying proposal, 
the head of the agency concerned shall ensure that the 
profit allowed on the contract accurately reflects the cost 
risk of the contractor as it existed on the date the con-
tractor submitted the qualifying proposal.’’. 
(b) FOREIGN MILITARY SALES.—Section 2326 of 
such title is further amended— 
(1) by redesignating subsections (f) and (g) as 
subsections (g) and (h), respectively; 
(2) by inserting after subsection (e) the fol-
lowing new subsection (f): 
‘‘(f) FOREIGN MILITARY SALES.—A contracting offi-
cer of the Department of Defense may not enter into an 
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undefinitized contractual action for a foreign military sale 
unless the contractual action provides for agreement upon 
contractual terms, specifications, and price by the end of 
the 180-day period beginning on the date on which the 
contractor submits a qualifying proposal to definitize such 
terms, specifications, and price. This subsection may be 
waived in the same manner as subsection (b) may be 
waived under subsection (b)(4).’’. 
(c) DEFINITIONS.—Subsection (h) of such section, as 
redesignated by subsection (b), is amended— 
(1) in paragraph (1)— 
(A) by striking subparagraph (A); and 
(B) by redesignating subparagraphs (B), 
(C), and (D) as subparagraphs (A), (B), and 
(C), respectively; and 
(2) in paragraph (2), by striking ‘‘complete and 
meaningful audits’’ and all that follows through the 
period and inserting ‘‘a meaningful audit of the in-
formation contained in the proposal.’’. 
SEC. 803. REVISION TO REQUIREMENTS RELATING TO IN-
VENTORY METHOD FOR DEPARTMENT OF DE-
FENSE CONTRACTS FOR SERVICES. 
(a) REVISION TO CURRENT REQUIREMENTS.—Sec-
tion 2330a of title 10, United States Code, is amended— 
(1) by striking subsections (c), (d), (f), and (g); 
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SEC. 809A. EXTENSION OF LIMITATION ON AGGREGATE AN-
NUAL AMOUNT AVAILABLE FOR CONTRACT 
SERVICES. 
Section 808 of the National Defense Authorization 
Act for Fiscal Year 2012 (Public Law 112–81; 125 Stat. 
1489), as most recently amended by section 813 of the 
National Defense Authorization Act for Fiscal Year 2015 
(Public Law 113–291; 128 Stat. 3429) is further amend-
ed— 
(1) in subsections (a) and (b), by striking ‘‘or 
2015’’ and inserting ‘‘2015, 2016, or 2017’’; 
(2) in subsection (c)(3), by striking ‘‘and 2015’’ 
and inserting ‘‘2015, 2016, and 2017’’; 
(3) in subsection (d)(4), by striking ‘‘or 2015’’ 
and inserting ‘‘2015, 2016, or 2017’’; and 
(4) in subsection (e), by striking ‘‘2015’’ and 
inserting ‘‘2017’’. 
SEC. 809B. EXTENSION OF AUTHORITY FOR ENHANCED 
TRANSFER OF TECHNOLOGY DEVELOPED AT 
DEPARTMENT OF DEFENSE LABORATORIES. 
Section 801(e) of the National Defense Authorization 
Act for Fiscal Year 2014 (Public Law 113–66; 127 Stat. 
804; 10 U.S.C. 2514 note) is amended by striking ‘‘2017’’ 
and inserting ‘‘2021’’. 
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Subtitle B—Provisions Relating to 
Major Defense Acquisition Pro-
grams 
SEC. 811. CHANGE IN DATE OF SUBMISSION TO CONGRESS 
OF SELECTED ACQUISITION REPORTS. 
Section 2432(f) of title 10, United States Code, is 
amended by striking ‘‘45’’ the first place it occurs and 
inserting ‘‘10’’. 
SEC. 812. AMENDMENTS RELATING TO INDEPENDENT COST 
ESTIMATION AND COST ANALYSIS. 
(a) AMENDMENTS.—Section 2334 of title 10, United 
States Code, is amended— 
(1) in subsection (a)(3), by striking ‘‘selection 
of confidence levels’’ both places it appears and in-
serting ‘‘discussion of risk’’; 
(2) in subsection (a)(6)— 
(A) by inserting ‘‘or approve’’ after ‘‘con-
duct’’; 
(B) by striking ‘‘major defense acquisition 
programs’’ and all that follows through ‘‘Au-
thority—’’ and inserting ‘‘all major defense ac-
quisition programs, major automated informa-
tion system programs, and major subpro-
grams—’’; and 
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(e) EFFECTIVE DATE.—The amendments made by 
this section take effect on the date of the enactment of 
this Act and apply with respect to assistance authorized 
to be provided under subsection (a) of section 1204 of the 
National Defense Authorization Act for Fiscal Year 2014 
on or after such date of enactment. 
