H. R. 7776—236 
(E) in clause (v), by striking ‘‘section 481l’’ and 
inserting ‘‘section 452(b)(15)’’; 
(7) in section 1002(b)(1), by striking ‘‘section 474(a)–(d), 
and (f),’’ and inserting ‘‘section 452’’; 
(8) in section 1003, by striking ‘‘sections 402–403b, 474– 
477, 479–481, and 414’’ and inserting ‘‘sections 402 through 
403b, 405, 414, 452, and 453’’; and 
(9) in section 1006(g)— 
(A) by striking ‘‘section 477’’ and inserting ‘‘section 
452(c)(2)’’; and 
(B) by striking ‘‘section 475a(a)’’ and inserting ‘‘section 
452(b)(11)’’. 
(i) CHILD NUTRITION ACT OF 1966.—Section 17(d)(2)(B)(ii) of 
the Child Nutrition Act of 1966 (42 U.S.C. 1786(d)(2)(B)(ii)) is 
amended by striking ‘‘section 475’’ and inserting ‘‘section 405’’. 
SEC. 627. PILOT PROGRAM TO REIMBURSE MEMBERS OF THE ARMED 
FORCES FOR CERTAIN CHILD CARE COSTS INCIDENT TO 
A PERMANENT CHANGE OF STATION OR ASSIGNMENT. 
(a) ESTABLISHMENT.—The Secretary of Defense shall carry out 
a pilot program to reimburse members of the Armed Forces for 
certain child care costs incident to a permanent change of station 
or assignment. 
(b) TRAVEL
AND TRANSPORTATION ALLOWANCES.—Under the 
pilot program, the Secretary of Defense shall treat a designated 
child care provider as an authorized traveler if child care is not 
available to a member of the Armed Forces at a military child 
development center at the permanent duty location of such member 
not later than 30 days after the member arrives at such location. 
(c) REIMBURSEMENT OF CERTAIN CHILD CARE COSTS.— 
(1) AUTHORITY.—Under the pilot program, the Secretary 
of Defense may reimburse a member of the Armed Forces 
for travel expenses for a designated child care provider when— 
(A) the member is reassigned, either as a permanent 
change of station or permanent change of assignment, to 
a new duty station; 
(B) the movement of the member’s dependents is 
authorized at the expense of the United States under sec-
tion 451 of title 37, United States Code, as part of the 
reassignment; 
(C) child care is not available at a military child 
development center at such duty station not later than 
30 days after the member arrives at such duty station; 
and 
(D) the dependent child is on the wait list for child 
care at such military child development center. 
(2) MAXIMUM
AMOUNTS.—Reimbursement provided to a 
member under this subsection may not exceed— 
(A) $500 for a reassignment between duty stations 
within the continental United States; and 
(B) $1,500 for a reassignment involving a duty station 
outside of the continental United States. 
(3) DEADLINE.—A member may not apply for reimburse-
ment under this subsection later than one year after a reassign-
ment described in paragraph (1). 
(4) CONCURRENT
RECEIPT
PROHIBITED.—In the event a 
household contains more than one member eligible for
H. R. 7776—237 
reimbursement under this subsection, reimbursement may be 
paid to one member among such members as such members 
shall jointly elect. 
(d) REPORT.—Not later than January 1, 2027, the Secretary 
shall submit to the Committees on Armed Services of the Senate 
and House of Representatives a report on the pilot program, 
including the recommendation of the Secretary whether to make 
the pilot program permanent. 
(e) TERMINATION.—The pilot program shall terminate on Sep-
tember 30, 2028. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘authorized traveler’’ has the meaning given 
such term in section 451 of title 37, United States Code. 
(2) The term ‘‘designated child care provider’’ means an 
adult selected by a member of the armed forces to provide 
child care to a dependent child of such member. 
(3) The term ‘‘military child development center’’ has the 
meaning given such term in section 1800 of title 10, United 
States Code. 
Subtitle D—Leave 
SEC. 631. TECHNICAL AMENDMENTS TO LEAVE ENTITLEMENT AND 
ACCUMULATION. 
(a) REPEAL OF OBSOLETE AUTHORITY.—Section 701 of title 10, 
United States Code, is amended— 
(1) by striking subsection (d); and 
(2) by redesignating subsections (e) through (m) as sub-
sections (d) through (l). 
(b) CONFORMING AMENDMENTS TO SECTION 701 OF TITLE 10.— 
Section 701 of title 10, United States Code, is amended— 
(1) in subsection (b), by striking ‘‘subsections (d), (f), and 
(g)’’ and inserting ‘‘subsections (e) and (f)’’; 
(2) in subsection (f), as redesignated by subsection (a)(2), 
in the first sentence, by striking ‘‘subsections (b), (d), and 
(f)’’ and inserting ‘‘subsections (b) and (e)’’; and 
(3) in subsection (i), as so redesignated, in the first sen-
tence, by striking ‘‘subsections (b), (d), and (f)’’ and inserting 
‘‘subsections (b) and (e)’’. 
(c) CONFORMING AMENDMENTS TO OTHER PROVISIONS OF LAW.— 
(1) TITLE 14.—Section 2508(a) of title 14, United States 
Code, is amended by striking ‘‘section 701(f)(2)’’ and inserting 
‘‘section 701(e)’’. 
(2) TITLE 37.—Title 37, United States Code, is amended— 
(A) in section 501— 
(i) in subsection (b)(6), by striking ‘‘120 days of 
leave under section 701(f)(1)’’ and inserting ‘‘90 days 
of leave under section 701(e)’’; and 
(ii) in subsection (h), by striking ‘‘section 701(g)’’ 
and inserting ‘‘section 701(f)’’; and 
(B) in section 502(b), by striking ‘‘section 701(h)’’ and 
inserting ‘‘section 701(g)’’. 
(d) EFFECTIVE DATE.—The amendments made by this section 
take effect on January 1, 2023.
H. R. 7776—238 
SEC. 632. MODIFICATION OF AUTHORITY TO ALLOW MEMBERS OF THE 
ARMED FORCES TO ACCUMULATE LEAVE IN EXCESS OF 
60 DAYS. 
(a) IN GENERAL.—Section 701 of title 10, United States Code, 
as amended by section 631, is further amended by striking sub-
section (e) and inserting the following: 
‘‘(e)(1) The Secretary concerned, under uniform regulations to 
be prescribed by the Secretary of Defense, may authorize a member 
described in paragraph (2) to retain not more than 30 days of 
excess leave. 
‘‘(2) A member described in this paragraph is a member who— 
‘‘(A)(i) serves on active duty for a continuous period of 
at least 120 days for which the member is entitled to special 
pay under section 310(a) of title 37; or 
‘‘(ii) is assigned to a deployable ship or mobile unit or 
to other duty designated for the purposes of this section; 
‘‘(B) except for this subsection, would lose any excess leave 
at the end of the fiscal year; and 
‘‘(C) receives, from the first officer in a grade above O- 
6 in the chain of command of such member, written authoriza-
tion to retain such excess leave. 
‘‘(3) Excess leave retained by a member under this subsection 
shall be forfeited unless used before the end of the second fiscal 
year after the end of the fiscal year in which the service or assign-
ment described in paragraph (2)(A) terminated. 
‘‘(4) In this subsection, the term ‘excess leave’ means leave 
accrued by a member in excess of the number of days of leave 
authorized to be accumulated under subsection (b).’’. 
(b) TRANSITION RULE.—Leave in excess of 90 days, accumulated 
by a member of the Armed Forces under section 701 of such title 
before the effective date under subsection (c), is forfeited unless— 
(1) used by the member on or before September 30, 2026; 
or 
(2) the retention of such leave is otherwise authorized 
by law. 
(c) EFFECTIVE DATE.—The amendment made by subsection (a) 
takes effect on January 1, 2023. 
SEC. 633. CONVALESCENT LEAVE FOR A MEMBER OF THE ARMED 
FORCES. 
(a) IN GENERAL.—Section 701 of title 10, United States Code, 
as amended by sections 631 and 632, is further amended by adding 
at the end the following new subsection: 
‘‘(m)(1) Except as provided by subsection (h)(3), and under 
regulations prescribed by the Secretary of Defense, a member of 
the armed forces diagnosed with a medical condition is allowed 
convalescent leave if— 
‘‘(A) the medical or behavioral health provider of the 
member— 
‘‘(i) determines that the member is not yet fit for duty 
as a result of that condition; and 
‘‘(ii) recommends such leave for the member to provide 
for the convalescence of the member from that condition; 
and 
‘‘(B) the commanding officer of the member or the com-
mander of the military medical treatment facility authorizes 
such leave for the member.
H. R. 7776—239 
‘‘(2) A member may take not more than 30 days of convalescent 
leave under paragraph (1) with respect to a condition described 
in that paragraph unless— 
‘‘(A) such leave in excess of 30 days is authorized by— 
‘‘(i) the Secretary concerned; or 
‘‘(ii) an individual at the level designated by the Sec-
retary concerned, but not below the grade of O–5 or the 
civilian equivalent; or 
‘‘(B) the member is authorized to receive convalescent leave 
under subsection (h)(3) in conjunction with the birth of a child. 
‘‘(3)(A) Convalescent leave may be authorized under paragraph 
(1) only for a medical condition of a member and may not be 
authorized for a member in connection with a condition of a 
dependent or other family member of the member. 
‘‘(B) In authorizing convalescent leave for a member under 
paragraph (1) with respect to a condition described in that para-
graph, the commanding officer of the member or the commander 
of the military medical treatment facility, as the case may be, 
shall— 
‘‘(i) limit the duration of such leave to the minimum nec-
essary in relation to the diagnosis, prognosis, and probable 
final disposition of the condition of the member; and 
‘‘(ii) authorize leave tailored to the specific medical needs 
of the member rather than (except for convalescent leave pro-
vided for under subsection (h)(3)) authorizing leave based on 
a predetermined formula. 
‘‘(4) A member taking convalescent leave under paragraph (1) 
shall not have the member’s leave account reduced as a result 
of taking such leave. 
‘‘(5) In this subsection, the term ‘military medical treatment 
facility’ means a facility described in subsection (b), (c), or (d) 
of section 1073d of this title.’’. 
(b) TREATMENT
OF
CONVALESCENT
LEAVE
FOR
BIRTH
OF 
CHILD.—Paragraph (4) of subsection (h) of such section, as redesig-
nated by section 632, is amended— 
(1) by redesignating subparagraphs (A) and (B) as clauses 
(i) and (ii), respectively; 
(2) by inserting ‘‘(A)’’ after ‘‘(4)’’; and 
(3) by adding at the end the following new subparagraph: 
‘‘(B) Convalescent leave may be authorized under subparagraph 
(A) only for a medical condition of a member and may not be 
authorized for a member in connection with a condition of a 
dependent or other family member of the member.’’. 
(c) EFFECTIVE DATE.—The amendments made by this section 
shall take effect on January 1, 2023. 
Subtitle E—Family and Survivor Benefits 
SEC. 641. CLAIMS RELATING TO THE RETURN OF PERSONAL EFFECTS 
OF A DECEASED MEMBER OF THE ARMED FORCES. 
Section 1482(a) of title 10, United States Code, is amended 
by adding at the end the following new paragraph: 
‘‘(11)(A) Delivery of personal effects of a decedent to the 
next of kin or other appropriate person. 
‘‘(B) If the Secretary concerned enters into an agreement 
with an entity to carry out subparagraph (A), the Secretary
H. R. 7776—240 
concerned may, at the request of the person described in such 
subparagraph, pursue a claim against such entity that arises 
from the failure of such entity to substantially perform such 
subparagraph. 
‘‘(C) If an entity described in subparagraph (B) fails to 
substantially perform subparagraph (A) by damaging, losing, 
or destroying the personal effects of a decedent, the Secretary 
concerned shall reimburse the person designated under sub-
section (c) the greater of $1,000 or the fair market value of 
such damage, loss, or destruction. The Secretary concerned 
may request, from the person designated under subsection (c), 
proof of fair market value and ownership of the personal 
effects.’’. 
SEC. 642. EXTENSION OF PARENT FEE DISCOUNT TO CHILD CARE 
EMPLOYEES. 
Section 1793 of title 10, United States Code, is amended by 
adding at the end the following new subsection: 
‘‘(d) CHILD
CARE
EMPLOYEE
DISCOUNT.—The Secretary of 
Defense may, to support recruitment and retention initiatives, 
charge a child care employee, whose child attends a military child 
development center, a reduced fee for such attendance.’’. 
SEC. 643. SURVIVOR BENEFIT PLAN OPEN SEASON. 
(a) ELECTIONS BY PERSONS NOT CURRENTLY PARTICIPATING IN 
SURVIVOR BENEFIT PLAN.— 
(1) ELECTION
OF
SBP
COVERAGE.—An eligible retired or 
former member may elect to participate in the Survivor Benefit 
Plan during the open season described in subsection (e). 
(2) ELIGIBLE RETIRED OR FORMER MEMBERS.—For purposes 
of paragraph (1), an eligible retired or former member is a 
member or former member of the uniformed services who, 
on or before the day before the first day of the open season 
described in subsection (e)— 
(A) is entitled to retired pay; or 
(B) would be entitled to retired pay under chapter 
1223 of title 10, United States Code (or chapter 67 of 
such title as in effect before October 5, 1994), but for 
the fact that such member or former member is under 
60 years of age. 
(3) STATUS UNDER SBP OF PERSONS MAKING ELECTIONS.— 
(A) STANDARD ANNUITY.—A person making an election 
under paragraph (1) by reason of eligibility under para-
graph (2)(A) shall be treated for all purposes as providing 
a standard annuity under the Survivor Benefit Plan. 
(B) RESERVE-COMPONENT ANNUITY.—A person making 
an election under paragraph (1) by reason of eligibility 
under paragraph (2)(B) shall be treated for all purposes 
as providing a reserve-component annuity under the Sur-
vivor Benefit Plan. 
(4) PREMIUMS FOR OPEN SEASON.— 
(A) PREMIUMS
TO
BE
CHARGED.—The Secretary of 
Defense shall prescribe in regulations premiums that a 
person who makes an election under paragraph (1) shall 
be required to pay for participating in the Survivor Benefit 
Plan pursuant to the election. 
(B) AMOUNT OF PREMIUMS.—The total amount of the 
premiums to be paid by a person under the regulations
H. R. 7776—241 
prescribed under subparagraph (A) shall be equal to the 
sum of— 
(i) the total amount by which the retired pay of 
the person would have been reduced before the effective 
date of the election under subsection (d) if the person 
had elected to participate in the Survivor Benefit Plan 
(for the same base amount specified in the election) 
at the first opportunity that was afforded the person 
to participate under chapter 73 of title 10, United 
States Code; 
(ii) interest on the amount by which the retired 
pay of the person would have been so reduced, com-
puted from the date on which the retired pay would 
have been so reduced at such rate or rates and 
according to such methodology as the Secretary deter-
mines reasonable; and 
(iii) any additional amount that the Secretary 
determines necessary to protect the actuarial sound-
ness of the Department of Defense Military Retirement 
Fund against any increased risk for the fund that 
is associated with the election. 
(C) PREMIUMS TO BE CREDITED TO RETIREMENT FUND.— 
Premiums paid under the regulations prescribed under 
subparagraph (A) shall be credited to the Department of 
Defense Military Retirement Fund. 
(b) ELECTIONS BY PERSONS CURRENTLY PARTICIPATING IN SUR-
VIVOR BENEFIT PLAN.— 
(1) ELECTION OF TO DISCONTINUE SBP PARTICIPATION.—A 
person participating in the Survivor Benefit Plan on the day 
before the first day of the open season described in subsection 
(e) may elect to discontinue such participation during the open 
season. 
(2) CONSENT OF BENEFICIARIES.— 
(A) IN GENERAL.—Except as provided in subparagraph 
(B), a person described in paragraph (1) may not make 
an election under that paragraph without the concurrence 
of— 
(i) each designated beneficiary of such person 
under the Survivor Benefit Plan; and 
(ii) the spouse of such person, if such person is 
married. 
(B) EXCEPTION
WHEN
BENEFICIARY
UNAVAILABLE.—A 
person may make an election under paragraph (1) without 
a concurrence required under subparagraph (2) if the per-
son establishes to the satisfaction of the Secretary con-
cerned— 
(i) that the whereabouts of the spouse or bene-
ficiary, as the case may be, cannot be determined; 
or 
(ii) 
that, 
due 
to 
exceptional 
circumstances, 
requiring the person to seek the consent of the spouse 
or beneficiary, as the case may be, would otherwise 
be inappropriate. 
(3) TREATMENT OF PREMIUMS.— 
(A) DISCONTINUATION OF REDUCTIONS IN PAY.—As of 
the effective date under subsection (d) of an election by 
a person under paragraph (1), the Secretary concerned
H. R. 7776—242 
shall discontinue the reduction being made in the retired 
pay of the person arising from participation in the Survivor 
Benefit Plan or, in the case of a person who has been 
required to make deposits in the Treasury on account of 
participation in the Survivor Benefit Plan, that person 
may discontinue making such deposits effective on such 
effective date. 
(B) TREATMENT OF PREVIOUS REDUCTIONS.—A person 
who makes an election under paragraph (1) is not entitled 
to a refund of any reduction or deposit described in 
subparagraph (A) made before such effective date. 
(c) MANNER OF MAKING ELECTIONS.— 
(1) IN GENERAL.—An election under subsection (a) or (b) 
shall be made in writing, signed by the person making the 
election, and received by the Secretary concerned before the 
end of the open season described in subsection (e). 
(2) CONDITIONS.—Except as provided in paragraph (3), an 
election under subsection (a) shall be made subject to the 
same conditions, and with the same opportunities for designa-
tion of beneficiaries and specification of base amount, that 
apply under the Survivor Benefit Plan. 
(3) ELECTION MUST BE VOLUNTARY.—An election under sub-
section (a) or (b) is not effective unless the person making 
the election declares the election to be voluntary. An election 
under subsection (a) or (b) to participate or not to participate 
in the Survivor Benefit Plan may not be required by any 
court. An election by a person under subsection (a) to partici-
pate in the Survivor Benefit Plan is not subject to the concur-
rence of a spouse or former spouse of the person. 
(4) DESIGNATION
WITH
RESPECT
TO
RESERVE-COMPONENT 
ANNUITY.—A person making an election under subsection (a) 
to provide a reserve-component annuity shall make a designa-
tion described in section 1448(e) of title 10, United States 
Code. 
(d) EFFECTIVE DATE FOR ELECTIONS.—An election under sub-
section (a) or (b) shall be effective on the first day of the first 
calendar month following the month in which the election is received 
by the Secretary concerned. 
(e) OPEN SEASON DESCRIBED.—The open season described in 
this subsection is the period beginning on the date of the enactment 
of this Act and ending on January 1, 2024. 
(f) APPLICABILITY OF CERTAIN PROVISIONS OF LAW.—The provi-
sions of sections 1449, 1453, and 1454 of title 10, United States 
Code, are applicable to a person making an election, and to an 
election, under subsection (a) or (b) in the same manner as if 
the election were made under the Survivor Benefit Plan. 
(g) DEFINITIONS.—In this section: 
(1) The terms ‘‘base amount’’, ‘‘reserve-component annuity’’, 
and ‘‘standard annuity’’ have the meanings given those terms 
in section 1447 of title 10, United States Code. 
(2) The term ‘‘Department of Defense Military Retirement 
Fund’’ means the fund established under section 1461(a) of 
title 10, United States Code. 
(3) The term ‘‘retired pay’’ includes retainer pay. 
(4) The terms ‘‘Secretary concerned’’ and ‘‘uniformed serv-
ices’’ have the meanings given those terms in section 101 of 
title 37, United States Code.
H. R. 7776—243 
(5) The term ‘‘Survivor Benefit Plan’’ means the program 
established under subchapter II of chapter 73 of title 10, United 
States Code. 
SEC. 644. MILITARY INSTALLATIONS WITH LIMITED CHILD CARE: 
BRIEFING. 
(a) BRIEFING.—Not later than one year after the date of the 
enactment of this Act, the Secretary of Defense shall submit to 
the congressional defense committees a briefing regarding child 
care at military installations of the covered Armed Forces— 
(1) that are not served by a military child development 
center; or 
(2) where the military child development center has few 
available spots. 
(b) ELEMENTS.—The briefing under subsection (a) shall include 
the following elements: 
(1) With regards to each military installation described 
in such subsection: 
(A) The current and maximum possible enrollment at 
the military child development center (if one exists). 
(B) Plans of the Secretary to expand an existing, or 
construct a new, military child development center. 
(C) The resulting capacity of each military child 
development center described in subparagraph (B). 
(D) The median cost of services at accredited child 
care facilities located near such military installation com-
pared to the amount of assistance provided by the Secretary 
of the military department concerned to members for child 
care services. 
(2) Any policy recommendations of the Secretary of 
Defense— 
(A) to address the rising cost of child care near military 
installations; and 
(B) regarding the rates of child care fee assistance 
provided to members of the covered Armed Forces. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘covered Armed Force’’ means the following: 
(A) The Army. 
(B) The Navy. 
(C) The Marine Corps. 
(D) The Air Force. 
(E) The Space Force. 
(2) The term ‘‘military child development center’’ has the 
meaning given such term in section 1800 of title 10, United 
States Code. 
SEC. 645. FOOD INSECURITY AMONG MILITARY FAMILIES: DATA 
COLLECTION; TRAINING; REPORT. 
(a) DATA COLLECTION.—Not later than one year after the date 
of the enactment of this Act, the Under Secretary of Defense for 
Personnel and Readiness, in coordination with the Under Secretary 
for Food, Nutrition, and Consumer Services of the Department 
of Agriculture, shall— 
(1) develop a survey, in collaboration with the Department 
of Agriculture, to determine how many members of the Armed 
Forces serving on active duty, and dependents of such members, 
are food insecure; 
(2) issue the survey to such members and dependents;
H. R. 7776—244 
(3) collect data related to the number of such members 
and dependents who— 
(A) are eligible for the basic needs allowance under 
section 402b of title 37, United States Code; 
(B) receive such basic needs allowance; and 
(C) are surveyed on the use, by such members and 
dependents, of Federal nutrition assistance programs, 
including— 
(i) the supplemental nutrition assistance program 
under the Food and Nutrition Act of 2008 (7 U.S.C. 
2011 et seq.); 
(ii) the special supplemental nutrition program for 
women, infants, and children under section 17 of the 
Child Nutrition Act of 1966 (42 U.S.C. 1786); and 
(iii) the school lunch program under the Richard 
B. Russell National School Lunch Act (42 U.S.C. 1751 
et seq.), and the school breakfast program under sec-
tion 4 of the Child Nutrition Act of 1966 (42 U.S.C. 
