I
104TH CONGRESS
2D SESSION
H. R. 3117
To amend title 38, United States Code, to enable the Secretary of Veterans
Affairs to improve service-delivery of health care to veterans, and for
other purposes.
IN THE HOUSE OF REPRESENTATIVES
MARCH 20, 1996
Mr. MONTGOMERY (for himself, Mr. STUMP, Mr. EDWARDS, and Mr. HUTCH-
INSON) introduced the following bill; which was referred to the Committee
on Veterans’ Affairs, and in addition to the Committee on Commerce,
and Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall within
the jurisdiction of the committee concerned
A BILL
To amend title 38, United States Code, to enable the Sec-
retary of Veterans Affairs to improve service-delivery of
health care to veterans, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. AUTHORITY TO ESTABLISH AND OPERATE MAN-
AGED HEALTH-CARE PLANS.
(a) IN GENERAL.—Chapter 17 of title 38, United
States Code, is amended by inserting after section 1704
the following new section:
‘‘(d) The Secretary, notwithstanding sections 1710(f)
and 1712(f) of this title, may establish such cost-sharing
requirements for veterans enrolled in a plan under this
section as the Secretary considers appropriate to cover
costs of providing benefits under the plan that are not
paid by the Medicare program under title XVIII of the
Social Security Act. Such cost-sharing requirements may
include an enrollment premium, copayment charges, and
deductibles.
‘‘(e) Payments received under subsection (d) and
under section 1729A of this title with respect to care or
services provided to a veteran enrolled in a health-care
plan under this section shall be credited to the applicable
Department medical appropriation and shall be used to
pay for the costs of furnishing care and services under
subsection (a).
‘‘(f) The Secretary may not in any fiscal year operate
a plan under subsection (a) at a Department facility un-
less the director of that facility has certified to the Under
Secretary for Health that sufficient medical care funds
have been allotted to that facility for that fiscal year to
enable the director to provide needed hospital care and
medical services authorized under this chapter to veterans
described in section 1710(a)(1) of this title in the number
that, in the judgment of the director, are likely to require
that care and services from that facility during that fiscal
year.’’.
(b) CLERICAL AMENDMENT.—The table of sections
at the beginning of such chapter is amended by inserting
after the item relating to section 1704 the following new
item:
‘‘1705. Establishment of managed health-care plans.’’.
SEC. 2. REQUIREMENT FOR PAYMENT FOR CERTAIN SERV-
ICES PROVIDED BY DEPARTMENT FACILI-
TIES.
(a) IN GENERAL.—Chapter 17 of title 38, United
States Code, is amended by inserting after section 1729
the following new section:
‘‘§ 1729A. Medicare payment for certain veterans
‘‘(a) Notwithstanding any other provision of law, the
Secretary of Health and Human Services shall make pay-
ments during a year to a Department managed health care
plan on behalf of veterans (other than veterans described
in section 1710(a)(1) of this title) who are Medicare-eligi-
ble individuals and are enrolled in such plan during the
year under similar terms as the Secretary makes payments
under title XVIII of the Social Security Act to other eligi-
ble managed care health plans.
‘‘(b)(1) For purposes of subsection (a), a managed
health care plan organized and operated under section
1705 of this title—
‘‘(A) which provides care to Medicare-eligible
veterans (other than veterans described in section
1710(a)(1) of this title); and
‘‘(B) for which there is a certification in effect
under paragraph (2),
shall be deemed to be a certified Medicare Choice organi-
zation under section 1857 of the Social Security Act.
‘‘(2) The Secretary shall certify to the Secretary of
Health and Human Services each year a list of all Depart-
ment managed health care plans established under section
1705 of this title which the Secretary finds conform to
the standards prescribed under such section.
‘‘(c) For purposes of this section—
‘‘(1) the term ‘Medicare program’ means the
health insurance program under title XVIII of the
Social Security Act;
‘‘(2) the term ‘Medicare-eligible veteran’ means
a veteran who is entitled to benefits under the Medi-
care program; and
‘‘(3) the term ‘Medicare Choice organization’
means a managed health care organization under
part C of title XVIII of the Social Security Act.’’.
(b) CLERICAL AMENDMENT.—The table of sections
at the beginning of such chapter is amended by inserting
after the item relating to section 1729 the following new
item:
‘‘1729A. Medicare payment for certain veterans.’’.
(c) EFFECTIVE DATE.—Section 1729A of title 38,
United States Code, as added by subsection (b), shall
apply with respect to care provided after the date of the
enactment of this Act.
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