SEC. 1204. EXTENSION OF AUTHORITY FOR SUPPORT OF 
SPECIAL 
OPERATIONS 
TO 
COMBAT 
TER-
RORISM. 
Subsection (h) of section 1208 of the Ronald W. 
Reagan National Defense Authorization Act for Fiscal 
Year 2005 (Public Law 108–375; 118 Stat. 2086), as 
most recently amended by section 1208(b) of the Carl 
Levin and Howard P. ‘‘Buck’’ McKeon National Defense 
Authorization Act for Fiscal Year 2015 (Public Law 113– 
291; 128 Stat. 3541), is further amended by striking 
‘‘2017’’ and inserting ‘‘2020’’. 
SEC. 1205. MODIFICATION AND CODIFICATION OF REPORT-
ING REQUIREMENTS RELATING TO SECURITY 
COOPERATION AUTHORITIES. 
(a) ANNUAL REPORT REQUIRED.—Subsection (a) of 
section 1211 of the Carl Levin and Howard P. ‘‘Buck’’ 
McKeon National Defense Authorization Act for Fiscal 
Year 2015 (Public Law 113–291; 128 Stat. 3544) is 
amended— 
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(11) The near-term and long-term costs and 
cost effectiveness of such programs. 
(12) The options for affecting the offense-de-
fense cost curve. 
(13) Accountability, transparency, and over-
sight with respect to such programs. 
(14) The role of international cooperation on 
missile defeat in the missile defeat policy and strat-
egy of the United States and the plans, policies, and 
requirements for integration and interoperability of 
missile defeat capability with allies. 
(15) Options for enhancing and making routine 
the codevelopment of missile defeat capabilities with 
allies of the United States in the near-term and far- 
term. 
(16) Declaratory policy governing the employ-
ment of missile defeat capabilities and the military 
options and plans and employment options of such 
capabilities. 
(17) The role of multi-mission defense and 
other assets of the United States, including space 
and terrestrial sensors and plans to achieve multi- 
mission capability in current, planned, and other fu-
ture assets and acquisition programs. 
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‘‘(i) IN
GENERAL.—If the Assistant 
Administrator rejects an amended plan 
under subparagraph (D), the eligible entity 
shall have the opportunity to appeal such 
decision to the Administrator, who may 
delegate such appeal to an appropriate of-
ficer of the Administration. 
‘‘(ii) 
OPPORTUNITY
FOR
EXPLA-
NATION.—Any appeal described under 
clause (i) shall provide an opportunity for 
the eligible entity to provide, in writing, an 
explanation of why the eligible entity’s plan 
remedies the problems identified in the an-
nual review. 
‘‘(iii) NOTICE OF DETERMINATION.— 
The determination of the appeal shall be 
provided to the eligible entity, in writing, 
within 15 calendar days from the eligible 
entity’s filing of the appeal. 
‘‘(iv) EFFECT OF FAILURE TO ACT.— 
If the Administrator fails to act on an ap-
peal made under this subparagraph within 
the 15 calendar day period specified under 
clause (iii), the eligible entity’s amended 
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‘‘§ 893a. Art. 93a. Prohibited activities with military 
recruit or trainee by person in position of 
special trust 
‘‘(a) ABUSE OF TRAINING LEADERSHIP POSITION.— 
Any person subject to this chapter— 
‘‘(1) who is an officer, a noncommissioned offi-
cer, or a petty officer; 
‘‘(2) who is in a training leadership position 
with respect to a specially protected junior member 
of the armed forces; and 
‘‘(3) who engages in prohibited sexual activity 
with such specially protected junior member of the 
armed forces; 
shall be punished as a court-martial may direct. 
‘‘(b) ABUSE
OF
POSITION
AS
MILITARY
RE-
CRUITER.—Any person subject to this chapter— 
‘‘(1) who is a military recruiter and engages in 
prohibited sexual activity with an applicant for mili-
tary service; or 
‘‘(2) who is a military recruiter and engages in 
prohibited sexual activity with a specially protected 
junior member of the armed forces who is enlisted 
under a delayed entry program; 
shall be punished as a court-martial may direct. 
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