1773); 
(4) develop and carry out a plan to train and designate 
an individual who will assist members at military installations 
on how and where to refer such members and their dependents 
for participation in Federal nutrition assistance programs 
described in paragraph (3)(C); and 
(5) coordinate efforts of the Department of Defense to 
address food insecurity and nutrition. 
(b) REPORT.—Not later than one year after the date of the 
enactment of this Act, and annually thereafter for the four subse-
quent years, the Under Secretary of Defense for Personnel & Readi-
ness shall submit to the congressional defense committees, the 
Committees on Agriculture and Education and Labor of the House 
of Representatives, and the Committee on Agriculture, Nutrition, 
and Forestry of the Senate, a report including the following: 
(1) The number of members of the Armed Forces serving 
on active duty and their dependents who are food insecure. 
(2) The number of such members and their dependents 
who use the Federal nutrition assistance programs described 
in subsection (a)(3). 
(3) The number of such members and their dependents 
described in subsection (a)(3). 
(4) The status of implementation of the plan under sub-
section (a)(5). 
Subtitle F—Defense Resale Matters 
SEC. 651. PROHIBITION OF THE SALE OF CERTAIN GOODS FROM THE 
XINJIANG 
UYGHUR 
AUTONOMOUS 
REGION 
IN 
COM-
MISSARIES AND EXCHANGES. 
(a) PROHIBITION.—Subchapter III of chapter 147 of title 10, 
United States Code, is amended by adding at the end the following 
new section:
H. R. 7776—245 
‘‘§ 2496. Sale of certain goods from the Xinjiang Uyghur 
Autonomous Region prohibited 
‘‘(a) PROHIBITION.—The Secretary of Defense may not knowingly 
permit the sale, at a commissary store or military exchange, of 
any good, ware, article, or merchandise— 
‘‘(1) containing any product mined, produced, or manufac-
tured, wholly or in part, by forced labor from the XUAR; or 
‘‘(2) from an entity that has used labor from within or 
transferred from XUAR as part of a ‘poverty alleviation’ or 
‘pairing assistance’ program. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) The term ‘forced labor’ means any work or service 
that is exacted from any person under the menace of any 
penalty for nonperformance and that the worker does not offer 
to perform. 
‘‘(2) The term ‘XUAR’ means the Xinjiang Uyghur Autono-
mous Region of the People’s Republic of China.’’. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of such subchapter is amended by adding at the end the 
following new item: 
‘‘2496. Sale of certain goods from the Xinjiang Uyghur Autonomous Region prohib-
ited.’’. 
Subtitle G—Miscellaneous Studies, 
Briefings and Reports 
SEC. 661. STUDY ON BASIC PAY. 
(a) IN GENERAL.—The Secretary of Defense shall seek to enter 
into an agreement with a nonprofit entity or a federally funded 
research and development center to conduct research and analysis 
on the value of basic pay for members of the Armed Forces. The 
Secretary may include such research and analysis in the next 
quadrennial review of military compensation. 
(b) ELEMENTS.—The research and analysis conducted under 
subsection (a) shall include the following: 
(1) An assessment of the model used to determine the 
basic pay in the current basic pay tables, including— 
(A) an analysis of whether to update the current model 
to meet the needs of the 2023 employment market; 
(B) a historical understanding of when the current 
model was established and how frequently it has been 
during the last 10 years; 
(C) an understanding of the assumptions on which 
the model is based and how such assumptions are vali-
dated; 
(D) an analysis of time-in-grade requirements and how 
they may affect retention and promotion; and 
(E) an assessment of how recruiting and retention 
information is used to adjust the model. 
(2) An assessment of whether to modify current basic pay 
tables to consider higher rates of pay for specialties the Sec-
retary determines are in critical need of personnel. 
(3) An analysis of—
H. R. 7776—246 
(A) how basic pay has compared with civilian pay 
since the 70th percentile benchmark for basic pay was 
established; and 
(B) whether to change the 70th percentile benchmark. 
(4) An assessment of whether— 
(A) to adjust the annual increase in basic pay, currently 
guided by changes in the Employment Cost Index as a 
measure of the growth in private-sector employment costs; 
or 
(B) to use a different index, such as the Defense 
Employment Cost Index. 
(5) Legislative and policy recommendations regarding basic 
pay table based on analyses and assessments under paragraphs 
(1) through (4). 
(c) BRIEFINGS AND PROGRESS REPORT.— 
(1) INTERIM BRIEFING.—Not later than April 1, 2023, the 
Secretary shall provide to the appropriate congressional 
committees an interim briefing on the elements described in 
subsection (b). 
(2) PROGRESS REPORT.—Not later than one year after the 
date of the enactment of this Act, the Secretary shall submit 
to the appropriate congressional committees a progress report 
on the study under this section. 
(3) FINAL BRIEFING.—Not later than two years after the 
date of the enactment of this Act, the Secretary shall submit 
to the appropriate congressional committees a final briefing 
on the study under this section. 
(d) APPROPRIATE CONGRESSIONAL COMMITTEES DEFINED.—In 
this section, the term ‘‘appropriate congressional committees’’ means 
the following: 
(1) The Committee on Armed Services of the House of 
Representatives. 
(2) The Committee on Armed Services of the Senate. 
SEC. 662. REPORT ON ACCURACY OF BASIC ALLOWANCE FOR HOUSING. 
(a) REPORT; ELEMENTS.—Not later than one year after the 
date of the enactment of this Act, the Secretary of Defense, in 
consultation with the Secretary of the department in which the 
Coast Guard is operating, shall submit to the Committees on Armed 
Services of the Senate and House of Representatives a report on 
BAH. Such report shall contain the following elements: 
(1) The evaluation of the Secretary— 
(A) of the efficiency and accuracy of the current system 
used to calculate BAH; 
(B) the appropriateness of using mean and median 
housing costs in such calculation; 
(C) of existing MHAs, in relation to choices in, and 
availability of, housing to servicemembers; 
(D) of the suitability of the six standard housing pro-
files 
in 
relation 
to 
the 
average 
family 
sizes 
of 
servicemembers, disaggregated by uniformed service, rank, 
and MHA; 
(E) of the flexibility of BAH to respond to changes 
in real estate markets; and 
(F) of residential real estate processes to determine 
rental rates. 
(2) The recommendation of the Secretary—
H. R. 7776—247 
(A) regarding the feasibility of including information, 
furnished by Federal entities, regarding school districts, 
in calculating BAH; 
(B) whether to calculate BAH more frequently, 
including in response to a sudden change in the housing 
market; 
(C) whether to enter into an agreement with a covered 
entity, to compile data and develop an enterprise grade, 
objective, data-driven algorithm to calculate BAH; 
(D) whether to publish the methods used by the Sec-
retary to calculate BAH on a publicly accessible website 
of the Department of Defense; and 
(E) whether BAH calculations appropriately account 
for increased housing costs associated with Coast Guard 
facilities. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘BAH’’ means the basic allowance for housing 
for members of the uniformed services under section 403 of 
title 37, United States Code. 
(2) The term ‘‘covered entity’’ means a nationally recognized 
entity in the field of commercial real estate that has data 
on local rental rates in real estate markets across the United 
States. 
(3) The term ‘‘MHA’’ means military housing area. 
(4) The term ‘‘servicemember’’ has the meaning given such 
term in section 101 of the Servicemembers Civil Relief Act 
(50 U.S.C. 3911). 
SEC. 663. REVIEW OF DISLOCATION AND RELOCATION ALLOWANCES. 
(a) IN GENERAL.—Not later than one year after the date of 
the enactment of this Act, the Secretary of Defense shall submit 
to the congressional defense committees a report— 
(1) reviewing the adequacy of the amounts of dislocation 
and relocation allowances paid under section 452 of title 37, 
United States Code, to members of the covered Armed Forces, 
in connection with changes in such members’ temporary or 
permanent duty assignment locations, taking into consideration 
the rising costs of moving, challenges in the housing market, 
and other expenses incurred by such members; 
(2) assessing the effects of delays in the issuance of orders 
relating to changes to temporary or permanent duty assignment 
locations on the timing of dislocation and relocation allowances 
paid to members of the covered Armed Forces; 
(3) assessing the feasibility and advisability of paying dis-
location or relocation allowances to members of the covered 
Armed Forces who are permanently assigned from one unit 
to another with no change of permanent duty station when 
the units are within the same metropolitan area; and 
(4) making recommendations with respect to the matters 
described in paragraphs (1), (2), and (3). 
(b) COVERED ARMED FORCES DEFINED.—In this section, the 
term ‘‘covered Armed Forces’’ means the Army, Navy, Marine Corps, 
Air Force, and Space Force. 
SEC. 664. COMPLEX OVERHAUL PAY: BRIEFING. 
(a) BRIEFING.—Not later than six months after the date of 
the enactment of this Act, the Secretary of the Navy shall submit 
to the Committees on Armed Services of the Senate and House
H. R. 7776—248 
of Representatives a briefing regarding the feasibility and advis-
ability of establishing complex overhaul pay. 
(b) COMPLEX OVERHAUL PAY DEFINED.—In this section, the 
term ‘‘complex overhaul pay’’ means a special monthly pay— 
(1) established pursuant to regulations prescribed under 
section 352 of title 37, United States Code; 
(2) paid to a member of the Armed Forces assigned to 
a naval vessel undergoing nuclear refueling or defueling, and 
any concurrent complex overhaul; 
(3) in addition to any other pay or allowance to which 
a member is entitled; and 
(4) in an amount equal to $200 per month. 
SEC. 665. STUDIES ON COMPENSATION FOR DOD CHILD CARE PRO-
VIDERS. 
(a) IN GENERAL.— 
(1) STUDIES REQUIRED.—The Secretary of Defense shall, 
for each geographic area in which the Secretary of a military 
department operates a military child development center, con-
duct a study— 
(A) comparing the total compensation, including all 
pay and benefits, of child care employees of each military 
child development center in the geographic area to the 
total compensation of similarly credentialed employees in 
such geographic area; and 
(B) estimating the difference in average pay and the 
difference in average benefits between such child care 
employees. 
(2) SCHEDULE.—The Secretary of Defense shall complete 
the studies required under paragraph (1)— 
(A) for the geographic areas containing the military 
installations with the 25 longest wait lists for child care 
services at military child development centers, not later 
than one year after the date of the enactment of this 
Act; and 
(B) for geographic areas other than geographic areas 
described in subparagraph (A), not later than two years 
after the date of the enactment of this Act. 
(3) REPORTS.— 
(A) INTERIM REPORT.—Not later than one year after 
the date of the enactment of this Act, the Secretary of 
Defense shall submit to the Committees on Armed Services 
of the Senate and House of Representatives a report 
summarizing the results of the studies required under para-
graph (1) that have been completed as of the date of the 
submission of such report. 
(B) FINAL REPORT.—Not later than 120 days after the 
completion of all the studies required under paragraph 
(1), the Secretary shall submit to the Committees on Armed 
Services of the Senate and House of Representatives a 
report summarizing the results of such studies. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘benefits’’ includes— 
(A) retirement benefits; 
(B) any insurance premiums paid by an employer; 
(C) education benefits, including tuition reimbursement 
and student loan repayment; and
H. R. 7776—249 
(D) any other compensation an employer provides to 
an employee for service performed as an employee (other 
than pay), as determined appropriate by the Secretary 
of Defense. 
(2) The terms ‘‘child care employee’’ and ‘‘military child 
development center’’ have the meanings given such terms in 
section 1800 of title 10, United States Code. 
(3) The term ‘‘pay’’ includes the basic rate of pay of an 
employee and any additional payments an employer pays to 
an employee for service performed as an employee. 
SEC. 666. BARRIERS TO HOME OWNERSHIP FOR MEMBERS OF THE 
ARMED FORCES: STUDY; REPORT. 
(a) STUDY.—Not later than one year after the date of the 
enactment of this Act, the Secretary of Defense shall seek to enter 
into an agreement with a federally funded research and develop-
ment center or non-profit entity to conduct a study on the unique 
barriers to home ownership for members of the Armed Forces. 
(b) REPORT.—At the conclusion of the study under subsection 
(a), the Secretary shall submit to the Committees on Armed Services 
of the Senate and House of Representatives a report containing 
the results of such study. 
TITLE VII—HEALTH CARE PROVISIONS 
Subtitle A—TRICARE and Other Health Care Benefits 
Sec. 701. Improvements to TRICARE dental program. 
Sec. 702. Health benefits for members of the National Guard following required 
training or other duty to respond to a national emergency. 
Sec. 703. Improvement of referrals for specialty care under TRICARE Prime during 
permanent changes of station. 
Sec. 704. Confidentiality requirements for mental health care services for members 
of the Armed Forces. 
Sec. 705. Audit of behavioral health care network providers listed in TRICARE di-
rectory. 
Sec. 706. Independent analysis of quality and patient safety review process under 
direct care component of TRICARE program. 
Sec. 707. Study on providing benefits under TRICARE Reserve Select and 
TRICARE dental program to members of the Selected Reserve and de-
pendents thereof. 
Sec. 708. GAO study on certain contracts relating to TRICARE program and over-
sight of such contracts. 
Sec. 709. GAO study on coverage of mental health services under TRICARE pro-
gram and relationship to certain mental health parity laws. 
Subtitle B—Health Care Administration 
Sec. 711. Accountability for wounded warriors undergoing disability evaluation. 
Sec. 712. Inclusion of level three trauma care capabilities in requirements for med-
ical centers. 
Sec. 713.
Centers of excellence for specialty care in military health system. 
Sec. 714. Maintenance of Core Casualty Receiving Facilities to improve medical 
force readiness. 
Sec. 715. Congressional notification requirement to modify scope of services pro-
vided at military medical treatment facilities. 
Sec. 716. Improvements to processes to reduce financial harm caused to civilians 
for care provided at military medical treatment facilities. 
Sec. 717. Authority to carry out studies and demonstration projects relating to de-
livery of health and medical care through use of other transaction au-
thority. 
Sec. 718. Licensure requirement for certain health-care professionals providing 
services as part of mission relating to emergency, humanitarian, or ref-
ugee assistance. 
Sec. 719. Authorization of permanent program to improve opioid management in 
the military health system.
H. R. 7776—250 
Sec. 720. Modification of requirement to transfer research and development and 
public health functions to Defense Health Agency. 
Sec. 721. Access to certain dependent medical records by remarried former spouses. 
Sec. 722. Authority for Department of Defense program to promote early literacy 
among certain young children. 
Sec. 723. Plan for Accountable Care Organization demonstration. 
Sec. 724. Feasibility study and plan on establishing a Military Health System Med-
ical Logistics Directorate and Military Health System Education and 
Training Directorate. 
Subtitle C—Reports and Other Matters 
Sec. 731. Briefing and report on reduction or realignment of military medical man-
ning and medical billets. 
Sec. 732. Independent analysis of Department of Defense Comprehensive Autism 
Care Demonstration program. 
Sec. 733. Clarification of membership requirements and compensation authority for 
independent suicide prevention and response review committee. 
Sec. 734. Termination of veterans’ advisory board on radiation dose reconstruction. 
Sec. 735. Brain health initiative of Department of Defense. 
Sec. 736. Establishment of partnership program between United States and 
Ukraine for military trauma care and research. 
Sec. 737. Improvements relating to behavioral health care available under military 
health system. 
Sec. 738. Certification program in provision of mental health services to members 
of the Armed Forces and military families. 
Sec. 739. Standardization of policies relating to service in Armed Forces by individ-
uals diagnosed with HBV. 
Sec. 740. Suicide cluster: standardized definition for use by Department of Defense; 
congressional notification. 
Sec. 741. Limitation on reduction of military medical manning end strength: certifi-
cation requirement and other reforms. 
Sec. 742. Feasibility study on establishment of Department of Defense internship 
programs relating to civilian behavioral health providers. 
Sec. 743. Updates to prior feasibility studies on establishment of new command on 
defense health. 
Sec. 744. Capability assessment and action plan with respect to effects of exposure 
to open burn pits and other environmental hazards. 
Sec. 745. Kyle Mullen Navy SEAL medical training review. 
Sec. 746. Reports on composition of medical personnel of each military department 
and related matters. 
Sec. 747. Report on effects of low recruitment and retention on operational tempo 
and physical and mental health of members of the Armed Forces. 
Sec. 748. Guidance for addressing healthy relationships and intimate partner vio-
lence through TRICARE Program. 
Sec. 749. Briefing on suicide prevention reforms for members of the Armed Forces. 
Subtitle A—TRICARE and Other Health 
Care Benefits 
SEC. 701. IMPROVEMENTS TO TRICARE DENTAL PROGRAM. 
(a) IN GENERAL.—Section 1076a of title 10, United States Code, 
is amended— 
(1) in subsection (b)— 
(A) by striking ‘‘The plans’’ and inserting the following: 
‘‘(1) IN GENERAL.—The plans’’; and 
(B) by adding at the end the following new paragraph: 
‘‘(2) PREMIUM SHARING PLANS.—Effective as of January 1, 
2026, the regulations prescribed pursuant to paragraph (1) 
shall include, with respect to premium sharing plans referred 
to in subsection (d)(1), the following elements: 
‘‘(A) A third party administrator shall manage the 
administrative features of such plans, including eligibility, 
enrollment, plan change and premium payment processes, 
submission of qualifying life events changes, and address 
changes.
H. R. 7776—251 
‘‘(B) Such plans shall include the following three enroll-
ment options: 
‘‘(i) Self. 
‘‘(ii) Self plus one. 
‘‘(iii) Family. 
‘‘(C) In the United States, to the extent practicable, 
individuals eligible to enroll in such a plan shall be offered 
options to enroll in plans of not fewer than two and not 
more than four dental insurance carriers. 
‘‘(D) To the extent practicable, each carrier described 
in subparagraph (C)— 
‘‘(i) shall manage dental care delivery matters, 
including claims adjudication (with required electronic 
submission of claims), coordination of benefits, covered 
services, enrollment verification, and provider net-
works; 
‘‘(ii) shall, in addition to offering a standard option 
plan, offer a non-standard option plan; 
‘‘(iii) may offer a non-standard option plan man-
aged as a dental health maintenance organization plan; 
‘‘(iv) shall establish and operate dental provider 
networks that provide— 
‘‘(I) accessible care with a prevention or 
wellness focus; 
‘‘(II) continuity of care; 
‘‘(III) coordinated care (including appropriate 
dental and medical referrals); 
‘‘(IV) patient-centered care (including effective 
communications, individualized care, and shared 
decision-making); and 
‘‘(V) high-quality, safe care; 
‘‘(v) shall develop and implement adult and pedi-
atric dental quality measures, including effective 
measurements for— 
‘‘(I) access to care; 
‘‘(II) continuity of care; 
‘‘(III) cost; 
‘‘(IV) adverse patient events; 
‘‘(V) oral health outcomes; and 
‘‘(VI) patient experience; and 
‘‘(vi) may conduct in the provider networks estab-
lished and operated by the carrier under clause (iv), 
to the extent practicable, pilot programs on the 
development of a model of care based on the model 
of care commonly referred to as patient-centered dental 
homes.’’; 
(2) in subsection (d)(1)— 
(A) in subparagraph (B), by striking ‘‘The member’s’’ 
and inserting ‘‘During the period preceding January 1, 
2026, the member’s’’; 
(B) in subparagraph (C), by striking ‘‘of each year,’’ 
and inserting ‘‘of each year during the period preceding 
January 1, 2026,’’; 
(C) in subparagraph (D), by striking ‘‘The Secretary 
of Defense’’ and inserting ‘‘During the period preceding 
January 1, 2026, the Secretary of Defense’’; and
H. R. 7776—252 
(D) by adding at the end the following new subpara-
graphs: 
‘‘(E) Beginning on January 1, 2026, the amount of the 
premium required under subparagraph (A)— 
‘‘(i) for standard option plans, shall be established by 
the Secretary annually such that in the aggregate (taking 
into account the adjustments under subparagraph (F) and 
subsection (e)(3), the Secretary’s share of each premium 
is 60 percent of the premium for each enrollment category 
(self, self plus one, and family, respectively) of each 
standard option plan; and 
‘‘(ii) for non-standard option plans, shall be equal to 
the amount determined under clause (i) plus 100 percent 
of the additional premium amount applicable to such non- 
standard option plan. 
‘‘(F) Beginning on January 1, 2026, the Secretary of Defense 
shall reduce the monthly premium required to be paid under 
paragraph (1) in the case of enlisted members in pay grade 
E–1, E–2, E–3, or E–4.’’; 
(3) in subsection (e), by adding at the end the following 
new paragraph: 
‘‘(3) Beginning on January 1, 2026, the Secretary of Defense 
shall reduce copayments required to be paid under paragraph (1) 
in the case of enlisted members in pay grade E–1, E–2, E–3, 
or E–4.’’; 
(4) in subsection (j), by striking ‘‘The Secretary of Defense 
may not reduce benefits provided under a plan established 
under this section until’’ and inserting ‘‘During the period pre-
ceding January 1, 2026, the Secretary of Defense may not 
reduce benefits provided under a plan established under this 
section, and on or after January 1, 2026, the Secretary may 
not reduce benefits provided under a standard option plan 
under this section, until’’; and 
(5) by adding at the end the following new subsection: 
‘‘(l) DEFINITIONS.—In this section: 
‘‘(1) The term ‘non-standard option plan’ means a high 
option dental insurance plan that includes covered services 
in addition to, or provides greater coverage with respect to, 
services covered under a standard option plan. 
‘‘(2) The term ‘standard option plan’ means a dental insur-
ance plan that provides for the coverage of preventive services, 
basic restorative services, and specialty dental care services 
at a level that is at least commensurate with the coverage 
of the same services provided under the premium sharing plans 
under this section during the period preceding January 1, 
2026.’’. 
(b) RULEMAKING.—Pursuant to the authority under section 
1076a(b)(1) of title 10, United States Code, as amended by sub-
section (a), the Secretary of Defense shall— 
(1) not later than January 1, 2025, prescribe an interim 
final rule to carry out the amendments made by subsection 
(a); and 
(2) after prescribing the interim final rule under subpara-
graph (A) and considering public comments with respect to 
such interim final rule, prescribe a final rule, effective on 
January 1, 2026, to carry out such amendments.
H. R. 7776—253 
(c) BRIEFINGS.—Not later than January 1 of each of 2024, 
2025, and 2026, the Secretary of Defense shall provide to the 
Committees on Armed Services of the House of Representatives 
and the Senate a briefing on the status of the implementation 
of the amendments made by subsection (a). 
SEC. 702. HEALTH BENEFITS FOR MEMBERS OF THE NATIONAL GUARD 
FOLLOWING REQUIRED TRAINING OR OTHER DUTY TO 
RESPOND TO A NATIONAL EMERGENCY. 
(a) TRANSITIONAL HEALTH CARE.—Subsection (a)(2) of section 
1145 of title 10, United States Code, is amended by adding at 
the end the following new subparagraph: 
‘‘(G) A member of the National Guard who is separated 
from full-time National Guard Duty to which called or ordered 
under section 502(f) of title 32 for a period of active service 
of more than 30 days to perform duties that are authorized 
by the President or the Secretary of Defense for the purpose 
of responding to a national emergency declared by Congress 
or the President and supported by Federal funds.’’. 
(b) CONFORMING
AMENDMENTS.—Such section is further 
amended— 
(1) in subsection (a)— 
(A) in paragraph (1), in the matter preceding subpara-
graph (A), by striking ‘‘active duty’’ and inserting ‘‘active 
service’’; 
(B) in paragraph (3), by striking ‘‘paragraph (2)(B)’’ 
and inserting ‘‘subparagraph (B) or (G) of paragraph (2)’’; 
(C) in paragraph (4)— 
(i) by striking ‘‘active duty’’ each place it appears 
and inserting ‘‘active service’’; and 
(ii) in the second sentence, by striking ‘‘or (D)’’ 
and inserting ‘‘(D), or (G)’’; 
(D) in paragraph (5), in subparagraphs (A) and (B), 
by striking ‘‘active duty’’ each place it appears and inserting 
‘‘active service’’; and 
(E) in paragraph (7)(A)— 
(i) by striking ‘‘service on active duty’’ and 
inserting ‘‘active service’’; and 
(ii) by striking ‘‘active duty for’’ and inserting 
‘‘active service for’’; 
(2) in subsection (b)(1), by striking ‘‘active duty’’ and 
inserting ‘‘active service’’; and 
(3) in subsection (d)(1)(A), by striking ‘‘active duty’’ and 
inserting ‘‘active service’’. 
SEC. 703. IMPROVEMENT OF REFERRALS FOR SPECIALTY CARE UNDER 
TRICARE PRIME DURING PERMANENT CHANGES OF STA-
TION. 
(a) IN GENERAL.—Section 714 of the John S. McCain National 
Defense Authorization Act for Fiscal Year 2019 (Public Law 115– 
232; 10 U.S.C. 1095f note) is amended— 
(1) by redesignating subsection (e) as subsection (f); and 
(2) by inserting after subsection (d) the following new sub-
section (e): 
‘‘(e) IMPROVEMENT
OF SPECIALTY CARE REFERRALS DURING 
PERMANENT CHANGES OF STATION.—In conducting evaluations and 
improvements under subsection (d) to the referral process described 
in subsection (a), the Secretary shall ensure beneficiaries enrolled
H. R. 7776—254 
in TRICARE Prime who are undergoing a permanent change of 
station receive referrals from their primary care manager to such 
specialty care providers in the new location as the beneficiary 
may need before undergoing the permanent change of station.’’. 
(b) BRIEFING.—Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense shall provide to 
the Committees on Armed Services of the Senate and the House 
of Representatives a briefing on the contractual and technical bar-
riers preventing record sharing between civilian provider networks 
under the TRICARE program that lead to increased wait times 
for care for members of the Armed Forces and the dependents 
thereof undergoing permanent changes of station across provider 
network regions. 
SEC. 704. CONFIDENTIALITY REQUIREMENTS FOR MENTAL HEALTH 
CARE SERVICES FOR MEMBERS OF THE ARMED FORCES. 
(a) IN GENERAL.—In order to reinforce the policies of elimi-
nating stigma in obtaining mental health care services and further 
encouraging help-seeking behavior by members of the Armed 
Forces, not later than July 1, 2023, the Secretary of Defense shall— 
(1) update and reissue Department of Defense Instruction 
6490.08, titled ‘‘Command Notification Requirements to Dispel 
Stigma in Providing Mental Health Care to Service Members’’ 
and issued on August 17, 2011, taking into account— 
(A) experience implementing the Instruction; and 
(B) opportunities to more effectively dispel stigma in 
obtaining mental health care services and encourage help- 
seeking behavior; and 
(2) develop standards within the Department of Defense 
that— 
(A) ensure, except in a case in which there is an 
exigent circumstance, the confidentiality of mental health 
care services provided to members who voluntarily seek 
such services; 
(B) include a model for making determinations with 
respect to exigent circumstances that clarifies the respon-
sibilities regarding the determination of the effect on mili-
tary function and the prevention of self-harm by the indi-
vidual; and 
(C) in a case in which there is an exigent circumstance, 
prevent health care providers from disclosing more than 
the minimum amount of information necessary to address 
the exigent circumstance. 
(b) ELEMENTS.—The standards required by subsection (a)(2) 
shall include the following elements: 
(1) Requirements for confidentiality regarding the request 
and receipt by a member of the Armed Forces of mental health 
care services under the self-initiated referral process under 
section 1090a(e) of title 10, United States Code. 
(2) Requirements for confidentiality regarding the results 
of any drug testing incident to such mental health care services. 
(3) Procedures that reflect best practices of the mental 
health profession with respect to suicide prevention. 
(4) A prohibition against retaliating against a member 
of the Armed Forces who requests mental health care services. 
(5) Such other elements as the Secretary determines will 
most effectively support the policies of—
H. R. 7776—255 
(A) eliminating stigma in obtaining mental health care 
services; and 
(B) encouraging help-seeking behavior by members of 
the Armed Forces. 
(c) JOINT POLICY WITH THE SECRETARY OF VETERANS AFFAIRS.— 
(1) IN GENERAL.—Not later than July 1, 2023, the Secretary 
of Defense and the Secretary of Veterans Affairs shall issue 
a joint policy that provides, except in a case in which there 
is an exigent circumstance, for the confidentiality of mental 
health care services provided by the Secretary of Veterans 
Affairs to members of the Armed Forces, including the reserve 
components, under section 1712A, 1720F, 1720H, or 1789 of 
title 38, United States Code, or other applicable law. 
(2) ELEMENTS.—The joint policy issued under paragraph 
(1) shall, to the extent practicable, include standards com-
parable to the standards developed under subsection (a)(2). 
(d) REPORT.—Not later than July 1, 2023, the Secretary of 
Defense shall submit to the Committees on Armed Services of 
the Senate and the House of Representatives a copy of the standards 
developed under subsection (a)(2) and the joint policy issued under 
subsection (c). 
(e) EXIGENT CIRCUMSTANCE DEFINED.—In this section, the term 
‘‘exigent circumstance’’ means a circumstance in which the Sec-
retary of Defense determines the need to prevent serious harm 
to an individual or essential military function clearly outweighs 
the need for confidentiality of information obtained by a health 
care provider incident to mental health care services voluntarily 
sought by a member of the Armed Forces. 
SEC. 705. AUDIT OF BEHAVIORAL HEALTH CARE NETWORK PROVIDERS 
LISTED IN TRICARE DIRECTORY. 
(a) AUDIT REQUIRED.—The Comptroller General of the United 
States shall conduct an audit of the behavioral health care providers 
listed in the TRICARE directory. 
(b) REPORT.—Not later than one year after the date of the 
enactment of this Act, the Comptroller General shall submit to 
the Committees on Armed Services of the House of Representatives 
and the Senate a report on the findings of the audit under sub-
section (a). Such report shall include the following: 
(1) An identification of the following, disaggregated by pro-
vider specialty and TRICARE provider network region: 
(A) The number of such behavioral health care pro-
viders with respect to which there are duplicate listings 
in the TRICARE directory. 
(B) The number of such behavioral health care pro-
viders that, as of the commencement of the audit, were 
listed in the TRICARE directory as available and accepting 
new TRICARE patients. 
(C) The number of such behavioral health care pro-
viders that, as a result of the audit, the Comptroller Gen-
eral determines are no longer available or accepting new 
TRICARE patients. 
(D) The number of such behavioral health care pro-
viders that were not previously listed in the TRICARE 
directory as available and accepting new TRICARE patients 
but that, as a result of the audit, the Comptroller General 
determines are so available and accepting.
H. R. 7776—256 
(E) The number of behavioral health care providers 
listed in the TRICARE directory that are no longer prac-
ticing. 
(F) The number of behavioral health care providers 
that, in conducting the audit, the Comptroller General 
could not reach for purposes of verifying information 
relating to availability or status. 
(2) An identification of the number of TRICARE bene-
ficiaries in each TRICARE region, disaggregated by beneficiary 
category. 
(3) A description of the methods by which the Secretary 
of Defense measures the following: 
(A) The accessibility and accuracy of the TRICARE 
directory, with respect to behavioral health care providers 
listed therein. 
(B) The adequacy of behavioral health care providers 
under the TRICARE program. 
(4) A description of the efforts of the Secretary of Defense 
to recruit and retain behavioral health care providers. 
(5) Recommendations by the Comptroller General, based 
on the findings of the audit, on how to improve the availability 
of behavioral health care providers that are network providers 
under the TRICARE program, including through the inclusion 
of specific requirements in the next generation of TRICARE 
contracts. 
(c) DEFINITIONS.—In this section: 
(1) The term ‘‘TRICARE directory’’ means the directory 
of network providers under the TRICARE program. 
(2) The term ‘‘TRICARE program’’ has the meaning given 
such term in section 1072 of title 10, United States Code. 
SEC. 706. INDEPENDENT ANALYSIS OF QUALITY AND PATIENT SAFETY 
REVIEW PROCESS UNDER DIRECT CARE COMPONENT OF 
TRICARE PROGRAM. 
(a) AGREEMENT.— 
(1) IN GENERAL.—The Secretary of Defense shall seek to 
enter into an agreement with a federally funded research and 
development center for the federally funded research and 
development center to carry out the activities described in 
subsections (b) and (c). 
(2) TIMING.—The Secretary shall seek to enter into the 
agreement described in paragraph (1) not later October 1, 2023. 
(b) ANALYSIS BY FFRDC.— 
(1) ANALYSIS.—Under an agreement between the Secretary 
and a federally funded research and development center entered 
into pursuant to subsection (a), the federally funded research 
and development center shall conduct an analysis of the quality 
and patient safety review process for health care provided 
under the direct care component of the TRICARE program 
and develop recommendations for the Secretary based on such 
analysis. 
(2) ELEMENTS.—The analysis conducted and recommenda-
tions developed under paragraph (1) shall include, with respect 
to the direct care component of the TRICARE program, an 
assessment of the following:
H. R. 7776—257 
(A) The procedures under such component regarding 
credentialing and privileging for health care providers (and 
an assessment of compliance with such procedures). 
(B) The processes under such component for quality 
assurance, standard of care, and incident review (and an 
assessment of compliance with such processes). 
(C) The accountability processes under such component 
for health care providers who are found to have not met 
a required standard of care. 
(D) The transparency activities carried out under such 
component, including an assessment of the publication of 
clinical quality metrics (at the level of military medical 
treatment facilities and other operational medical units 
of the Department of Defense), and a comparison with 
similar metrics for non-Department health care entities. 
(E) The standardization activities carried under such 
component, including activities aimed at eliminating 
unwarranted variation in clinical quality metrics at the 
level of military medical treatment facilities and other oper-
ational medical units of the Department. 
(F) The implementation under such component of the 
requirements of section 744 of the National Defense 
Authorization Act for Fiscal Year 2021 (Public Law 116– 
283; 134 Stat. 3708; 10 U.S.C. 1071 note), including with 
respect to health care delivery on ships and planes, in 
deployed settings, and in all other circumstances outside 
of military medical treatment facilities. 
(G) The organizational roles and responsibilities of 
military health system entities involved in clinical quality 
management functions under such component, including 
the Assistant Secretary of Defense for Health Affairs, the 
Director of the Defense Health Agency, and the Surgeons 
General of the Army, Navy, and Air Force, each of whom 
shall conduct and submit to the federally funded research 
and development center an internal assessment of the 
respective entity regarding each element set forth under 
this paragraph. 
(3) INFORMATION ACCESS AND PRIVACY.— 
(A) ACCESS
TO
RECORDS.—Notwithstanding section 
1102 of title 10, United States Code, the Secretary shall 
provide the federally funded research and development 
center with access to such records of the Department of 
Defense as the Secretary may determine necessary for pur-
poses of the federally funded research and development 
center conducting the analysis and developing the rec-
ommendations under paragraph (1). 
(B) PRIVACY OF INFORMATION.—In conducting the anal-
ysis and developing the recommendations under paragraph 
(1), the federally funded research and development center— 
(i) shall maintain any personally identifiable 
information in records accessed by the federally funded 
research and development center pursuant to subpara-
graph (A) in accordance with applicable laws, protec-
tions, and best practices regarding the privacy of 
information; and
H. R. 7776—258 
(ii) may not permit access to such information 
by any individual or entity not engaged in conducting 
such analysis or developing such recommendations. 
(c) BRIEFING AND REPORTS.— 
(1) INTERIM BRIEFING.—Not later than 180 days after the 
date of the enactment of this Act, the Secretary shall submit 
to the Committees on Armed Services of the House of Rep-
resentatives and the Senate an interim briefing on— 
(A) the selection of a federally funded research and 
development center with which the Secretary shall seek 
to enter into an agreement with under subsection (a); 
(B) any related guidance issued by the Secretary; and 
(C) the methodology for conducting the study to be 
used by such federally funded research and development 
center. 
(2) REPORT TO SECRETARY.—Under an agreement entered 
into between the Secretary and a federally funded research 
and development center under subsection (a), the federally 
funded research and development center, not later than one 
year after the date of the execution of the agreement, shall 
submit to the Secretary a report on the findings of the federally 
funded research and development center with respect to the 
analysis conducted and recommendations developed under sub-
section (b). 
(3) REPORT TO CONGRESS.—Not later than 120 days after 
the date on which the Secretary receives the report of the 
federally funded research and development center under para-
graph (1), the Secretary shall submit to the Committees on 
Armed Services of the House of Representatives and the Senate 
such report, along with an assessment by the Secretary of 
the analysis, findings, and recommendations contained therein 
and the plan of the Secretary for strengthening clinical quality 
management in the military health system. 
(4) PUBLICATION.—The Secretary shall make the report 
under paragraph (2) available on a public website in unclassi-
fied form. 
(d) TRICARE PROGRAM DEFINED.—In this section, the term 
‘‘TRICARE program’’ has the meaning given such term in section 
1072 of title 10, United States Code. 
SEC. 707. STUDY ON PROVIDING BENEFITS UNDER TRICARE RESERVE 
SELECT AND TRICARE DENTAL PROGRAM TO MEMBERS 
OF THE SELECTED RESERVE AND DEPENDENTS THEREOF. 
(a) STUDY.—The Secretary of Defense may conduct a study 
on the feasibility, potential cost effects to the budget of the Depart-
ment of Defense, changes in out-of-pocket costs to beneficiaries, 
and effects on other Federal programs of expanding eligibility for 
TRICARE Reserve Select and the TRICARE dental program to 
include all members of the Selected Reserve of the Ready Reserve 
of a reserve component of the Armed Forces, the dependents thereof, 
and the non-dependent children thereof under the age of 26. 
(b) SPECIFICATIONS.—If the Secretary conducts the study under 
subsection (a), the Secretary shall include in the study an assess-
ment of the following: 
(1) Cost-shifting to the Department of Defense to support 
the expansion of TRICARE Reserve Select and the TRICARE 
dental program from—
H. R. 7776—259 
(A) health benefit plans under chapter 89 of title 5, 
United States Code; 
(B) employer-sponsored health insurance; 
(C) private health insurance; 
(D) insurance under a State health care exchange; 
and 
(E) the Medicaid program under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.). 
(2) New costs for the Department of Defense to enroll 
in TRICARE Reserve Select and the TRICARE dental program 
members of the Selected Reserve of the Ready Reserve of a 
reserve component of the Armed Forces who were previously 
uninsured. 
(3) The resources needed to implement TRICARE Reserve 
Select and the TRICARE dental program for all such members, 
the dependents thereof, and the non-dependent children thereof 
under the age of 26. 
(4) Cost-savings, if any, resulting from the expansion of 
TRICARE Reserve Select and the TRICARE dental program 
with regard to increased training days performed in support 
of mass medical events during battle assemblies of the reserve 
components, including an assessment of the impact of such 
expansion on— 
(A) medical readiness; 
(B) overall deployability rates; 
(C) deployability timelines; 
(D) fallout rates at mobilization sites; 
(E) cross-leveling of members of the reserve compo-
nents to backfill medical fallouts at mobilization sites; and 
(F) any other readiness metrics affected by such expan-
sion. 
(5) Any effect of such expansion on recruitment and reten-
tion of members of the Armed Forces, including members of 
the Ready Reserve of the reserve components of the Armed 
Forces. 
(6) Cost-savings, if any, in contracts that implement the 
Reserve Health Readiness Program of the Department of 
Defense. 
(c) DETERMINATION OF COST EFFECTS.—If the Secretary con-
ducts the study under subsection (a), the Secretary shall include 
in such study an assessment of the potential cost effects to the 
budget of the Department of Defense for scenarios of expanded 
eligibility for TRICARE Reserve Select and the TRICARE dental 
program as follows: 
(1) Premium free for members of the Selected Reserve 
of the Ready Reserve of a reserve component of the Armed 
Forces, the dependents thereof, and the non-dependent children 
thereof under the age of 26. 
(2) Premium free for such members and subsidized pre-
miums for such dependents and non-dependent children. 
(3) Subsidized premiums for such members, dependents, 
and non-dependent children. 
(d) USE OF A FEDERALLY FUNDED RESEARCH AND DEVELOPMENT 
CENTER.—The Secretary may enter into a contract with a federally 
funded research and development center the Secretary determines 
is qualified and appropriate to conduct the study under subsection 
(a).
H. R. 7776—260 
(e) BRIEFING; REPORT.— 
(1) BRIEFING.—If the Secretary conducts the study under 
subsection (a), not later than one year after the date of the 
enactment of this Act, the Secretary shall provide to the 
Committees on Armed Services of the Senate and the House 
of Representatives a briefing on the methodology and approach 
of the study. 
(2) REPORT.—If the Secretary conducts the study under 
subsection (a), not later than two years after the date of the 
enactment of this Act, the Secretary shall submit to the 
Committees on Armed Services of the Senate and the House 
of Representatives a report on the results of the study. 
(f) DEFINITIONS.—In this section: 
(1) The term ‘‘TRICARE dental program’’ means dental 
benefits under section 1076a of title 10, United States Code. 
(2) The term ‘‘TRICARE Reserve Select’’ means health 
benefits under section 1076d of such title. 
SEC. 708. GAO STUDY ON CERTAIN CONTRACTS RELATING TO TRICARE 
PROGRAM AND OVERSIGHT OF SUCH CONTRACTS. 
(a) STUDY.—The Comptroller General of the United States shall 
conduct a study on certain contracts relating to the TRICARE 
program and the oversight provided by the Director of the Defense 
Health Agency with respect to such contracts. 
(b) MATTERS.—The study under subsection (a) shall include 
an assessment of the following: 
(1) TRICARE MANAGED CARE SUPPORT CONTRACTS.—With 
respect to TRICARE managed care support contracts (including 
the TRICARE managed care support contract for which the 
Director of the Defense Health Agency published a request 
for proposals on April 15, 2021, commonly referred to as ‘‘T- 
5’’), the process used in awarding such contracts. 
(2) OTHER
CONTRACTS.—With respect to each contract 
relating to the TRICARE program other than a contract speci-
fied in paragraph (1) entered into by the Director of the Defense 
Health Agency during the period beginning on October 1, 2017, 
and ending on September 30, 2022, where the value of such 
contract is greater than $500,000,000, the following: 
(A) The total number of such contracts, disaggregated 
by fiscal year, contract type, type of product or service 
procured, and total expenditure under each such contract 
by fiscal year. 
(B) The total number of bid protests filed with respect 
to such contracts, and the outcome of such protests. 
(C) The total number of such contracts awarded 
through means other than full and open competition. 
(3) DEFENSE HEALTH AGENCY CONTRACT OVERSIGHT.—With 
respect to the period beginning on October 1, 2017, and ending 
on September 30, 2022, the following: 
(A) The staff of the Defense Health Agency responsible 
for performing oversight of the contracts specified in para-
graphs (1) and (2), including the following: 
(i) The number of such staff. 
(ii) Any professional training requirements for such 
staff. 
(iii) Any acquisition certifications or accreditations 
held by such staff.
H. R. 7776—261 
(B) Any office or other element of the Defense Health 
Agency responsible for contract award, administration, or 
oversight with respect to the TRICARE program, including 
the organizational structure, responsibilities, authorities, 
and key roles of each such office or element. 
(C) The process used by the Director of the Defense 
Health Agency for determining staffing needs and com-
petencies relating to contract award, administration, or 
oversight with respect to the TRICARE program. 
(c) INTERIM BRIEFING; REPORT.— 
(1) INTERIM BRIEFING.—Not later than one year after the 
date of the enactment of this Act, the Comptroller General 
shall provide to the Committees on Armed Services of the 
House of Representatives and the Senate an interim briefing 
on the study under subsection (a). 
(2) REPORT.—Not later than two years after the date of 
the enactment of this Act, the Comptroller General shall submit 
to the Committees on Armed Services of the House of Rep-
resentatives and the Senate a report containing the results 
of the study under subsection (a). 
SEC. 709. GAO STUDY ON COVERAGE OF MENTAL HEALTH SERVICES 
UNDER TRICARE PROGRAM AND RELATIONSHIP TO CER-
TAIN MENTAL HEALTH PARITY LAWS. 
(a) STUDY AND REPORT REQUIRED.—Not later than one year 
after the date of the enactment of this Act, the Comptroller General 
of the United States shall— 
(1) conduct a study to describe— 
(A) coverage of mental health services under the 
TRICARE program; 
(B) any limits on such coverage that are not also 
imposed on health services other than mental health serv-
ices under the TRICARE program; and 
(C) the efforts of the Department of Defense to align 
coverage of mental health services under the TRICARE 
program with coverage requirements under mental health 
parity laws; and 
(2) submit to the Secretary of Defense, the congressional 
defense committees, and (with respect to any findings con-
cerning the Coast Guard when it is not operating as a service 
in the Department of the Navy), the Secretary of Homeland 
Security, the Committee on Transportation and Infrastructure 
of the House of Representatives, and the Committee on Com-
merce, Science, and Transportation of the Senate a report con-
taining the findings of such study. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘mental health parity laws’’ means— 
(A) section 2726 of the Public Health Service Act (42 
U.S.C. 300gg–26); 
(B) section 712 of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1185a); 
(C) section 9812 of the Internal Revenue Code of 1986 
(26 U.S.C. 9812); or 
(D) any other Federal law that applies the require-
ments under any of the sections described in subparagraph 
(A), (B), or (C), or requirements that are substantially
H. R. 7776—262 
similar to those provided under any such section, as deter-
mined by the Comptroller General. 
(2) The term ‘‘TRICARE program’’ has the meaning given 
such term in section 1072 of title 10, United States Code. 
Subtitle B—Health Care Administration 
SEC. 711. ACCOUNTABILITY FOR WOUNDED WARRIORS UNDERGOING 
DISABILITY EVALUATION. 
(a) POLICY.—Not later than April 1, 2023, the Secretary of 
Defense, in consultation with the Secretaries concerned, shall estab-
lish a policy to ensure accountability for actions taken under the 
authorities of the Defense Health Agency and the Armed Forces, 
respectively, concerning wounded, ill, and injured members of the 
Armed Forces during the integrated disability evaluation system 
process. Such policy shall include the following: 
(1) A restatement of the requirement that, in accordance 
with section 1216(b) of title 10, United States Code, a deter-
mination of fitness for duty of a member of the Armed Forces 
under chapter 61 of title 10, United States Code, is the responsi-
bility of the Secretary concerned. 
(2) A description of the role of the Director of the Defense 
Health Agency in supporting the Secretaries concerned in car-
rying out determinations of fitness for duty as specified in 
paragraph (1). 
(3) A description of how the medical evaluation board proc-
esses of the Armed Forces are integrated with the Defense 
Health Agency, including with respect to case management, 
appointments, and other relevant matters. 
(4) A requirement that, in determining fitness for duty 
of a member of the Armed Forces under chapter 61 of title 
10, United States Code, the Secretary concerned shall consider 
the results of any medical evaluation of the member provided 
under the authority of the Defense Health Agency pursuant 
to section 1073c of title 10, United States Code. 
(5) A description of how the Director of the Defense Health 
Agency adheres to the medical evaluation processes of the 
Armed Forces, including an identification of each applicable 
regulation or policy to which the Director is required to so 
adhere. 
(6) An assessment of the feasibility of affording various 
additional due process protections to members of the Armed 
Forces undergoing the medical evaluation board process. 
(7) A restatement of the requirement that wounded, ill, 
and injured members of the Armed Forces may not be denied 
any due process protection afforded under applicable law or 
regulation of the Department of Defense or the Armed Forces. 
(8) A description of the types of due process protections 
specified in paragraph (7), including an identification of each 
specific due process protection. 
(b) CLARIFICATION OF RESPONSIBILITIES REGARDING MEDICAL 
EVALUATION BOARDS.—Section 1073c of title 10, United States Code, 
is amended— 
(1) by redesignating subsection (h) as subsection (i); and 
(2) by inserting after subsection (g) the following new sub-
section (h):
H. R. 7776—263 
‘‘(h) RULE
OF CONSTRUCTION REGARDING SECRETARIES CON-
CERNED AND MEDICAL EVALUATION BOARDS.—Nothing in this sec-
tion shall be construed as transferring to the Director of the Defense 
Health Agency, or otherwise revoking, any authority or responsi-
bility of the Secretary concerned under chapter 61 of this title 
with respect to a member of the armed forces (including with 
respect to the administration of morale and welfare and the deter-
mination of fitness for duty for the member) while the member 
is being considered by a medical evaluation board.’’. 
(c) BRIEFING.—Not later than February 1, 2023, the Secretary 
of Defense shall provide to the Committees on Armed Services 
of the House of Representatives and the Senate a briefing on 
the status of the implementation of subsections (a) and (b). 
(d) REPORT.—Not later than one year after the date of the 
enactment of this Act, the Secretary of Defense shall submit to 
the Committees on Armed Services of the House of Representatives 
and the Senate a report on the implementation of subsections 
(a) and (b), lessons learned as a result of such implementation, 
and the recommendations of the Secretary relating to the policy 
on wounded, ill, and injured members of the Armed Forces under-
going the integrated disability evaluation system process. 
(e) SECRETARY CONCERNED DEFINED.—In this section, the term 
‘‘Secretary concerned’’ has the meaning given that term in section 
101 of title 10, United States Code. 
SEC. 712. INCLUSION OF LEVEL THREE TRAUMA CARE CAPABILITIES 
IN REQUIREMENTS FOR MEDICAL CENTERS. 
Section 1073d(b)(3) of title 10, United States Code, is amended 
by striking ‘‘or level two’’ and inserting ‘‘, level two, or level three’’. 
SEC. 713. CENTERS OF EXCELLENCE FOR SPECIALTY CARE IN MILI-
TARY HEALTH SYSTEM. 
(a) CENTERS OF EXCELLENCE.—Section 1073d(b)(4) of title 10, 
United States Code, is amended to read as follows: 
‘‘(4)(A) The Secretary shall designate certain major medical 
centers as regional centers of excellence for the provision of specialty 
care services in the areas of specialty care described in subpara-
graph (D). A major medical center may be designated as a center 
of excellence under this subparagraph for more than one such 
area of specialty care. 
‘‘(B) The Secretary may designate certain medical centers as 
satellite centers of excellence for the provision of specialty care 
services for specific conditions, such as the following: 
‘‘(i) Post-traumatic stress. 
‘‘(ii) Traumatic brain injury. 
‘‘(iii) Such other conditions as the Secretary determines 
appropriate. 
‘‘(C) Centers of excellence designated under this paragraph 
shall serve the purposes of— 
‘‘(i) ensuring the military medical force readiness of the 
Department of Defense and the medical readiness of the armed 
forces; 
‘‘(ii) improving the quality of health care furnished by the 
Secretary to eligible beneficiaries; and 
‘‘(iii) improving health outcomes for eligible beneficiaries. 
‘‘(D) The areas of specialty care described in this subparagraph 
are as follows: 
‘‘(i) Oncology.
H. R. 7776—264 
‘‘(ii) Burn injuries and wound care. 
‘‘(iii) Rehabilitation medicine. 
‘‘(iv) Psychological health and traumatic brain injury. 
‘‘(v) Amputations and prosthetics. 
‘‘(vi) Neurosurgery. 
‘‘(vii) Orthopedic care. 
‘‘(viii) Substance abuse. 
‘‘(ix) Infectious diseases and preventive medicine. 
‘‘(x) Cardiothoracic surgery. 
‘‘(xi) Such other areas of specialty care as the Secretary 
determines appropriate. 
‘‘(E)(i) Centers of excellence designated under this paragraph 
shall be the primary source within the military health system 
for the receipt by eligible beneficiaries of specialty care. 
‘‘(ii) Eligible beneficiaries seeking a specialty care service 
through the military health system shall be referred to a center 
of excellence designated under subparagraph (A) for that area of 
specialty care or, if the specialty care service sought is unavailable 
at such center, to an appropriate specialty care provider in the 
private sector. 
‘‘(F) Not later than 90 days prior to the designation of a center 
of excellence under this paragraph, the Secretary shall notify the 
Committees on Armed Services of the House of Representatives 
and the Senate of such designation. 
‘‘(G) In this paragraph, the term ‘eligible beneficiary’ means 
any beneficiary under this chapter.’’. 
(b) DEADLINE.—The Secretary of Defense shall designate certain 
major medical centers as regional centers of excellence in accordance 
with section 1073d(b)(4)(A) of title 10, United States Code, as added 
by subsection (a), by not later than one year after the date of 
the enactment of this Act. 
(c) REPORT.— 
(1) SUBMISSION.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense shall 
submit to the Committees on Armed Services of the House 
of Representatives and the Senate a report that sets forth 
the plan of the Department of Defense to designate centers 
of excellence under section 1073d(b)(4) of title 10, United States 
Code, as added by subsection (a). 
(2) ELEMENTS.—The report under paragraph (1) shall 
include the following: 
(A) A list of the centers of excellence to be designated 
under such section 1073d(b)(4) and the locations of such 
centers. 
(B) A description of the specialty care services to be 
provided at each such center and a staffing plan for each 
such center. 
(C) A description of how each such center shall 
improve— 
(i) the military medical force readiness of the 
Department and the medical readiness of the Armed 
Forces; 
(ii) the quality of care received by eligible bene-
ficiaries; and 
(iii) the health outcomes of eligible beneficiaries.
H. R. 7776—265 
(D) A comprehensive plan for the referral of eligible 
beneficiaries for specialty care services at centers of excel-
lence designated under such section 1073d(b)(4) and appro-
priate specialty care providers in the private sector. 
(E) A plan to assist eligible beneficiaries with travel 
and lodging, if necessary, in connection with the receipt 
of specialty care services at centers of excellence designated 
under such section 1073d(b)(4) or appropriate specialty care 
providers in the private sector. 
(F) A plan to transfer specialty care providers of the 
Department to centers of excellence designated under such 
section 1073d(b)(4), in a number as determined by the 
Secretary to be required to provide specialty care services 
to eligible beneficiaries at such centers. 
(G) A plan to monitor access to care, beneficiary satis-
faction, experience of care, and clinical outcomes to under-
stand better the impact of such centers on the health 
care of eligible beneficiaries. 
(d) ELIGIBLE BENEFICIARY DEFINED.—In this section, the term 
‘‘eligible beneficiary’’ means any beneficiary under chapter 55 of 
title 10, United States Code. 
SEC. 714. MAINTENANCE OF CORE CASUALTY RECEIVING FACILITIES 
TO IMPROVE MEDICAL FORCE READINESS. 
(a) IN GENERAL.—Section 1073d(b) of title 10, United States 
Code, as amended by section 713, is further amended by adding 
at the end the following new paragraph: 
‘‘(5)(A) The Secretary of Defense shall designate and maintain 
certain military medical treatment facilities as core casualty 
receiving facilities, to ensure the medical capability and capacity 
required to diagnose, treat, and rehabilitate large volumes of combat 
casualties and, as may be directed by the President or the Secretary, 
provide a medical response to events the President determines 
or declares as natural disasters, mass casualty events, or other 
national emergencies. 
‘‘(B) The Secretary shall ensure that the military medical treat-
ment facilities selected for designation pursuant to subparagraph 
(A) are geographically located to facilitate the aeromedical evacu-
ation of casualties from theaters of operations. 
‘‘(C) The Secretary— 
‘‘(i) shall ensure that the Secretaries of the military depart-
ments assign military personnel to core casualty receiving facili-
ties designated under subparagraph (A) at not less than 90 
percent of the staffing level required to maintain the operating 
bed capacity necessary to support operation planning require-
ments; 
‘‘(ii) may augment the staffing of military personnel at 
core casualty receiving facilities under subparagraph (A) with 
civilian employees of the Department of Defense to fulfil the 
staffing requirement under clause (i); and 
‘‘(iii) shall ensure that each core casualty receiving facility 
under subparagraph (A) is staffed with a civilian Chief Finan-
cial Officer and a civilian Chief Operating Officer with experi-
ence in the management of civilian hospital systems, for the 
purpose of ensuring continuity in the management of the 
facility. 
‘‘(D) In this paragraph:
H. R. 7776—266 
‘‘(i) The term ‘core casualty receiving facility’ means a 
Role 4 medical treatment facility that serves as a medical 
hub for the receipt and treatment of casualties, including 
civilian casualties, that may result from combat or from an 
event the President determines or declares as a natural dis-
aster, mass casualty event, or other national emergency. 
‘‘(ii) The term ‘Role 4 medical treatment facility’ means 
a medical treatment facility that provides the full range of 
preventative, curative, acute, convalescent, restorative, and 
rehabilitative care.’’. 
(b) TIMELINE FOR ESTABLISHMENT.— 
(1) DESIGNATION.—Not later than October 1, 2024, the 
Secretary of Defense shall designate four military medical treat-
ment facilities as core casualty receiving facilities under section 
1073d(b)(5) of title 10, United States Code (as added by sub-
section (a)). 
(2) OPERATIONAL.—Not later than October 1, 2025, the 
Secretary shall ensure that each such designated military med-
ical treatment facility is fully staffed and operational as a 
core casualty receiving facility, in accordance with the require-
ments of such section 1073d(b)(5). 
SEC. 715. CONGRESSIONAL NOTIFICATION REQUIREMENT TO MODIFY 
SCOPE OF SERVICES PROVIDED AT MILITARY MEDICAL 
TREATMENT FACILITIES. 
Section 1073d of title 10, United States Code, as amended 
by section 714, is further amended by adding at the end the fol-
lowing new subsection: 
‘‘(f) NOTIFICATION REQUIRED TO MODIFY SCOPE OF SERVICES 
PROVIDED AT MILITARY MEDICAL TREATMENT FACILITIES.—(1) The 
Secretary of Defense may not modify the scope of medical care 
provided at a military medical treatment facility, or the beneficiary 
population served at the facility, unless— 
‘‘(A) the Secretary submits to the Committees on Armed 
Services of the House of Representatives and the Senate a 
notification of the proposed modification in scope; 
‘‘(B) a period of 180 days has elapsed following the date 
on which the Secretary submits such notification; and 
‘‘(C) if the proposed modification in scope involves the 
termination or reduction of inpatient capabilities at a military 
medical treatment facility located outside the United States, 
the Secretary has provided to each member of the armed forces 
or covered beneficiary receiving services at such facility a 
transition plan for the continuity of health care for such 
member or covered beneficiary. 
‘‘(2) Each notification under paragraph (1) shall contain 
information demonstrating, with respect to the military medical 
treatment facility for which the modification in scope has been 
proposed, the extent to which the commander of the military 
installation at which the facility is located has been consulted 
regarding such modification, to ensure that the proposed modifica-
tion in scope would have no impact on the operational plan for 
such installation.’’.
H. R. 7776—267 
SEC. 716. IMPROVEMENTS TO PROCESSES TO REDUCE FINANCIAL 
HARM CAUSED TO CIVILIANS FOR CARE PROVIDED AT 
MILITARY MEDICAL TREATMENT FACILITIES. 
(a) CLARIFICATION OF FEE WAIVER PROCESS.—Section 1079b 
of title 10, United States Code, is amended— 
(1) by amending subsection (b) to read as follows: 
‘‘(b) WAIVER OF FEES.—The Director of the Defense Health 
Agency may issue a waiver for a fee that would otherwise be 
charged under the procedures implemented under subsection (a) 
to a civilian provided medical care who is not a covered beneficiary 
if the provision of such care enhances the knowledge, skills, and 
abilities of health care providers, as determined by the Director 
of the Defense Health Agency.’’; and 
(2) by redesignating subsection (c) as subsection (d). 
(b) MODIFIED PAYMENT PLAN FOR CERTAIN CIVILIANS.—Such 
section is further amended— 
(1) by inserting after subsection (b), as amended by sub-
section (a), the following: 
‘‘(c) MODIFIED PAYMENT PLAN FOR CERTAIN CIVILIANS.—(1)(A) 
If a civilian specified in subsection (a) is covered by a covered 
payer at the time care under this section is provided, the civilian 
shall only be responsible to pay the standard copays, coinsurance, 
deductibles, or nominal fees that are otherwise applicable under 
the covered payer plan. 
‘‘(B) Except with respect to the copays, coinsurance, deductibles, 
and nominal fees specified in subparagraph (A)— 
‘‘(i) the Secretary of Defense may bill only the covered 
payer for care provided to a civilian described in subparagraph 
(A); and 
‘‘(ii) payment received by the Secretary from the covered 
payer of a civilian for care provided under this section that 
is provided to the civilian shall be considered payment in full 
for such care. 
‘‘(2) If a civilian specified in subsection (a) does not meet the 
criteria under paragraph (1), is underinsured, or has a remaining 
balance and is at risk of financial harm, the Director of the Defense 
Health Agency shall reduce each fee that would otherwise be 
charged to the civilian under this section according to a sliding 
fee discount program, as prescribed by the Director of the Defense 
Health Agency. 
‘‘(3) If a civilian specified in subsection (a) does not meet the 
criteria under paragraph (1) or (2), the Director of the Defense 
Health Agency shall implement an additional catastrophic waiver 
to prevent severe financial harm. 
‘‘(4) The modified payment plan under this subsection may 
not be administered by a Federal agency other than the Department 
of Defense.’’; and 
(2) by adding at the end the following new subsection: 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) The term ‘covered payer’ means a third-party payer 
or other insurance, medical service, or health plan. 
‘‘(2) The terms ‘third-party payer’ and ‘insurance, medical 
service, or health plan’ have the meaning given those terms 
in section 1095(h) of this title.’’. 
(c) APPLICABILITY.—The amendments made by subsections (a) 
and (b) shall apply with respect to care provided on or after the
H. R. 7776—268 
date that is 180 days after the date of the enactment of this 
Act. 
SEC. 717. AUTHORITY TO CARRY OUT STUDIES AND DEMONSTRATION 
PROJECTS RELATING TO DELIVERY OF HEALTH AND MED-
ICAL CARE THROUGH USE OF OTHER TRANSACTION 
AUTHORITY. 
(a) IN GENERAL.—Section 1092(b) of title 10, United States 
Code, is amended by inserting ‘‘or transactions (other than con-
tracts, cooperative agreements, and grants)’’ after ‘‘contracts’’. 
(b) BRIEFING.—Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Defense shall provide to 
the Committees on Armed Services of the Senate and the House 
of Representatives a briefing on how the Secretary intends to use 
the authority to enter into transactions under section 1092(b) of 
title 10, United States Code, as amended by subsection (a). 
SEC. 718. LICENSURE REQUIREMENT FOR CERTAIN HEALTH-CARE 
PROFESSIONALS PROVIDING SERVICES AS PART OF MIS-
SION RELATING TO EMERGENCY, HUMANITARIAN, OR REF-
UGEE ASSISTANCE. 
Section 1094(d)(2) of title 10, United States Code, is amended 
by inserting ‘‘ contractor not covered under section 1091 of this 
title who is providing medical treatment as part of a mission 
relating to emergency, humanitarian, or refugee assistance,’’ after 
‘‘section 1091 of this title,’’. 
SEC. 719. AUTHORIZATION OF PERMANENT PROGRAM TO IMPROVE 
OPIOID MANAGEMENT IN THE MILITARY HEALTH SYSTEM. 
Section 716 of the John S. McCain National Defense Authoriza-
tion Act for Fiscal Year 2019 (Public Law 115–232; 10 U.S.C. 
1090 note), is amended— 
(1) in subsection (a)(1), by striking ‘‘Beginning not’’ and 
inserting ‘‘Except as provided in subsection (e), beginning not’’; 
(2) by redesignating subsection (e) as subsection (f); and 
(3) by inserting after subsection (d) the following new sub-
section (e): 
‘‘(e) ALTERNATIVE INITIATIVE
TO IMPROVE OPIOID MANAGE-
MENT.—As an alternative to the pilot program under this section, 
the Director of the Defense Health Agency, not later than January 
1, 2023— 
‘‘(1) may implement a permanent program to improve opioid 
management for beneficiaries under the TRICARE program; 
and 
‘‘(2) if the Director decides to implement such a permanent 
program, shall submit to the Committees on Armed Services 
of the Senate and the House of Representatives the specifica-
tions of and reasons for implementing such program.’’. 
SEC. 720. MODIFICATION OF REQUIREMENT TO TRANSFER RESEARCH 
AND DEVELOPMENT AND PUBLIC HEALTH FUNCTIONS TO 
DEFENSE HEALTH AGENCY. 
(a) TEMPORARY RETENTION.—Notwithstanding section 1073c(e) 
of title 10, United States Code, at the discretion of the Secretary 
of Defense, a military department may retain, until not later than 
February 1, 2024, a covered function if the Secretary of Defense 
determines the covered function—
H. R. 7776—269 
(1) addresses a need that is unique to the military depart-
ment; and 
(2) is in direct support of operating forces and necessary 
to execute strategies relating to national security and defense. 
(b) BRIEFING.— 
(1) IN GENERAL.—Not later than March 1, 2023, the Sec-
retary of Defense shall provide to the Committees on Armed 
Services of the House of Representatives and the Senate a 
briefing on any covered function that the Secretary has deter-
mined should be retained by a military department pursuant 
to subsection (a). 
(2) ELEMENTS.—The briefing required by paragraph (1) 
shall address the following: 
(A) A description of each covered function that the 
Secretary has determined should be retained by a military 
department pursuant to subsection (a). 
(B) The rationale for each such determination. 
(C) Recommendations for amendments to section 1073c 
of title 10, United States Code, to authorize the ongoing 
retention of covered functions by military departments. 
(c) MODIFICATION TO NAMES OF PUBLIC HEALTH COMMANDS.— 
Section 1073c(e)(2)(B) of title 10, United States Code, is amended 
by striking ‘‘Army Public Health Command, the Navy–Marine Corps 
Public Health Command’’ and inserting ‘‘Army Public Health 
Center, the Navy–Marine Corps Public Health Center’’. 
(d) COVERED FUNCTION DEFINED.—In this section, the term 
‘‘covered function’’ means— 
(1) a function relating to research and development that 
would otherwise be transferred to the Defense Health Agency 
Research and Development pursuant to section 1073c(e)(1) of 
title 10, United States Code; or 
(2) a function relating to public health that would otherwise 
be transferred to the Defense Health Agency Public Health 
pursuant to section 1073c(e)(2) of such title. 
SEC. 721. ACCESS TO CERTAIN DEPENDENT MEDICAL RECORDS BY 
REMARRIED FORMER SPOUSES. 
(a) ACCESS.—The Secretary of Defense may authorize a 
remarried former spouse who is a custodial parent of a dependent 
child to retain electronic access to the privileged medical records 
of such dependent child, notwithstanding that the former spouse 
is no longer a dependent under section 1072(2) of title 10, United 
States Code. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘dependent’’ has the meaning given that term 
in section 1072 of title 10, United States Code. 
(2) The term ‘‘dependent child’’ means a dependent child 
of a remarried former spouse and a member or former member 
of a uniformed service. 
(3) The term ‘‘remarried former spouse’’ means a remarried 
former spouse of a member or former member of a uniformed 
service. 
SEC. 722. AUTHORITY FOR DEPARTMENT OF DEFENSE PROGRAM TO 
PROMOTE EARLY LITERACY AMONG CERTAIN YOUNG 
CHILDREN. 
(a) AUTHORITY.—The Secretary of Defense may carry out a 
program to promote early literacy among young children in child
H. R. 7776—270 
development centers and libraries located on installations of the 
Department of Defense. 
(b) ACTIVITIES.—Activities under the program under subsection 
(a) shall include the following: 
(1) The provision of training on early literacy promotion 
to appropriate personnel of the Department. 
(2) The purchase and distribution of age-appropriate books 
to covered caregivers assigned to or serving at an installation 
of the Department with a child development center or library 
at which the Secretary is carrying out the program. 
(3) The dissemination to covered caregivers of education 
materials on early literacy. 
(4) Such other activities as the Secretary determines appro-
priate. 
(c) LOCATIONS.—In carrying out the program under subsection 
(a), the Secretary may conduct the activities under subsection (b) 
at any child development center or library located on an installation 
of the Department. 
(d) BRIEFING.—Not later than one year after the date of the 
enactment of this Act, the Secretary shall provide to the Committees 
on Armed Services of the House of Representatives and the Senate 
a briefing on the extent to which the authority under subsection 
(a) is used, including— 
(1) a description of any activities carried out under the 
program so authorized; and 
(2) an evaluation of the potential expansion of such program 
to be included as a part of the pediatric primary care of young 
children and to be carried out in military medical treatment 
facilities. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘covered caregiver’’ means a member of the 
Armed Forces who is a caregiver of a young child. 
(2) The term ‘‘young child’’ means any child from birth 
to the age of five years old, inclusive. 
SEC. 723. PLAN FOR ACCOUNTABLE CARE ORGANIZATION DEM-
ONSTRATION. 
(a) IN GENERAL.—Not later than 180 days after the date of 
the enactment of this Act, the Secretary of Defense, acting through 
the Director of the Defense Health Agency, shall submit to the 
Committees on Armed Services of the House of Representatives 
and the Senate a plan for the conduct of the Accountable Care 
Organization demonstration, notice of which was published in the 
Federal Register on August 16, 2019 (84 Fed. Reg. 41974), (in 
this section referred to as the ‘‘Demonstration’’). 
(b) ELEMENTS.—The plan under subsection (a) shall include, 
the following: 
(1) A description of how the Demonstration shall be con-
ducted to deliver improved health outcomes, improved quality 
of care, and lower costs under the TRICARE program. 
(2) A description of the results for the TRICARE program 
that the Secretary plans to achieve through the Demonstration, 
with respect to the following outcome measures: 
(A) Clinical performance. 
(B) Utilization improvement. 
(C) Beneficiary engagement. 
(D) Membership growth and retention.
H. R. 7776—271 
(E) Case management. 
(F) Continuity of care. 
(G) Use of telehealth. 
(3) A description of how the Demonstration shall be con-
ducted to shift financial risk from the Department of Defense 
to civilian health care providers. 
(4) A description of how investment in the Demonstration 
shall serve as a bridge to future competitive demonstrations 
of the Department of Defense with accountable care organiza-
tions. 
(5) A detailed description of the geographic locations at 
which the Secretary plans to conduct such future competitive 
demonstrations. 
(6) A description of how a third-party administrator shall 
manage the administrative components of the Demonstration, 
including with respect to eligibility, enrollment, premium pay-
ment processes, submission of qualifying life events changes, 
and mailing address changes. 
(c) TRICARE PROGRAM DEFINED.—In this section, the term 
‘‘TRICARE program’’ has the meaning given that term in section 
1072 of title 10, United States Code. 
SEC. 724. FEASIBILITY STUDY AND PLAN ON ESTABLISHING A MILI-
TARY HEALTH SYSTEM MEDICAL LOGISTICS DIRECTORATE 
AND 
MILITARY 
HEALTH 
SYSTEM 
EDUCATION 
AND 
TRAINING DIRECTORATE. 
(a) STUDY AND PLAN.—The Secretary of Defense, in consultation 
with the Secretaries of the military departments and the Joint 
Chiefs of Staff, shall— 
(1) conduct a study on the feasibility of the establishment 
within the Defense Health Agency of two subordinate organiza-
tions, to be known as the Military Health System Medical 
Logistics Directorate and the Military Health System Education 
and Training Directorate, respectively; and 
(2) develop a plan for such establishment. 
(b) ELEMENTS.—The plan under subsection (a)(2) shall include 
the following: 
(1) MILITARY HEALTH SYSTEM MEDICAL LOGISTICS DIREC-
TORATE.—With respect to the Military Health System Medical 
Logistics Directorate, the following: 
(A) A description of the organizational structure of 
the Directorate (including any subordinate organizations), 
including the incorporation into the Directorate of existing 
organizations of the military departments that provide 
operational theater medical materiel support. 
(B) A description of the resourcing by the Secretary 
of the executive leadership of the Directorate. 
(C) A description of the geographic location, or multiple 
such locations, of the elements of the Directorate. 
(D) A description of how the head of the medical 
research and development organization within the Defense 
Health Agency shall coordinate with the Directorate. 
(E) A description of the ability of the Directorate to 
address the medical logistics requirements of the military 
departments, the combatant commands, and the Joint 
Staff.
H. R. 7776—272 
(F) A description of any additional funding required 
to establish the Directorate. 
(G) A description of any additional legislative authori-
ties required to establish the Directorate, including any 
such authorities required for the leadership and direction 
of the Directorate. 
(H) A description of any military department-specific 
capabilities, requirements, or best practices relating to 
medical logistics necessary to be considered prior to the 
establishment of the Directorate. 
(I) Such other matters relating to the establishment, 
operations, or activities of the Directorate as the Secretary 
may determine appropriate. 
(2) MILITARY
HEALTH
SYSTEM
EDUCATION
AND
TRAINING 
DIRECTORATE.—With respect to the Military Health System 
Education and Training Directorate, the following: 
(A) A description of the organizational structure of 
the Directorate (including any subordinate organizations), 
including the incorporation into the Directorate of existing 
organizations that provide relevant medical education and 
training, such as the following: 
(i) The Uniformed Services University of the 
Health Sciences. 
(ii) The College of Allied Health Sciences of the 
Uniformed Services University of the Health Sciences. 
(iii) The Medical Education and Training Campus 
of the Department of Defense. 
(iv) The medical education and training commands 
and organizations of the military departments. 
(v) The medical training programs of the military 
departments affiliated with civilian academic institu-
tions. 
(B) A description of the resourcing by the Secretary 
of the executive leadership of the Directorate. 
(C) A description of the geographic location, or multiple 
such locations, of the elements of the Directorate. 
(D) A description of the ability of the Directorate to 
address the medical education and training requirements 
of the military departments. 
(E) A description of any additional funding required 
for the establishment the Directorate. 
(F) A description of any additional legislative authori-
ties required for the establishment of the Directorate, 
including any such authorities required for the leadership 
and direction of the Directorate. 
(G) Such other matters relating to the establishment, 
operations, or activities of the Directorate as the Secretary 
may determine appropriate. 
(c) SUBMISSION.—Not later than one year after the date of 
the enactment of this Act, the Secretary of Defense shall submit 
to the Committees on Armed Services of the House of Representa-
tives and the Senate— 
(1) the results of the study under subsection (a)(1); and 
(2) the plan under subsection (a)(2).
H. R. 7776—273 
Subtitle C—Reports and Other Matters 
SEC. 731. BRIEFING AND REPORT ON REDUCTION OR REALIGNMENT 
OF MILITARY MEDICAL MANNING AND MEDICAL BILLETS. 
Section 731(a)(2)(A) of the National Defense Authorization Act 
for Fiscal Year 2022 (Public Law 117–81; 135 Stat. 1796) is amended 
to read as follows: 
‘‘(A) BRIEFING; REPORT.—The Comptroller General of 
the United States shall— 
‘‘(i) not later than February 1, 2023, provide to 
the Committees on Armed Services of the House of 
Representatives and the Senate a briefing on prelimi-
nary observations regarding the analyses used to sup-
port any reduction or realignment of military medical 
manning, including any reduction or realignment of 
medical billets of the military departments; and 
‘‘(ii) not later than May 31, 2023, submit to the 
Committees on Armed Services of the House of Rep-
resentatives and the Senate a report on such anal-
yses.’’. 
SEC. 732. INDEPENDENT ANALYSIS OF DEPARTMENT OF DEFENSE 
COMPREHENSIVE AUTISM CARE DEMONSTRATION PRO-
GRAM. 
Section 737 of the National Defense Authorization Act for Fiscal 
Year 2022 (Public Law 117–81; 135 Stat. 1800) is amended— 
(1) in subsection (b)(2)— 
(A) in subparagraph (A)— 
(i) by inserting ‘‘broadly’’ after ‘‘disorder’’; and 
(ii) by striking ‘‘demonstration project’’ and 
inserting ‘‘demonstration program’’; 
(B) in subparagraph (B), by striking ‘‘demonstration 
project’’ and inserting ‘‘demonstration program’’; 
(C) in subparagraph (C), by inserting ‘‘parental involve-
ment in applied behavioral analysis treatment, and’’ after 
‘‘including’’; 
(D) in subparagraph (D), by striking ‘‘for an individual 
who has’’ and inserting ‘‘, including mental health out-
comes, for individuals who have’’; 
(E) in subparagraph (E), by inserting ‘‘since its incep-
tion’’ after ‘‘demonstration program’’; 
(F) in subparagraph (F), by inserting ‘‘cost effective-
ness, program effectiveness, and clinical’’ after ‘‘measure 
the’’; 
(G) in subparagraph (G), by inserting ‘‘than in the 
general population’’ after ‘‘families’’; 
(H) by redesignating subparagraph (H) as subpara-
graph (I); and 
(I) by inserting after subparagraph (G) the following 
new subparagraph (H): 
‘‘(H) An analysis of whether the diagnosis and treat-
ment of autism is higher among the children of military 
families than in the general population.’’; and 
(2) in subsection (c), in the matter preceding paragraph 
(1), by striking ‘‘nine’’ and inserting ‘‘31’’.
H. R. 7776—274 
SEC. 733. CLARIFICATION OF MEMBERSHIP REQUIREMENTS AND COM-
PENSATION 
AUTHORITY 
FOR 
INDEPENDENT 
SUICIDE 
PREVENTION AND RESPONSE REVIEW COMMITTEE. 
Section 738 of the National Defense Authorization Act for Fiscal 
Year 2022 (Public Law 117–81; 135 Stat. 1801) is amended— 
(1) in subsection (b)(3), by striking ‘‘none of whom may 
be’’ and all that follows through the closing period and inserting 
‘‘none of whom may be—’’ 
‘‘(A) a member of an Armed Force; or 
‘‘(B) a civilian employee of the Department of Defense, 
unless the individual is a former member of an Armed 
Force.’’. 
(2) by redesignating subsections (f) through (h) as sub-
sections (g) through (i), respectively; and 
(3) by inserting after subsection (e) the following new sub-
section (f): 
‘‘(f) COMPENSATION.— 
‘‘(1) IN GENERAL.—Except as provided in paragraph (2), 
the Secretary may compensate members of the committee estab-
lished under subsection (a) for the work of such members 
for the committee. 
‘‘(2) EXCEPTION.—A member of the committee established 
under subsection (a) who is a civilian employee of the Depart-
ment of Defense and a former member of an Armed Force 
may not receive compensation under paragraph (1). 
‘‘(3) TREATMENT OF COMPENSATION.—A member of the com-
mittee established under subsection (a) who receives compensa-
tion under paragraph (1) shall not be considered a civilian 
employee of the Department of Defense for purposes of sub-
section (b)(3)(B).’’. 
SEC. 734. TERMINATION OF VETERANS’ ADVISORY BOARD ON RADI-
ATION DOSE RECONSTRUCTION. 
Section 601 of the Veterans Benefit Act of 2003 (Public Law 
108–183; 38 U.S.C. 1154 note) is amended— 
(1) in subsection (b), by striking ‘‘, including the establish-
ment of the advisory board required by subsection (c)’’; and 
(2) by striking subsection (c). 
SEC. 735. BRAIN HEALTH INITIATIVE OF DEPARTMENT OF DEFENSE. 
(a) IN GENERAL.—The Secretary of Defense, in consultation 
with the Secretaries concerned, shall establish a comprehensive 
initiative for brain health to be known as the ‘‘Warfighter Brain 
Health Initiative’’ (in this section referred to as the ‘‘Initiative’’) 
for the purpose of unifying efforts and programs across the Depart-
ment of Defense to improve the cognitive performance and brain 
health of members of the Armed Forces. 
(b) OBJECTIVES.—The objectives of the Initiative shall be the 
following: 
(1) To enhance, maintain, and restore the cognitive 
performance of members of the Armed Forces through edu-
cation, training, prevention, protection, monitoring, detection, 
diagnosis, treatment, and rehabilitation, including through the 
following activities: 
(A) The establishment of a program to monitor cog-
nitive brain health across the Department of Defense, with 
the goal of detecting any need for cognitive enhancement
H. R. 7776—275 
or restoration resulting from potential brain exposures of 
members of Armed Forces, to mitigate possible evolution 
of injury or disease progression. 
(B) The identification and dissemination of thresholds 
for blast pressure safety and associated emerging scientific 
evidence. 
(C) The modification of high-risk training and oper-
ational activities to mitigate the negative effects of repet-
itive blast exposure. 
(D) The identification of individuals who perform high- 
risk training or occupational activities, for purposes of 
increased monitoring of the brain health of such individ-
uals. 
(E) The development and operational fielding of non- 
invasive, portable, point-of-care medical devices, to inform 
the diagnosis and treatment of traumatic brain injury. 
(F) The establishment of a standardized monitoring 
program that documents and analyzes blast exposures that 
may affect the brain health of members of the Armed 
Forces. 
(G) The consideration of the findings and recommenda-
tions of the report of the National Academies of Science, 
Engineering, and Medicine titled ‘‘Traumatic Brain Injury: 
A Roadmap for Accelerating Progress’’ and published in 
2022 (relating to the acceleration of progress in traumatic 
brain injury research and care), or any successor report, 
in relation to the activities of the Department relating 
to brain health, as applicable. 
(2) To harmonize and prioritize the efforts of the Depart-
ment of Defense into a single approach to brain health. 
(c) ANNUAL BUDGET JUSTIFICATION DOCUMENTS.—In the budget 
justification materials submitted to Congress in support of the 
Department of Defense budget for each of fiscal years 2025 through 
2029 (as submitted with the budget of the President under section 
1105(a) of title 31, United States Code), the Secretary of Defense 
shall include a budget justification display that includes all activi-
ties of the Department relating to the Initiative. 
(d) PILOT PROGRAM RELATING TO MONITORING OF BLAST COV-
ERAGE.— 
(1) AUTHORITY.—The Director of the Defense Health Agency 
may conduct, as part of the Initiative, a pilot program under 
which the Director shall monitor blast overpressure exposure 
through the use of commercially available, off-the-shelf, wear-
able sensors, and document and evaluate data collected as 
a result of such monitoring. 
(2) LOCATIONS.—Monitoring activities under a pilot pro-
gram conducted pursuant to paragraph (1) shall be carried 
out in each training environment that the Director determines 
poses a risk for blast overpressure exposure. 
(3) DOCUMENTATION AND SHARING OF DATA.—If the Director 
conducts a pilot program pursuant to paragraph (1), the 
Director shall— 
(A) ensure that any data collected pursuant to such 
pilot program that is related to the health effects of the 
blast overpressure exposure of a member of the Armed 
Forces who participated in the pilot program is documented
H. R. 7776—276 
and maintained by the Secretary of Defense in an electronic 
health record for the member; and 
(B) to the extent practicable, and in accordance with 
applicable provisions of law relating to data privacy, make 
data collected pursuant to such pilot program available 
to other academic and medical researchers for the purpose 
of informing future research and treatment options. 
(e) STRATEGY AND IMPLEMENTATION PLAN.—Not later than one 
year after the date of the enactment of this Act, the Secretary 
of Defense shall submit to the Committees on Armed Services 
of the House of Representatives and the Senate a report setting 
forth a strategy and implementation plan of the Department of 
Defense to achieve the objectives of the Initiative under subsection 
(b). 
(f) ANNUAL BRIEFINGS.—Not later than January 31, 2024, and 
annually thereafter until January 31, 2027, the Secretary of Defense 
shall provide to the Committees on Armed Services of the House 
of Representatives and the Senate a report on the Initiative that 
includes the following: 
(1) A description of the activities taken under the Initiative 
and resources expended under the Initiative during the prior 
fiscal year. 
(2) A summary of the progress made during the prior 
fiscal year with respect to the objectives of the Initiative under 
subsection (b). 
(g) SECRETARY CONCERNED DEFINED.—In this section, the term 
‘‘Secretary concerned’’ has the meaning given that term in section 
101 of title 10, United States Code. 
SEC. 736. ESTABLISHMENT OF PARTNERSHIP PROGRAM BETWEEN 
UNITED STATES AND UKRAINE FOR MILITARY TRAUMA 
CARE AND RESEARCH. 
Not later than February 24, 2023, the Secretary of Defense 
shall seek to enter into a partnership with the appropriate counter-
part from the Government of Ukraine for the establishment of 
a joint program on military trauma care and research. Such pro-
gram shall consist of the following: 
(1) The sharing of relevant lessons learned from the Russo- 
Ukraine War. 
(2) The conduct of relevant joint conferences and exchanges 
with military medical professionals from Ukraine and the 
United States. 
(3) Collaboration with the armed forces of Ukraine on mat-
ters relating to health policy, health administration, and med-
ical supplies and equipment, including through knowledge 
exchanges. 
(4) The conduct of joint research and development on the 
health effects of new and emerging weapons. 
(5) The entrance into agreements with military medical 
schools of Ukraine for reciprocal education programs under 
which students at the Uniformed Services University of the 
Health Sciences receive specialized military medical instruction 
at the such military medical schools of Ukraine and military 
medical personnel of Ukraine receive specialized military med-
ical instruction at the Uniformed Services University of the 
Health Sciences, pursuant to section 2114(f) of title 10, United 
States Code.
H. R. 7776—277 
(6) The provision of support to Ukraine for the purpose 
of facilitating the establishment in Ukraine of a program 
substantially similar to the Wounded Warrior Program in the 
United States. 
(7) The provision of training to the armed forces of Ukraine 
in the following areas: 
(A) Health matters relating to chemical, biological, 
radiological, nuclear and explosive weapons. 
(B) Preventive medicine and infectious disease. 
(C) Post traumatic stress disorder. 
(D) Suicide prevention. 
(8) The maintenance of a list of medical supplies and equip-
ment needed. 
(9) Such other elements as the Secretary of Defense may 
determine appropriate. 
SEC. 737. IMPROVEMENTS RELATING TO BEHAVIORAL HEALTH CARE 
AVAILABLE UNDER MILITARY HEALTH SYSTEM. 
(a) STUDY RELATING TO UNIFORMED SERVICES UNIVERSITY OF 
THE HEALTH SCIENCE.— 
(1) STUDY.—The Secretary of Defense shall conduct a study 
on the feasibility and advisability of the following: 
(A) Establishing graduate degree-granting programs 
in counseling and social work at the Uniformed Services 
University of the Health Sciences. 
(B) Expanding the clinical psychology graduate pro-
gram of the Uniformed Services University of the Health 
Sciences. 
(2) MATTERS.—The study under paragraph (1) shall include 
a description of— 
(A) the process by which, as a condition of enrolling 
in a degree-granting program specified in such paragraph, 
a civilian student would be required to commit to post- 
award employment obligations; and 
(B) the processes and consequences that would apply 
if such obligations are not met. 
(3) REPORT.—Not later than one year after the date of 
the enactment of this Act, the Secretary shall submit to the 
Committees on Armed Services of the House of Representatives 
and the Senate a report containing the findings of the study 
under paragraph (1). 
(b) PILOT PROGRAM ON SCHOLARSHIP-FOR-SERVICE FOR CIVILIAN 
BEHAVIORAL HEALTH PROVIDERS.— 
(1) PILOT PROGRAM.—Not later than two years after the 
date of the enactment of this Act, the Secretary of Defense 
shall commence the conduct of a pilot program under which— 
(A) the Secretary may provide— 
(i) scholarships to cover tuition and related fees 
at an institution of higher education to an individual 
enrolled in a program of study leading to a graduate 
degree in clinical psychology, social work, counseling, 
or a related field (as determined by the Secretary); 
and 
(ii) student loan repayment assistance to a 
credentialed behavioral health provider who has a 
graduate degree in clinical psychology, social work,
H. R. 7776—278 
counseling, or a related field (as determined by the 
Secretary); and 
(B) in exchange for such assistance, the recipient shall 
commit to work as a covered civilian behavioral health 
provider in accordance with paragraph (2). 
(2) POST-AWARD EMPLOYMENT OBLIGATIONS.— 
(A) IN GENERAL.—Subject to subparagraph (B), as a 
condition of receiving assistance under paragraph (1), the 
recipient of such assistance shall enter into an agreement 
with the Secretary of Defense pursuant to which the 
recipient agrees to work on a full-time basis as a covered 
civilian behavioral health provider for a period of a duration 
that is at least equivalent to the period during which 
the recipient received assistance under such paragraph. 
(B) OTHER
TERMS
AND
CONDITIONS.—An agreement 
entered into pursuant to subparagraph (A) may include 
such other terms and conditions as the Secretary of Defense 
may determine necessary to protect the interests of the 
United States or otherwise appropriate for purposes of 
this section, including terms and conditions providing for 
limited exceptions from the post-award employment obliga-
tion specified in such subparagraph. 
(3) REPAYMENT.— 
(A) IN GENERAL.—An individual who receives assist-
ance under paragraph (1) and does not complete the 
employment obligation required under the agreement 
entered into pursuant to paragraph (2) shall repay to the 
Secretary of Defense a prorated portion of the financial 
assistance received by the individual under paragraph (1). 
(B) DETERMINATION OF AMOUNT.—The amount of any 
repayment required under subparagraph (A) shall be deter-
mined by the Secretary. 
(4) DURATION.—The authority to carry out the pilot pro-
gram under paragraph (1) shall terminate on the date that 
is 10 years after the date on which such pilot program com-
mences. 
(5) IMPLEMENTATION PLAN.—Not later than one year after 
the date of the enactment of this Act, the Secretary of Defense 
shall submit to the Committees on Armed Services of the House 
of Representatives and the Senate a plan for the implementa-
tion of this section. 
(6) REPORTS.— 
(A) IN GENERAL.—Not later than each of one year and 
five years after the commencement of the pilot program 
under paragraph (1), the Secretary of Defense shall submit 
to the Committees on Armed Services of the House of 
Representative and the Senate a report on the pilot pro-
gram. 
(B) ELEMENTS.—Each report under subparagraph (A) 
shall include, with respect to the pilot program under sub-
section (1), the following: 
(i) The number of students receiving scholarships 
under the pilot program. 
(ii) The institutions of higher education at which 
such students are enrolled. 
(iii) The total amount of financial assistance 
expended under the pilot program per academic year.
H. R. 7776—279 
(iv) The average scholarship amount per student 
under the pilot program. 
(v) The number of students hired as covered behav-
ioral health providers pursuant to the pilot program. 
(vi) Any recommendations for terminating the pilot 
program, extending the pilot program, or making the 
pilot program permanent. 
(c) REPORT ON BEHAVIORAL HEALTH WORKFORCE.— 
(1) REPORT.—Not later than 180 days after the date of 
the enactment of this Act, the Secretary of Defense shall con-
duct an analysis of the behavioral health workforce under the 
direct care component of the military health system and submit 
to the Committees on Armed Services of the House of Rep-
resentatives and the Senate a report containing the results 
of such analysis. Such report shall include, with respect to 
such workforce, the following: 
(A) The number of positions authorized for military 
behavioral health providers within such workforce, and 
the number of such positions filled, disaggregated by the 
professions described in paragraph (2). 
(B) The number of positions authorized for civilian 
behavioral health providers within such workforce, and 
the number of such positions filled, disaggregated by the 
professions described in paragraph (2). 
(C) For each military department, the ratio of military 
behavioral health providers assigned to military medical 
treatment facilities compared to civilian behavioral health 
providers so assigned, disaggregated by the professions 
described in paragraph (2). 
(D) For each military department, the number of mili-
tary behavioral health providers authorized to be embedded 
within an operational unit, and the number of such posi-
tions filled, disaggregated by the professions described in 
paragraph (2). 
(E) Data on the historical demand for behavioral health 
services by members of the Armed Forces. 
(F) An estimate of the number of health care providers 
necessary to meet the demand by such members for behav-
ioral health care services under the direct care component 
of the military health system, disaggregated by provider 
type. 
(G) An identification of any shortfall between the esti-
mated number under subparagraph (F) and the total 
number of positions for behavioral health providers filled 
within such workforce. 
(H) Such other information as the Secretary may deter-
mine appropriate. 
(2) PROVIDER
TYPES.—The professions described in this 
paragraph are as follows: 
(A) Clinical psychologists. 
(B) Social workers. 
(C) Counselors. 
(D) Such other professions as the Secretary may deter-
mine appropriate. 
(3) BEHAVIORAL
HEALTH
WORKFORCE
AT
REMOTE
LOCA-
TIONS.—In conducting the analysis of the behavioral health 
workforce under paragraph (1), the Secretary of Defense shall
H. R. 7776—280 
ensure such behavioral health workforce at remote locations 
(including Guam and Hawaii) and any shortfalls thereof, is 
taken into account. 
(d) PLAN
TO ADDRESS SHORTFALLS
IN BEHAVIORAL HEALTH 
WORKFORCE.—Not later than one year after the date on which 
the report under subsection (c) is submitted, the Secretary of 
Defense shall submit to the Committees on Armed Services of 
the House of Representatives and the Senate a plan to address 
any shortfall of the behavioral health workforce identified under 
paragraph (1)(G) of such subsection. Such plan shall address the 
following: 
(1) With respect to any such shortfall of military behavioral 
health providers (addressed separately with respect to such 
providers assigned to military medical treatment facilities and 
such providers assigned to be embedded within operational 
units), the recruitment, accession, retention, special pay and 
other aspects of compensation, workload, role of the Uniformed 
Services University of the Health Sciences and the Armed 
Forces Health Professions Scholarship Program under chapter 
105 of title 10, United States Code, any additional authorities 
or resources necessary for the Secretary to increase the number 
of such providers, and such other considerations as the Sec-
retary may consider appropriate. 
(2) With respect to addressing any such shortfall of civilian 
behavioral health providers, the recruitment, hiring, retention, 
pay and benefits, workload, educational scholarship programs, 
any additional authorities or resources necessary for the Sec-
retary to increase the number of such providers, and such 
other considerations as the Secretary may consider appropriate. 
(3) A recommendation as to whether the number of military 
behavioral health providers in each military department should 
be increased, and if so, by how many. 
(4) A plan to ensure that remote installations are prioritized 
for the assignment of military behavioral health providers. 
(5) Updated access standards for behavioral health care 
under the military health system, taking into account— 
(A) the duration of time between a patient receiving 
a referral for such care and the patient receiving individual-
ized treatment (following an initial intake assessment) from 
a behavioral health provider; and 
(B) the frequency of regular follow-up appointments 
subsequent to the first appointment at which a patient 
receives such individualized treatment. 
(6) A plan to expand access to behavioral health care under 
the military health system using telehealth. 
(e) DEFINITIONS.—In this section: 
(1) The term ‘‘behavioral health’’ includes psychiatry, clin-
ical psychology, social work, counseling, and related fields. 
(2) The term ‘‘civilian behavioral health provider’’ means 
a behavioral health provider who is a civilian employee of 
the Department of Defense. 
(3) The term ‘‘counselor’’ means an individual who holds— 
(A) a master’s or doctoral degree from an accredited 
graduate program in— 
(i) marriage and family therapy; or 
(ii) clinical mental health counseling; and
H. R. 7776—281 
(B) a current license or certification from a State that 
grants the individual the authority to provide counseling 
services as an independent practitioner in the respective 
field of the individual. 
(4) The term ‘‘covered civilian behavioral health provider’’ 
means a civilian behavioral health provider whose employment 
by the Secretary of Defense involves the provision of behavioral 
health services at a military medical treatment facility. 
(5) The term ‘‘institution of higher education’’ has the 
meaning given that term in section 101 of the Higher Education 
Act of 1965 (20 U.S.C. 1001). 
(6) The term ‘‘military behavioral health provider’’ means 
a behavioral health provider who is a member of the Armed 
Forces. 
(7) The term ‘‘military installation’’ has the meaning given 
that term in section 2801 of title 10, United States Code. 
(8) The term ‘‘military medical treatment facility’’ means 
a facility specified in section 1073d of such title. 
(9) The term ‘‘remote installation’’ means a military 
installation that the Secretary determines to be in a remote 
location. 
(10) The term ‘‘State’’ means each of the several States, 
the District of Columbia, and each commonwealth, territory 
or possession of the United States. 
SEC. 738. CERTIFICATION PROGRAM IN PROVISION OF MENTAL 
HEALTH SERVICES TO MEMBERS OF THE ARMED FORCES 
AND MILITARY FAMILIES. 
(a) IN GENERAL.—The Secretary of Defense, in consultation 
with the President of the Uniformed Services University of the 
Health Sciences, shall develop a curriculum and certification pro-
gram to provide civilian mental health professionals and students 
in mental health-related disciplines with the specialized knowledge 
and skills necessary to address the unique mental health needs 
of members of the Armed Forces and military families. 
(b) IMPLEMENTATION.—Not later than 90 days after completing 
the development of the curriculum and certification program under 
subsection (a), the Secretary of Defense shall implement such cur-
riculum and certification program in the Uniformed Services 
University of the Health Sciences. 
(c) AUTHORITY
TO DISSEMINATE BEST PRACTICES.—The Sec-
retary of Defense may disseminate best practices based on the 
curriculum and certification program developed and implemented 
under this section to other institutions of higher education, as 
such term is defined in section 102 of the Higher Education Act 
of 1965 (20 U.S.C. 1002). 
(d) TERMINATION.—The authority to carry out the curriculum 
and certification program under this section shall terminate on 
the date that is five years after the date of the enactment of 
this Act. 
(e) BRIEFING.—Not later than 180 days after the termination 
date specified in subsection (d), the Secretary of Defense shall 
provide to the Committees on Armed Services of the House of 
Representatives and the Senate a briefing on the results of the 
curriculum and certification program developed and implemented 
under this section.
H. R. 7776—282 
SEC. 739. STANDARDIZATION OF POLICIES RELATING TO SERVICE IN 
ARMED FORCES BY INDIVIDUALS DIAGNOSED WITH HBV. 
(a) IN GENERAL.—Not later than one year after the date of 
the enactment of this Act, the Secretary of Defense, in coordination 
with the Secretaries concerned, shall— 
(1) review regulations, establish policies, and issue guid-
ance relating to service in the Armed Forces by individuals 
diagnosed with HBV, consistent with the health care standards 
and clinical guidelines of the Department of Defense; and 
(2) identify areas where the regulations, policies, and guid-
ance of the Department relating to individuals diagnosed with 
HBV (including with respect to enlistments, assignments, 
deployments, and retention standards) may be standardized 
across the Armed Forces. 
(b) DEFINITIONS.—In this section: 
(1) The term ‘‘HBV’’ means the Hepatitis B Virus. 
(2) The term ‘‘Secretary concerned’’ has the meaning given 
that term in section 101 of title 10, United States Code. 
SEC. 740. SUICIDE CLUSTER: STANDARDIZED DEFINITION FOR USE 
BY 
DEPARTMENT 
OF 
DEFENSE; 
CONGRESSIONAL 
NOTIFICATION. 
(a) STANDARDIZATION OF DEFINITION.—Not later than one year 
after the date of the enactment of this Act, the Secretary of Defense, 
in consultation with the Secretaries concerned, shall develop, for 
use across the Armed Forces, a standardized definition for the 
term ‘‘suicide cluster’’. 
(b) NOTIFICATION REQUIRED.—Beginning not later than one 
year after the date of the enactment of this Act, whenever the 
Secretary determines the occurrence of a suicide cluster (as that 
term is defined pursuant to subsection (a)) among members of 
the Armed Forces, the Secretary shall submit to the Committees 
on Armed Services of the House of Representatives and the Senate 
a notification of such determination. 
(c) BRIEFING.—Not later than April 1, 2023, the Secretary of 
Defense shall provide to the Committees on Armed Services of 
the House of Representatives and the Senate a briefing on the 
following: 
(1) The methodology being used in the development of 
the definition under subsection (a). 
(2) The progress made towards the development of the 
process for submitting required notifications under subsection 
(b). 
(3) An estimated timeline for the implementation of this 
section. 
(d) COORDINATION REQUIRED.—In developing the definition 
under subsection (a) and the process for submitting required 
notifications under subsection (b), the Secretary of Defense shall 
coordinate with the Secretaries concerned. 
(e) SECRETARY CONCERNED DEFINED.—In this section, the term 
‘‘Secretary concerned’’ has the meaning given that term in section 
101 of title 10, United States Codes. 
SEC. 741. LIMITATION ON REDUCTION OF MILITARY MEDICAL MAN-
NING END STRENGTH: CERTIFICATION REQUIREMENT 
AND OTHER REFORMS. 
(a) LIMITATION.—
H. R. 7776—283 
(1) IN GENERAL.—Except as provided in paragraph (2), and 
in addition to the limitation under section 719 of the National 
Defense Authorization Act for Fiscal Year 2020 (Public Law 
116–92; 133 Stat. 1454), as most recently amended by section 
731 of the National Defense Authorization Act for Fiscal Year 
2022 (Public Law 117–81; 135 Stat. 1795), during the five- 
year period beginning on the date of the enactment of this 
Act, neither the Secretary of Defense nor a Secretary concerned 
may reduce military medical end strength authorizations, and 
following such period, neither may reduce such authorizations 
unless the Secretary of Defense issues a waiver pursuant to 
paragraph (6). 
(2) EXCEPTION.—The limitation under paragraph (1) shall 
not apply with respect to the following: 
(A) Administrative billets of a military department that 
have remained unfilled since at least October 1, 2018. 
(B) Billets identified as non-clinical in the budget of 
the President for fiscal year 2020 submitted to Congress 
pursuant to section 1105(a) of title 31, United States Code, 
except that the number of such billets may not exceed 
1,700. 
(C) Medical headquarters billets of the military depart-
ments not assigned to, or providing direct support to, oper-
ational commands. 
(3) REPORT
ON
COMPOSITION
OF
MILITARY
MEDICAL 
WORKFORCE
REQUIREMENTS.—The Secretary of Defense, in 
coordination with the Secretaries of the military departments, 
shall conduct an assessment of current military medical man-
ning requirements (taking into consideration factors including 
future 
operational 
planning, 
training, 
and 
beneficiary 
healthcare) and submit to the Committees on Armed Services 
of the House of Representatives and the Senate a report con-
taining the findings of such assessment. Such assessment shall 
be informed by the following: 
(A) The National Defense Strategy submitted under 
section 113(g) of title 10, United States Code. 
(B) The National Military Strategy prepared under 
section 153(b) of such title. 
(C) The campaign plans of the combatant commands. 
(D) Theater strategies. 
(E) The joint medical estimate under section 732 of 
the John S. McCain National Defense Authorization Act 
for Fiscal Year 2019 (Public Law 115–232; 132 Stat. 1817). 
(F) The plan of the Department of Defense on 
integrated medical operations, as updated pursuant to 
paragraph (1) of section 724(a) of the National Defense 
Authorization Act for Fiscal Year 2022 (Public Law 117– 
81; 135 Stat. 1793; 10 U.S.C. 1096 note). 
(G) The plan of the Department of Defense on global 
patient movement, as updated pursuant to paragraph (2) 
of such section 724(a). 
(H) The biosurveillance program of the Department 
of Defense established pursuant to Department of Defense 
Directive 6420.02 (relating to biosurveillance). 
(I) Requirements for graduate medical education. 
(J) The report of the COVID–19 Military Health 
System Review Panel under section 731 of the William
H. R. 7776—284 
M. (Mac) Thornberry National Defense Authorization Act 
for Fiscal Year 2021 (Public Law 116–283; 134 Stat. 3698). 
(K) The report of the Inspector General of the Depart-
ment of Defense titled ‘‘Evaluation of Department of 
Defense Military Medical Treatment Facility Challenges 
During the Coronavirus Disease-2019 (COVID-19) Pan-
demic in Fiscal Year 2021 (DODIG-2022-081)’’ and pub-
lished on April 5, 2022. 
(L) Reports of the Comptroller General of the United 
States relating to military health system reforms under-
taken on or after January, 1, 2017, including any such 
reports relating to military medical manning and force 
composition mix. 
(M) Such other reports as may be determined appro-
priate by the Secretary of Defense. 
(4) CERTIFICATION.—The Secretary of Defense shall submit 
to the Committees on Armed Services of the House of Rep-
resentatives and the Senate a certification containing the fol-
lowing: 
(A) A certification of the completion of a comprehensive 
review of military medical manning, including with respect 
to the medical corps (or other health- or medical-related 
component of a military department), designator, profes-
sion, occupation, and rating of medical personnel. 
(B) A justification for any proposed increase, realign-
ment, reduction, or other change to the specialty or occupa-
tional composition of military medical end strength 
authorizations, which may include compliance with a 
requirement or recommendation set forth in a strategy, 
plan, or other matter specified in paragraph (3). 
(C) A certification that, in the case that any change 
to such specialty or occupational composition is required, 
a vacancy resulting from such change may not be filled 
with a position other than a health- or medical-related 
position until such time as there are no military medical 
billets remaining to fill the vacancy. 
(D) A risk analysis associated with the potential 
realignment or reduction of any military medical end 
strength authorizations. 
(E) An identification of any plans of the Department 
to backfill military medical personnel positions with civilian 
personnel. 
(F) A plan to address persistent vacancies for civilian 
personnel in health- or medical-related positions, and a 
risk analysis associated with the hiring, onboarding, and 
retention of such civilian personnel, taking into account 
provider shortfalls across the United States. 
(G) A comprehensive plan to mitigate any risk identi-
fied pursuant to subparagraph (D) or (F), including with 
respect to funding necessary for such mitigation across 
fiscal years. 
(5) PROCESS REQUIRED.—The Secretaries of the military 
departments, in coordination with the Secretary of Defense 
and the Chairman of the Joint Chiefs of Staff, shall develop 
and submit to the Committees on Armed Services of the House 
of Representatives and the Senate a process for the authoriza-
tion of proposed modifications to the composition of the medical
H. R. 7776—285 
manning force mix across the military departments while 
maintaining compliance with the limitation under paragraph 
(1). Such process shall— 
(A) take into consideration the funding required for 
any such proposed modification; and 
(B) include distinct processes for proposed increases 
and proposed decreases, respectively, to the medical man-
ning force mix of each military department. 
(6) WAIVER.— 
(A) IN GENERAL.—Following the conclusion of the five- 
year period specified in paragraph (1), the Secretary of 
Defense may waive the prohibition under such subsection 
if— 
(i) the report requirement under paragraph (3), 
the certification requirement under paragraph (4), and 
the process requirement under paragraph (5) have been 
completed; 
(ii) the Secretary determines that the waiver is 
necessary and in the interests of the national security 
of the United States; and 
(iii) the waiver is issued in writing. 
(B) NOTIFICATION TO CONGRESS.—Not later than five 
days after issuing a waiver under subparagraph (A), the 
Secretary of Defense shall submit to the Committees on 
Armed Services of the House of Representatives and the 
Senate a notification of the waiver (including the text of 
the waiver and a justification for the waiver) and provide 
to such committees a briefing on the components of the 
waiver. 
(b) TEMPORARY SUSPENSION OF IMPLEMENTATION OF PLAN FOR 
RESTRUCTURE OR REALIGNMENT OF MILITARY MEDICAL TREATMENT 
FACILITIES.—The Secretary of Defense may not implement the plan 
under section 703(d)(1) of the National Defense Authorization Act 
for Fiscal Year 2017 (Public Law 114–328; 130 Stat. 2199) until 
the later of the following: 
(1) The date that is one year after the date of the enactment 
of this Act. 
(2) The date on which the Secretary of Defense completes 
the following: 
(A) A risk analysis for each military medical treatment 
facility to be realigned, restructured, or otherwise affected 
under the implementation plan under such section 
703(d)(1), including an assessment of the capacity of the 
TRICARE network of providers in the area of such military 
medical treatment facility to provide care to the TRICARE 
Prime beneficiaries that would otherwise be assigned to 
such military medical treatment facility. 
(B) An identification of the process by which the assess-
ment conducted under subsection (a)(3) and the certification 
required under subsection (a)(4) shall be linked to any 
restructuring or realignment of military medical treatment 
facilities. 
(c) BRIEFINGS; FINAL REPORT.— 
(1) INITIAL BRIEFING.—Not later than April 1, 2023, the 
Secretary of Defense shall provide to the Committees on Armed 
Services of the House of Representatives and the Senate a 
briefing on—
H. R. 7776—286 
(A) the method by which the Secretary plans to meet 
the report requirement under subsection (a)(3), the certifi-
cation requirement under subsection (a)(4), and the process 
requirement under subsection (a)(5); and 
(B) the matters specified in subparagraphs (A) and 
(B) of subsection (b)(2). 
(2) BRIEFING ON PROGRESS.—Not later than two years after 
the date of the enactment of this Act, the Secretary of Defense 
shall provide to the Committees on Armed Services of the 
House of Representatives and the Senate a briefing on the 
progress made towards completion of the requirements specified 
in paragraph (1)(A). 
(3) FINAL BRIEFING.—Not later than three years after the 
date of the enactment of this Act, the Secretary of Defense 
shall provide to the Committees on Armed Services of the 
House of Representatives and the Senate a final briefing on 
the completion of such requirements. 
(4) FINAL REPORT.—Not later than three years after the 
date of the enactment of this Act, the Secretary of Defense 
shall submit to the Committees on Armed Services of the House 
of Representatives and the Senate a final report on the comple-
tion of such requirements. Such final report shall be in addition 
to the report, certification, and process submitted under para-
graphs (3), (4), and (5) of subsection (a), respectively. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘medical personnel’’ has the meaning given 
such term in section 115a(e) of title 10, United States Code. 
(2) The term ‘‘Secretary concerned’’ has the meaning given 
that term in section 101(a) of such title. 
(3) The term ‘‘theater strategy’’ means an overarching con-
struct outlining the vision of a combatant commander for the 
integration and synchronization of military activities and oper-
ations with other national power instruments to achieve the 
strategic objectives of the United States. 
SEC. 742. FEASIBILITY STUDY ON ESTABLISHMENT OF DEPARTMENT 
OF DEFENSE INTERNSHIP PROGRAMS RELATING TO 
CIVILIAN BEHAVIORAL HEALTH PROVIDERS. 
(a) FEASIBILITY STUDY.—The Secretary of Defense shall conduct 
a study on the feasibility of establishing paid pre-doctoral and 
post-doctoral internship programs for the purpose of training clinical 
psychologists to work as covered civilian behavioral health pro-
viders. 
(b) ELEMENTS.—The feasibility study under subsection (a) shall 
assess, with respect to the potential internship programs specified 
in such subsection, the following: 
(1) A model under which, as a condition of participating 
in such an internship program, the participant would enter 
into an agreement with the Secretary under which the partici-
pant agrees to work on a full-time basis as a covered civilian 
behavioral health provider for a period of a duration that is 
at least equivalent to the period of participation in such intern-
ship program. 
(2) Methods by which the Secretary may address scenarios 
in which an individual who participates in such an internship 
program does not complete the employment obligation required 
under the agreement referred to in paragraph (1), including
H. R. 7776—287 
by requiring the individual to repay to the Secretary a prorated 
portion of the cost of administering such program (to be deter-
mined by the Secretary) with respect to such individual and 
of any payment received by the individual under such program. 
(3) The methods by which the Secretary may adjust the 
workload and staffing of behavioral health providers in military 
medical treatment facilities to ensure sufficient capacity to 
supervise participants in such internship programs. 
(c) REPORT.—Not later than one year after the date of the 
enactment of this Act, the Secretary shall submit to the Committees 
on Armed Services of the House of Representatives and the Senate 
a report containing the findings of the feasibility study under sub-
section (a). 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘behavioral health’’ includes psychiatry, clin-
ical psychology, social work, counseling, and related fields. 
(2) The term ‘‘behavioral health provider’’ includes the fol-
lowing: 
(A) A licensed professional counselor. 
(B) A licensed mental health counselor. 
(C) A licensed clinical professional counselor. 
(D) A licensed professional clinical counselor of mental 
health. 
(E) A licensed clinical mental health counselor. 
(F) A licensed mental health practitioner. 
(3) The term ‘‘covered civilian behavioral health provider’’ 
means a civilian behavioral health provider whose employment 
by the Secretary of Defense involves the provision of behavioral 
health services at a military medical treatment facility. 
(4) The term ‘‘civilian behavioral health provider’’ means 
a behavioral health provider who is a civilian employee of 
the Department of Defense. 
(5) The term ‘‘military medical treatment facility’’ means 
a facility specified in section 1073d of title 10, United States 
Code. 
SEC. 743. UPDATES TO PRIOR FEASIBILITY STUDIES ON ESTABLISH-
MENT OF NEW COMMAND ON DEFENSE HEALTH. 
(a) UPDATES.—The Secretary of Defense shall update prior 
studies regarding the feasibility of establishing a new defense health 
command under which the Defense Health Agency would be a 
joint component. In conducting such updates, the Secretary shall 
consider for such new command each of the following potential 
structures: 
(1) A unified combatant command. 
(2) A specified combatant command. 
(3) Any other command structure the Secretary determines 
is appropriate for consideration. 
(b) MATTERS.—The updates under subsection (a) shall include, 
with respect to the new command specified in such subsection, 
the following: 
(1) An assessment of the potential organizational structure 
of the new command sufficient for the new command to carry 
out the responsibilities described in subsection (c), including 
a description of the following: 
(A) The potential reporting relationship between the 
commander of the new command, the Assistant Secretary
H. R. 7776—288 
of Defense for Health Affairs, and the Under Secretary 
of Defense for Personnel and Readiness. 
(B) The potential relationship of the new command 
to the military departments, the combatant commands, 
and the Joint Staff. 
(C) The potential responsibilities of the commander 
of the new command and how such responsibilities would 
differ from the responsibilities of the Director of the 
Defense Health Agency. 
(D) The potential chain of command between such com-
mander and the Secretary of Defense. 
(E) The potential roles of the Surgeons General of 
the Army, Navy, and Air Force, with respect to such com-
mander. 
(F) Any organizations that support the Defense Health 
Agency, such as the medical departments and medical logis-
tics organizations of each military department. 
(G) The potential organizational structure of the new 
command, including any subordinate commands. 
(H) The geographic location, or multiple such locations, 
of the headquarters of the new command and any subordi-
nate commands. 
(I) How the Defense Health Agency currently serves 
as a provider of optimally trained and clinically proficient 
health care professionals to support combatant commands. 
(J) How the new command may further serve as a 
provider of optimally trained and clinically proficient health 
care professionals to support combatant commands. 
(2) An assessment of any additional funding necessary 
to establish the new command. 
(3) An assessment of any additional legislative authorities 
necessary to establish the new command, including with respect 
to the executive leadership and direction of the new command. 
(4) An assessment of the required resourcing of the execu-
tive leadership of the new command. 
(5) If the Secretary makes the determination to establish 
the new command, a timeline for such establishment. 
(6) If the Secretary defers such determination pending fur-
ther implementation of other organizational reforms to the 
military health system, a timeline for such future determina-
tion. 
(7) Such other matters relating to the establishment, oper-
ations, or activities of the new command as the Secretary 
may determine appropriate. 
(c) 
RESPONSIBILITIES
DESCRIBED.—The 
responsibilities 
described in this subsection are as follows: 
(1) The conduct of health operations among operational 
units of the Armed Forces. 
(2) The administration of military medical treatment facili-
ties. 
(3) The administration of the TRICARE program. 
(4) Serving as the element of the Armed Forces with the 
primary responsibility for the following: 
(A) Medical treatment, advanced trauma management, 
emergency surgery, and resuscitative care. 
(B) Emergency and specialty surgery, intensive care, 
medical specialty care, and related services.
H. R. 7776—289 
(C) Preventive, acute, restorative, curative, rehabilita-
tive, and convalescent care. 
(5) Collaboration with medical facilities participating in 
the National Disaster Medical System established pursuant 
to section 2812 of the Public Health Service Act (42 U.S.C. 
300hh–11), the Veterans Health Administration, and such other 
Federal 
departments 
and 
agencies 
and 
nongovermental 
organizations as may be determined appropriate by the Sec-
retary, including with respect to the care services specified 
in paragraph (4)(C). 
(6) The conduct of existing research and education activities 
of the Department of Defense in the field of health sciences. 
(7) The conduct of public health and global health activities 
not otherwise assigned to the Armed Forces. 
(8) The administration of the Defense Health Program 
Account under section 1100 of title 10, United States Code. 
(d) INTERIM BRIEFING.—Not later than 180 days after the date 
of the enactment of this Act, the Secretary of Defense shall provide 
to the Committees on Armed Services of the House of Representa-
tives and the Senate a briefing on the method by which the Sec-
retary intends to update prior studies as required pursuant to 
subsection (a). 
(e) FINAL BRIEFING; REPORT.—Not later than one year after 
the date of the enactment of this Act, the Secretary of Defense 
shall— 
(1) provide to the Committees on Armed Services of the 
House of Representatives and the Senate a final briefing on 
the implementation of this section; and 
(2) submit to the Committees on Armed Services of the 
House of Representatives and the Senate a report containing 
the updates to prior studies required pursuant to subsection 
(a), including each of the elements specified in subsection (b). 
SEC. 744. CAPABILITY ASSESSMENT AND ACTION PLAN WITH RESPECT 
TO EFFECTS OF EXPOSURE TO OPEN BURN PITS AND 
OTHER ENVIRONMENTAL HAZARDS. 
(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 capability assessment of potential improve-
ments to activities of the Department of Defense to reduce 
the effects of environmental exposures with respect to members 
of the Armed Forces; and 
(2) develop an action plan to implement such improvements 
assessed under paragraph (1) as the Secretary considers appro-
priate. 
(b) ELEMENTS.—The capability assessment required by sub-
section (a)(1) shall include the following elements: 
(1) With respect to the conduct of periodic health assess-
ments, the following: 
(A) An assessment of the feasibility and advisability 
of adding additional screening questions relating to 
environmental and occupational exposures to current 
health assessments of members of the Armed Forces con-
ducted by the Secretary of Defense, including pre- and 
post-deployment assessments and pre-separation assess-
ments.
H. R. 7776—290 
(B) An assessment of the potential value and feasibility 
of regularly requiring spirometry or other pulmonary func-
tion testing pre- and post-deployment for all members, 
or selected members, of the Armed Forces. 
(2) With respect to the conduct of outreach and education, 
the following: 
(A) An evaluation of clinician training on the health 
effects of airborne hazards and how to document exposure 
information in health records maintained by the Depart-
ment of Defense and the Department of Veterans Affairs. 
(B) An assessment of the adequacy of current actions 
by the Secretary of Defense and the Secretary of Veterans 
Affairs to increase awareness among members of the Armed 
Forces and veterans of the purposes and uses of the Air-
borne Hazards and Open Burn Pit Registry and the effect 
of a potential requirement that individuals meeting 
applicable criteria be automatically enrolled in the registry 
unless such individuals opt out of enrollment. 
(C) An assessment of operational plans for deployment 
with respect to the adequacy of educational activities for, 
and evaluations of, performance of command authorities, 
medical personnel, and members of the Armed Forces on 
deployment on anticipated environmental exposures and 
potential means to minimize and mitigate any adverse 
health effects of such exposures, including through the 
use of monitoring, personal protective equipment, and med-
ical responses. 
(D) An evaluation of potential means to improve the 
education of health care providers of the Department of 
Defense with respect to the diagnosis and treatment of 
health conditions associated with environmental exposures. 
(3) With respect to the monitoring of exposure during 
deployment operations, the following: 
(A) An evaluation of potential means to strengthen 
tactics, techniques, and procedures used in deployment 
operations to document— 
(i) specific locations where members of the Armed 
Forces served; 
(ii) environmental exposures in such locations; and 
(iii) any munitions involved during such service 
in such locations. 
(B) An assessment of potential improvements in the 
acquisition and use of wearable monitoring technology and 
remote sensing capabilities to record environmental expo-
sures by geographic location. 
(C) An analysis of the potential value and feasibility 
of maintaining a repository of frozen soil samples from 
each deployment location to be later tested as needed when 
concerns relating to environmental exposures are identified. 
(4) With respect to the use of the Individual Longitudinal 
Exposure Record, the following: 
(A) An assessment of feasibility and advisability of 
recording individual clinical diagnosis and treatment 
information in the Individual Longitudinal Exposure 
Record to be integrated with exposure data. 
(B) An evaluation of—
H. R. 7776—291 
(i) the progress toward making the Individual 
Longitudinal Exposure Record operationally capable 
and accessible to members of the Armed Forces and 
veterans by 2023; and 
(ii) the integration of data from the Individual 
Longitudinal Exposure Record with the electronic 
health records of the Department of Defense and the 
Department of Veterans Affairs. 
(C) An assessment of the feasibility and advisability 
of making such data accessible to the surviving family 
members of members of the Armed Forces and veterans. 
(5) With respect to the conduct of research, the following: 
(A) An assessment of the potential use of the Airborne 
Hazards and Open Burn Pit Registry for research on moni-
toring and identifying the health consequences of exposure 
to open burn pits. 
(B) An analysis of options for increasing the amount 
and the relevance of additional research into the health 
effects of open burn pits and effective treatments for such 
health effects. 
(C) An evaluation of potential research of biomarker 
monitoring to document environmental exposures during 
deployment or throughout the military career of a member 
of the Armed Forces. 
(D) An analysis of potential organizational strength-
ening with respect to the management of research on 
environmental exposure hazards, including the establish-
ment of a joint program executive office for such manage-
ment. 
(E) An assessment of the findings and recommenda-
tions of the 2020 report by the National Academies of 
Science, Engineering, and Medicine titled ‘‘Respiratory 
Health Effects of Airborne Hazards Exposures in the South-
west Asia Theater of Military Operations’’. 
(6) An evaluation of such other matters as the Secretary 
of Defense determines appropriate to ensure a comprehensive 
review of activities relating to the effects of exposure to open 
burn pits and other environmental hazards. 
(c) SUBMISSION OF PLAN AND BRIEFING.—Not later than 240 
days after the date of the enactment of this Act, the Secretary 
of Defense shall— 
(1) submit to the Committees on Armed Services of the 
House of Representatives and the Senate the action plan 
required by subsection (a)(2); and 
(2) provide to such committees a briefing on the results 
of the capability assessment required by subsection (a)(1). 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘Airborne Hazards and Open Burn Pit Reg-
istry’’ means the registry established under section 201 of the 
Dignified Burial and Other Veterans’ Benefits Improvement 
Act of 2012 (Public Law 112–260; 38 U.S.C. 527 note). 
(2) The term ‘‘environmental exposure’’ means an exposure 
to an open burn pit or other environmental hazard, as deter-
mined by the Secretary of Defense.
H. R. 7776—292 
(3) The term ‘‘open burn pit’’ has the meaning given that 
term in section 201(c) of the Dignified Burial and Other Vet-
erans’ Benefits Improvement Act of 2012 (Public Law 112– 
260; 38 U.S.C. 527 note). 
SEC. 745. KYLE MULLEN NAVY SEAL MEDICAL TRAINING REVIEW. 
(a) REVIEW.—The Inspector General of the Department of 
Defense shall conduct a comprehensive review of the medical 
training for health care professionals furnishing medical care to 
individuals undergoing Navy Sea, Air, and Land (SEAL) training, 
the quality assurance mechanisms in place with respect to such 
care, and the efforts to mitigate health stress of individuals under-
going such training. 
(b) ELEMENTS.—The review under subsection (a) shall include 
the following elements: 
(1) A review of the policies for improved medical care 
of individuals undergoing Navy SEAL training and quality 
assurance with respect to such care. 
(2) A review of sleep deprivation practices implemented 
with respect to Navy SEAL training, including an identification 
of when such practices were initially implemented and how 
frequently such practices are updated. 
(3) An assessment of the policies and rules relating to 
the use of performance enhancing drugs by individuals under-
going Navy SEAL training. 
(4) An assessment of the oversight of health care profes-
sionals (including enlisted and officer medical personnel, 
civilian employees of the Department of Defense, and contrac-
tors of the Department) with respect to the provision by such 
professionals of health care services to individuals undergoing 
Navy SEAL training. 
(5) A review and assessment of deaths, occurring during 
the twenty-year period preceding the date of the review, of 
individuals who were undergoing Navy SEAL training at the 
time of death. 
(6) A review of ongoing efforts and initiatives to ensure 
the safety of individuals undergoing Navy SEAL training and 
to prevent the occurrence of long-term injury, illness, and death 
among such individuals. 
(7) An assessment of the role of nutrition in Navy SEAL 
training. 
(c) INTERIM BRIEFING.—Not later than March 1, 2023, the 
Inspector General of the Department of Defense shall provide to 
the Committees on Armed Services of the House of Representatives 
and the Senate a briefing on how the Inspector General plans 
to conduct the review under subsection (a), including with respect 
to each element specified in subsection (b). 
(d) FINAL REPORT.—Not later than one year after the date 
of the enactment of this Act, the Inspector General of the Depart-
ment of Defense shall submit to the Committees on Armed Services 
of the House of Representatives and the Senate a final report 
on the completion of the review under subsection (a), including 
recommendations of the Inspector General developed as a result 
of such review.
H. R. 7776—293 
SEC. 746. REPORTS ON COMPOSITION OF MEDICAL PERSONNEL OF 
EACH MILITARY DEPARTMENT AND RELATED MATTERS. 
(a) REPORTS.—Not later than 180 days after the date of the 
enactment of this Act, and annually thereafter for three years, 
the Secretary of Defense, in coordination with the Secretaries of 
the military departments, shall submit to the Committees on Armed 
Services of the House of Representatives and the Senate a report 
on the composition of the medical personnel of each military depart-
ment and related matters. 
(b) ELEMENTS.—Each report under subsection (a) shall include 
the following: 
(1) With respect to each military department, the following: 
(A) An identification of the number of medical per-
sonnel of the military department who are officers in a 
grade above O–6. 
(B) An identification of the number of such medical 
personnel who are officers in a grade below O–7. 
(C) A description of any plans of the Secretary to— 
(i) reduce the total number of such medical per-
sonnel; or 
(ii) eliminate any covered position for such medical 
personnel. 
(D) A recommendation by the Secretary for the number 
of covered positions for such medical personnel that should 
be required for purposes of maximizing medical readiness 
(without regard to current statutory limitations, or poten-
tial future statutory limitations, on such number), pre-
sented as a total number for each military department 
and disaggregated by grade. 
(2) An assessment of the grade for the position of the 
Medical Officer of the Marine Corps, including— 
(A) a comparison of the effects of filling such position 
with an officer in the grade of O–6 versus an officer in 
the grade of O–7; 
(B) an assessment of potential issues associated with 
the elimination of such position; and 
(C) a description of any potential effects of such elimi-
nation with respect to medical readiness. 
(3) An assessment of all covered positions for medical per-
sonnel of the military departments, including the following: 
(A) The total number of authorizations for such covered 
positions, disaggregated by— 
(i) whether the authorization is for a position in 
a reserve component; and 
(ii) whether the position so authorized is filled 
or vacant. 
(B) A description of any medical- or health-related 
specialty requirements for such covered positions. 
(C) For each such covered position, an identification 
of the title and geographic location of, and a summary 
of the responsibility description for, the position. 
(D) For each such covered position, an identification 
of the span of control of the position, including with respect 
to the highest grade at which each such position has been 
filled. 
(E) An identification of any downgrading, upgrading, 
or other changes to such covered positions occurring during
H. R. 7776—294 
the 10-year period preceding the date of the report, and 
an assessment of whether any such changes have resulted 
in the transfer of responsibilities previously assigned to 
such a covered position to— 
(i) a position in the Senior Executive Service or 
another executive personnel position; or 
(ii) a position other than a covered position. 
(F) A description of any officers in a grade above O– 
6 assigned to the Defense Health Agency, the Office of 
the Assistant Secretary of Defense for Health Affairs, the 
Joint Staff, or any other position within the military health 
system. 
(G) A description of the process by which the positions 
specified in subparagraph (F) are validated against military 
requirements or similar billet justification processes. 
(H) A side-by-side comparison demonstrating, across 
the military departments, the span of control and the 
responsibilities of covered positions for medical personnel 
of each military department. 
(c) DISAGGREGATION OF CERTAIN DATA.—The data specified in 
subparagraphs (A) and (B) of subsection (b)(1) shall be presented 
as a total number and disaggregated by each medical component 
of the respective military department. 
(d) DEFINITIONS.—In this section: 
(1) The term ‘‘covered position’’ means a position for an 
officer in a grade above O–6. 
(2) The term ‘‘officer’’ has the meanings given that term 
in section 101(b) of title 10, United States Code. 
(3) The term ‘‘medical component’’ means— 
(A) in the case of the Army, the Medical Corps, Dental 
Corps, Nurse Corps, Medical Service Corps, Veterinary 
Corps, and Army Medical Specialist Corps; 
(B) in the case of the Air Force, members designated 
as medical officers, dental officers, Air Force nurses, med-
ical service officers, and biomedical science officers; and 
(C) in the case of the Navy, the Medical Corps, Dental 
Corps, Nurse Corps, and Medical Service Corps. 
(4) The term ‘‘medical personnel’’ has the meaning given 
such term in section 115a(e) of title 10, United States Code. 
(5) The term ‘‘military department’’ has the meaning given 
that term in section 101(a) of such title. 
SEC. 747. REPORT ON EFFECTS OF LOW RECRUITMENT AND RETEN-
TION ON OPERATIONAL TEMPO AND PHYSICAL AND 
MENTAL HEALTH OF MEMBERS OF THE ARMED FORCES. 
(a) REPORT.—Not later than one year after the date of the 
enactment of this Act, the Secretary of Defense, in coordination 
with the Secretaries of the military departments, shall submit to 
the Committees on Armed Services of the House of Representatives 
and the Senate a report on the effects of low recruitment and 
retention on the Armed Forces. 
(b) MATTERS.—The report under subsection (a) shall include 
an assessment of the following: 
(1) The effect of low recruitment on the tempo for oper-
ational units during the previous five years, including with 
respect to deployed units and units in pre-deployment training.
H. R. 7776—295 
(2) Whether the rate of operational tempo during the per-
vious five years has affected the retention of members of the 
Armed Forces, including with respect to deployed units and 
units in pre-deployment training. 
(3) How the rate of operational tempo during the previous 
five years has affected the number of mental health visits 
of members of the Armed Forces serving in such units. 
(4) How the rate of operational tempo during the pervious 
five years has affected the number of suicides occurring within 
such units. 
(5) Whether the rate of operational tempo during the per-
vious five years has affected the number of musculoskeletal 
and related injuries incurred by members of the Armed Forces 
serving in such units. 
(6) The type or types of military occupational specialties 
most affected by low recruitment. 
(7) Lessons learned in the process of gathering data for 
the report under this section. 
(8) Any policy or legislative recommendations to mitigate 
the effect of low recruitment on the operational tempo of the 
Armed Forces. 
SEC. 748. GUIDANCE FOR ADDRESSING HEALTHY RELATIONSHIPS AND 
INTIMATE PARTNER VIOLENCE THROUGH TRICARE PRO-
GRAM. 
(a) GUIDANCE.—The Secretary of Defense shall disseminate 
guidance on the implementation through the TRICARE program 
of— 
(1) education on healthy relationships and intimate partner 
violence; and 
(2) protocols for— 
(A) the routine assessment of intimate partner violence 
and sexual assault; and 
(B) the promotion of, and strategies for, trauma- 
informed care plans. 
(b) BRIEFING.—Not later than one year after the date of the 
enactment of this Act, the Secretary of Defense shall provide to 
the Committees on Armed Services of the House of Representatives 
and the Senate a briefing on the implementation of this section. 
SEC. 749. BRIEFING ON SUICIDE PREVENTION REFORMS FOR MEM-
BERS OF THE ARMED FORCES. 
(a) IN GENERAL.—Not later than March 1, 2023, the Secretary 
of Defense shall provide to the Committees on Armed Services 
of the Senate and the House of Representatives a briefing on 
the following: 
(1) The feasibility and advisability of implementing reforms 
related to suicide prevention among members of the Armed 
Forces as follows: 
(A) Eliminating mental health history as a disqualifier 
for service in the Armed Forces, including by eliminating 
restrictions related to mental health history that are spe-
cific to military occupational specialties. 
(B) Requiring comprehensive and in-person annual 
mental health assessments of members of the Armed 
Forces. 
(C) Requiring behavioral health providers under the 
TRICARE program, including providers contracted through
H. R. 7776—296 
such program, to undergo evidence-based and suicide-spe-
cific training. 
(D) Requiring leaders at all levels of the Armed Forces 
to be trained on the following: 
(i) Total wellness. 
(ii) Suicide warning signs and risk factors. 
(iii) Evidence-based, suicide-specific interventions. 
(iv) Effectively communicating with medical and 
behavioral health providers. 
(v) 
Communicating 
with 
family 
members, 
including extended family members who are not co- 
located with a member of the Armed Forces, on support 
and access to resources for members of the Armed 
Forces and the dependents thereof. 
(E) Requiring mandatory referral to Warriors in 
Transition programs, or other transitional programs, for 
members of the Armed Forces who are eligible for such 
programs. 
(2) Recommendations for additional legislative actions nec-
essary to further enhance or expand suicide prevention efforts 
of the Department of Defense. 
(b) DEFINITIONS.—In this section— 
(1) The term ‘‘TRICARE program’’ has the meaning given 
that term in section 1072 of title 10, United States Code. 
(2) The term ‘‘Warriors in Transition program’’ has the 
meaning given that term in section 738(e) of the National 
Defense Authorization Act for Fiscal Year 2013 (Public Law 
112–239; 10 U.S.C. 1071 note). 
TITLE VIII—ACQUISITION POLICY, AC-
QUISITION MANAGEMENT, AND RE-
LATED MATTERS 
TITLE VIII—ACQUISITION POLICY, ACQUISITION MANAGEMENT, AND 
RELATED MATTERS 
Subtitle A—Acquisition Policy and Management 
Sec. 801. Writing award to encourage curiosity and persistence in overcoming ob-
stacles in acquisition. 
Sec. 802. Task and delivery order contracting for architectural and engineering 
services. 
Sec. 803. Data requirements for commercial products for major weapon systems. 
Sec. 804. Revision of authority for procedures to allow rapid acquisition and deploy-
ment of capabilities needed under specified high-priority circumstances. 
Sec. 805. Treatment of certain clauses implementing Executive orders. 
Sec. 806. Life cycle management and product support. 
Sec. 807. Amendments to contractor employee protections from reprisal for disclo-
sure of certain information. 
Sec. 808. Use of fixed-price type contracts for certain major defense acquisition pro-
grams. 
Sec. 809. Acquisition reporting system. 
Subtitle B—Amendments to General Contracting Authorities, Procedures, and 
Limitations 
Sec. 811. Inclusion in budget justification materials of enhanced reporting on pro-
posed cancellations and modifications to multiyear contracts. 
Sec. 812. Comptroller General assessment of acquisition programs and related ef-
forts. 
Sec. 813. Extension of Defense Modernization Account authority. 
Sec. 814. Clarification to fixed-price incentive contract references.
H. R. 7776—297 
Sec. 815. Modification of reporting requirement in connection with requests for 
multiyear procurement authority for large defense acquisitions. 
Sec. 816. Modification of provision relating to determination of certain activities 
with unusually hazardous risks. 
Sec. 817. Modification to prohibition on operation or procurement of foreign-made 
unmanned aircraft systems. 
Sec. 818. Extension of pilot program to accelerate contracting and pricing proc-
esses. 
Sec. 819. Extension of pilot program for distribution support and services for weap-
ons systems contractors. 
Sec. 820. Extension and modification of Never Contract with the Enemy. 
Sec. 821. Repeal of requirement for Inspector General of the Department of De-
fense to conduct certain reviews. 
Sec. 822. Modification of contracts to provide extraordinary relief due to inflation 
impacts. 
Subtitle C—Provisions Relating to Acquisition Workforce 
Sec. 831. Key experiences and enhanced pay authority for acquisition workforce ex-
cellence. 
Sec. 832. Defense Acquisition University reforms. 
Sec. 833. Modifications to Defense Civilian Training Corps. 
Sec. 834. Acquisition workforce incentives relating to training on, and agreements 
with, certain start-up businesses. 
Sec. 835. Curricula on software acquisitions and cybersecurity software or hard-
ware acquisitions for covered individuals. 
Sec. 836. Department of Defense national imperative for industrial skills program. 
Subtitle D—Provisions Relating to Software and Technology 
Sec. 841. Guidelines and resources on the acquisition or licensing of intellectual 
property. 
Sec. 842. Modification of authority of the Department of Defense to carry out cer-
tain prototype projects. 
Sec. 843. Other transaction authority clarification. 
Sec. 844. Prizes for advanced technology achievements. 
Sec. 845. Congressional notification for pilot program to accelerate the procurement 
and fielding of innovative technologies. 
Sec. 846. Report on software delivery times. 
Subtitle E—Industrial Base Matters 
Sec. 851. Modification to the national technology and industrial base. 
Sec. 852. Modification to miscellaneous limitations on the procurement of goods 
other than United States goods. 
Sec. 853. Requirements for the procurement of certain components for certain naval 
vessels and auxiliary ships. 
Sec. 854. Modifications to the procurement technical assistance program. 
Sec. 855. Codification of prohibition on certain procurements from the Xinjiang 
Uyghur Autonomous Region. 
Sec. 856. Codification of the Department of Defense Mentor–Protege Program. 
Sec. 857. Procurement requirements relating to rare earth elements and strategic 
and critical materials. 
Sec. 858. Analyses of certain activities for action to address sourcing and industrial 
capacity. 
Sec. 859. Demonstration exercise of enhanced planning for industrial mobilization 
and supply chain management. 
Sec. 860. Risk management for Department of Defense pharmaceutical supply 
chains. 
Sec. 861. Strategy for increasing competitive opportunities for certain critical tech-
nologies. 
Sec. 862. Key advanced system development industry days. 
Subtitle F—Small Business Matters 
Sec. 871. Codification of Small Business Administration scorecard. 
Sec. 872. Modifications to the SBIR and STTR programs. 
Sec. 873. Access to data on bundled or consolidated contracts. 
Sec. 874. Small business integration working group. 
Sec. 875. Demonstration of commercial due diligence for small business programs. 
Sec. 876. Development and assessment of mission effectiveness metrics. 
Subtitle G—Other Matters 
Sec. 881. Technical correction to effective date of the transfer of certain title 10 ac-
quisition provisions.
H. R. 7776—298 
Sec. 882. Security clearance bridge pilot program. 
Sec. 883. Existing agreement limits for Operation Warp Speed. 
Sec. 884. Incorporation of controlled unclassified information guidance into pro-
gram classification guides and program protection plans. 
Subtitle A—Acquisition Policy and 
Management 
SEC. 801. WRITING AWARD TO ENCOURAGE CURIOSITY AND PERSIST-
ENCE IN OVERCOMING OBSTACLES IN ACQUISITION. 
(a) IN GENERAL.—Chapter 87 of title 10, United States Code, 
is amended by inserting after section 1742 the following new section: 
‘‘§ 1743. Awards to recognize members of the acquisition 
workforce 
‘‘(a) ESTABLISHMENT.—The President of the Defense Acquisition 
University shall establish two programs to provide awards to recog-
nize members of the acquisition workforce as follows: 
‘‘(1) An award of not more than $5,000 to such members 
who use an iterative writing process to document a first-hand 
account of using independent judgment to overcome an obstacle 
the member faced while working within the defense acquisition 
system (as defined in section 3001 of this title). 
‘‘(2) An award of not more than $5,000 to such members 
who make the best use of the flexibilities and authorities 
granted by the Federal Acquisition Regulation and Department 
of Defense Instruction 5000.02 (Operation of the Defense 
Acquisition System). 
‘‘(b) NUMBER OF AWARDS.— 
‘‘(1) IN GENERAL.—The President of the Defense Acquisition 
University may make not more than five awards under sub-
section (a)(1) and one award under subsection (a)(2) each year. 
‘‘(2) LIMITATION.—A member of the acquisition workforce 
may receive one award each year. 
‘‘(c) REQUIREMENTS FOR WRITING AWARD.— 
‘‘(1) SUBMISSION REQUIRED.—A member of the acquisition 
workforce desiring an award under subsection (a)(1) shall 
submit to the President of the Defense Acquisition University 
the first-hand account described in such subsection. Such first- 
hand account shall demonstrate— 
‘‘(A) an original and engaging idea documenting the 
use of independent judgment to overcome an obstacle the 
recipient faced while working within the defense acquisition 
system; and 
‘‘(B) the use of an iterative writing process, including 
evidence of— 
‘‘(i) critical thinking; 
‘‘(ii) incorporation of feedback from diverse perspec-
tives; and 
‘‘(iii) editing to achieve plain writing (as defined 
in section 3 of the Plain Writing Act of 2010 (5 U.S.C. 
301 note)). 
‘‘(2) WEBSITE.—The President of the Defense Acquisition 
University shall establish and maintain a website to serve 
as a repository for submissions made under paragraph (1). 
Such website shall allow for public comments and discussion.
H. R. 7776—299 
‘‘(d) REQUIREMENTS
FOR FLEXIBILITY AWARD.—A member of 
the acquisition workforce desiring an award under subsection (a)(2) 
shall submit to the President of the Defense Acquisition University 
documentation that such member uses approaches to program 
management that emphasize innovation and local adaptation, 
including the use of— 
‘‘(1) simplified acquisition procedures; 
‘‘(2) inherent flexibilities within the Federal Acquisition 
Regulation; 
‘‘(3) commercial contracting approaches; 
‘‘(4) public-private partnership agreements and practices; 
‘‘(5) cost-sharing arrangements; 
‘‘(6) innovative contractor incentive practices; or 
‘‘(7) other innovative implementations of acquisition flexi-
bilities. 
‘‘(e) FUNDING.—The Secretary of Defense shall use funds from 
the Defense Acquisition Workforce Development Account to carry 
out this section.’’. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of such chapter is amended by inserting after section 1742 
the following new item: 
‘‘1743. Awards to recognize members of the acquisition workforce.’’. 
(c) CONFORMING AMENDMENT.—Section 834 of the National 
Defense Authorization Act for Fiscal Year 2017 (Public Law 114– 
328; 130 Stat. 2285; 10 U.S.C. 1701a note) is repealed. 
SEC. 802. TASK AND DELIVERY ORDER CONTRACTING FOR ARCHITEC-
TURAL AND ENGINEERING SERVICES. 
Section 3406 of title 10, United States Code, is amended by 
adding at the end the following new subsection: 
‘‘(h) ARCHITECTURAL AND ENGINEERING SERVICES.— 
‘‘(1) QUALIFICATION-BASED SELECTIONS REQUIRED.—Task or 
delivery orders for architectural and engineering services issued 
under section 3403 or 3405 of this title shall be qualification- 
based selections executed in accordance with chapter 11 of 
title 40. 
‘‘(2) MULTIPLE AWARD CONTRACTS.—When issuing a task 
or delivery order for architectural and engineering services 
under a multiple award contract, the head of an agency may 
not routinely request additional information relating to quali-
fications from the contractor for such multiple award contract.’’. 
SEC. 803. DATA REQUIREMENTS FOR COMMERCIAL PRODUCTS FOR 
MAJOR WEAPON SYSTEMS. 
(a) AMENDMENTS RELATING TO SUBSYSTEMS OF MAJOR WEAPONS 
SYSTEMS.—Section 3455(b) of title 10, United States Code is 
amended— 
(1) by redesignating paragraphs (1) and (2) as subpara-
graphs (A) and (B); 
(2) by inserting ‘‘(1)’’ before ‘‘A subsystem of a major weapon 
system’’; and 
(3) by adding at the end the following new paragraph: 
‘‘(2)(A) For a subsystem proposed as commercial (as defined 
in section 103(1) of title 41) and that has not been previously 
determined commercial in accordance with section 3703(d) of this 
title, the offeror shall—
H. R. 7776—300 
‘‘(i) identify the comparable commercial product the offeror 
sells to the general public or nongovernmental entities that 
serves as the basis for the ‘of a type’ assertion; 
‘‘(ii) submit to the contracting officer a comparison nec-
essary to serve as the basis of the ‘of a type’ assertion of 
the physical characteristics and functionality between the sub-
system and the comparable commercial product identified under 
clause (i); and 
‘‘(iii) provide to the contracting officer the National Stock 
Number for both the comparable commercial product identified 
under clause (i), if one is assigned, and the subsystem, if 
one is assigned. 
‘‘(B) If the offeror does not sell a comparable commercial product 
to the general public or nongovernmental entities for purposes 
other than governmental purposes that can serve as the basis 
for an ‘of a type’ assertion with respect to the subsystem— 
‘‘(i) the offeror shall— 
‘‘(I) notify the contracting officer in writing that it 
does not so sell such a comparable commercial product; 
and 
‘‘(II) provide to the contracting officer a comparison 
necessary to serve as the basis of the ‘of a type’ assertion 
of the physical characteristics and functionality between 
the subsystem and the most comparable commercial 
product in the commercial marketplace, to the extent 
reasonably known by the offeror; and 
‘‘(ii) subparagraph (A) shall not apply with respect to the 
offeror for such subsystem.’’. 
(b) AMENDMENT RELATING TO COMPONENTS AND SPARE PARTS.— 
Section 3455(c)(2) of such title is amended to read as follows: 
‘‘(2)(A) For a component or spare part proposed as commercial 
(as defined in section 103(1) of title 41) and that has not previously 
been determined commercial in accordance with section 3703(d) 
of this title, the offeror shall— 
‘‘(i) identify the comparable commercial product the offeror 
sells to the general public or nongovernmental entities that 
serves as the basis for the ‘of a type’ assertion; 
‘‘(ii) submit to the contracting officer a comparison nec-
essary to serve as the basis of the ‘of a type’ assertion of 
the physical characteristics and functionality between the 
component or spare part and the comparable commercial 
product identified under clause (i); and 
‘‘(iii) provide to the contracting officer the National Stock 
Number for both the comparable commercial product identified 
under clause (i), if one is assigned, and the component or 
spare part, if one is assigned. 
‘‘(B) If the offeror does not sell a comparable commercial product 
to the general public or nongovernmental entities for purposes 
other than governmental purposes that can serve as the basis 
for an ‘of a type’ assertion with respect to the component or spare 
part— 
‘‘(i) the offeror shall— 
‘‘(I) notify the contracting officer in writing that it 
does not so sell such a comparable commercial product; 
and 
‘‘(II) provide to the contracting officer a comparison 
necessary to serve as the basis of the ‘of a type’ assertion
H. R. 7776—301 
of the physical characteristics and functionality between 
the component or spare part and the most comparable 
commercial product in the commercial marketplace, to the 
extent reasonably known by the offeror; and 
‘‘(ii) subparagraph (A) shall not apply with respect to the 
offeror for such component or spare part.’’. 
(c) AMENDMENTS RELATING TO INFORMATION SUBMITTED.—Sec-
tion 3455(d) of such title is amended— 
(1) in the subsection heading, by inserting after ‘‘SUB-
MITTED’’ the following: ‘‘FOR PROCUREMENTS THAT ARE NOT 
COVERED BY THE EXCEPTIONS IN SECTION 3703(A)(1) OF THIS 
TITLE’’; 
(2) in paragraph (1)— 
(A) in the matter preceding subparagraph (A), by 
striking ‘‘the contracting officer shall require the offeror 
to submit—’’ and inserting ‘‘the offeror shall, in accordance 
with paragraph (4), submit to the contracting officer or 
provide the contracting officer access to—’’; 
(B) in subparagraph (A)— 
(i) by inserting ‘‘a representative sample, as deter-
mined by the contracting officer, of the’’ before ‘‘prices 
paid’’; and 
(ii) by inserting ‘‘, and the terms and conditions 
of such sales’’ after ‘‘Government and commercial cus-
tomers’’; 
(C) in subparagraph (B), by striking ‘‘information on— 
’’ and all that follows and inserting the following: ‘‘a rep-
resentative sample, as determined by the contracting 
officer, of the prices paid for the same or similar commercial 
products sold under different terms and conditions, and 
the terms and conditions of such sales; and’’; and 
(D) in subparagraph (C)— 
(i) by inserting ‘‘only’’ before ‘‘if the contracting 
officer’’; and 
(ii) by inserting after ‘‘reasonableness of price’’ the 
following: ‘‘because either the comparable commercial 
products provided by the offeror are not a valid basis 
for a price analysis or the contracting officer deter-
mines the proposed price is not reasonable after evalu-
ating sales data, and the contracting officer receives 
the approval described in paragraph (5)’’; and 
(3) by adding at the end the following new paragraphs: 
‘‘(4)(A) An offeror may redact data information submitted or 
made available under subparagraph (A) or (B) of paragraph (1) 
with respect to sales of an item acquired under this section only 
to the extent necessary to remove information individually identi-
fying government customers, commercial customers purchasing such 
item for governmental purposes, and commercial customers pur-
chasing such item for commercial, mixed, or unknown purposes. 
‘‘(B) Before an offeror may exercise the authority under 
subparagraph (A) with respect to a customer, the offeror shall 
certify in writing to the contracting officer whether the customer 
is a government customer, a commercial customer purchasing the 
item for governmental purpose, or a commercial customer pur-
chasing the item for a commercial, mixed, or unknown purpose.
H. R. 7776—302 
‘‘(5) A contracting officer may not require an offeror to submit 
or make available information under paragraph (1)(C) without 
approval from a level above the contracting officer. 
‘‘(6) Nothing in this subsection shall relieve an offeror of other 
obligations under any other law or regulation to disclose and sup-
port the actual rationale of the offeror for the price proposed by 
the offeror to the Government for any good or service.’’. 
(d) APPLICABILITY.—Section 3455 of such title is amended by 
adding at the end the following new subsection: 
‘‘(g) APPLICABILITY.— 
‘‘(1) IN GENERAL.—Subsections (b) and (c) shall apply only 
with respect to subsystems described in subsection (b) and 
components or spare parts described in subsection (c), respec-
tively, that the Department of Defense acquires through— 
‘‘(A) a prime contract; 
‘‘(B) a modification to a prime contract; or 
‘‘(C) a subcontract described in paragraph (2). 
‘‘(2) SUBCONTRACT DESCRIBED.—A subcontract described in 
this paragraph is a subcontract through which the Department 
of Defense acquires a subsystem or component or spare part 
proposed as commercial (as defined in section 103(1) of title 
41) under this section and that has not previously been deter-
mined commercial in accordance with section 3703(d).’’. 
SEC. 804. REVISION OF AUTHORITY FOR PROCEDURES TO ALLOW 
RAPID ACQUISITION AND DEPLOYMENT OF CAPABILITIES 
NEEDED 
UNDER 
SPECIFIED 
HIGH-PRIORITY 
CIR-
CUMSTANCES. 
(a) REVISION
AND
CODIFICATION
OF
RAPID
ACQUISITION 
AUTHORITY.—Chapter 253 of part V of title 10, United States Code, 
is amended to read as follows: 
‘‘CHAPTER 253—RAPID ACQUISITION PROCEDURES 
‘‘Sec. 
‘‘3601. Procedures for urgent acquisition and deployment of capabilities needed in 
response to urgent operational needs or vital national security interest. 
‘‘§ 3601. Procedures for urgent acquisition and deployment 
of capabilities needed in response to urgent oper-
ational needs or vital national security interest 
‘‘(a) PROCEDURES.— 
‘‘(1) IN GENERAL.—The Secretary of Defense shall prescribe 
procedures for the urgent acquisition and deployment of 
capabilities needed in response to urgent operational needs. 
The capabilities for which such procedures may be used in 
response to an urgent operational need are those— 
‘‘(A) that, subject to such exceptions as the Secretary 
considers appropriate for purposes of this section— 
‘‘(i) can be fielded within a period of two to 24 
months; 
‘‘(ii) do not require substantial development effort; 
‘‘(iii) are based on technologies that are proven 
and available; and 
‘‘(iv) can appropriately be acquired under fixed- 
price contracts; or 
‘‘(B) that can be developed or procured under a section 
804 rapid acquisition pathway.
H. R. 7776—303 
‘‘(2) DEFINITION.—In this section, the term ‘section 804 
rapid acquisition pathway’ means the rapid fielding acquisition 
pathway or the rapid prototyping acquisition pathway author-
ized under section 804 of the National Defense Authorization 
Act for Fiscal Year 2016 (Public Law 114–92; 10 U.S.C. 3201 
prec.). 
‘‘(b) MATTERS
TO BE INCLUDED.—The procedures prescribed 
under subsection (a) shall include the following: 
‘‘(1) A process for streamlined communications between 
the Chairman of the Joint Chiefs of Staff, the acquisition 
community, and the research and development community, 
including— 
‘‘(A) a process for the commanders of the combatant 
commands and the Chairman of the Joint Chiefs of Staff 
to communicate their needs to the acquisition community 
and the research and development community; and 
‘‘(B) a process for the acquisition community and the 
research and development community to propose capabili-
ties that meet the needs communicated by the combatant 
commands and the Chairman of the Joint Chiefs of Staff. 
‘‘(2) Procedures for demonstrating, rapidly acquiring, and 
deploying a capability proposed pursuant to paragraph (1)(B), 
including— 
‘‘(A) a process for demonstrating and evaluating for 
current operational purposes the performance of the capa-
bility; 
‘‘(B) a process for developing an acquisition and funding 
strategy for the deployment of the capability; and 
‘‘(C) a process for making deployment and utilization 
determinations based on information obtained pursuant 
to subparagraphs (A) and (B). 
‘‘(3) A process to determine the disposition of a capability, 
including termination (demilitarization or disposal), continued 
sustainment, or transition to a program of record. 
‘‘(4) Specific procedures in accordance with the guidance 
developed under section 804(a) of the National Defense 
Authorization Act for Fiscal Year 2016 (Public Law 114–92; 
10 U.S.C. 3201 prec.). 
‘‘(c) RESPONSE TO COMBAT EMERGENCIES AND CERTAIN URGENT 
OPERATIONAL NEEDS.— 
‘‘(1) DETERMINATION OF NEED FOR URGENT ACQUISITION AND 
DEPLOYMENT.—(A) In the case of any capability that, as deter-
mined in writing by the Secretary of Defense, is urgently needed 
to eliminate a documented deficiency that has resulted in com-
bat casualties, or is likely to result in combat casualties, the 
Secretary may use the procedures developed under this section 
in order to accomplish the urgent acquisition and deployment 
of the needed capability. 
‘‘(B) In the case of any capability that, as determined 
in writing by the Secretary of Defense, is urgently needed 
to eliminate a documented deficiency that impacts an ongoing 
or anticipated contingency operation and that, if left unfulfilled, 
could potentially result in loss of life or critical mission failure, 
the Secretary may use the procedures developed under this 
section in order to accomplish the urgent acquisition and 
deployment of the needed capability.
H. R. 7776—304 
‘‘(C)(i) In the case of any cyber capability that, as deter-
mined in writing by the Secretary of Defense, is urgently needed 
to eliminate a deficiency that as the result of a cyber attack 
has resulted in critical mission failure, the loss of life, property 
destruction, or economic effects, or if left unfilled is likely 
to result in critical mission failure, the loss of life, property 
destruction, or economic effects, the Secretary may use the 
procedures developed under this section in order to accomplish 
the urgent acquisition and deployment of the needed offensive 
or defensive cyber capability. 
‘‘(ii) In this subparagraph, the term ‘cyber attack’ means 
a deliberate action to alter, disrupt, deceive, degrade, or destroy 
computer systems or networks or the information or programs 
resident in or transiting these systems or networks. 
‘‘(2) DESIGNATION OF SENIOR OFFICIAL RESPONSIBLE.—(A)(i) 
Except as provided under clause (ii), whenever the Secretary 
of Defense makes a determination under subparagraph (A), 
(B), or (C) of paragraph (1) that a capability is urgently needed 
to eliminate a deficiency described in that subparagraph, the 
Secretary shall designate a senior official of the Department 
of Defense to ensure that the needed capability is acquired 
and deployed as quickly as possible, with a goal of awarding 
a contract for the acquisition of the capability within 15 days. 
‘‘(ii) Clause (i) does not apply to an acquisition initiated 
in the case of a determination by the Secretary of Defense 
that funds are necessary to immediately initiate a project under 
a section 804 rapid acquisition pathway if the designated official 
for acquisitions using such pathway is a service acquisition 
executive. 
‘‘(B) Upon designation of a senior official under subpara-
graph (A) with respect to a needed capability, the Secretary 
shall authorize that senior official to waive any provision of 
law or regulation described in subsection (d) that such senior 
official determines in writing would unnecessarily impede the 
urgent acquisition and deployment of such capability. In a 
case in which such capability cannot be acquired without an 
extensive delay, the senior official shall require that an interim 
solution be implemented and deployed using the procedures 
developed under this section to minimize adverse consequences 
resulting from the urgent need. 
‘‘(3) USE OF FUNDS.—(A) Subject to subparagraph (C), in 
any fiscal year in which the Secretary of Defense makes a 
determination described in subparagraph (A), (B), or (C) of 
paragraph (1) with respect to a capability, or upon the Secretary 
making a determination that funds are necessary to imme-
diately initiate a project under a section 804 rapid acquisition 
pathway based on a compelling national security need, the 
Secretary may use any funds available to the Department 
of Defense to urgently acquire and deploy such capability or 
immediately initiate such project, respectively, if the determina-
tion includes a written finding that the use of such funds 
is necessary to address in a timely manner the deficiency 
documented or identified under such subparagraph (A), (B), 
or (C) or the compelling national security need identified for 
purposes of such section 804 pathway, respectively. 
‘‘(B) The authority provided by this section may only be 
used to acquire capability—