equal or reciprocal reduction of the operating and mainte-
nance budget of the providing facility.’’.
SEC. 4. MEDICAL AND DENTAL CARE FOR DEPENDENTS.
Section 1076(a) of title 10, United States Code, is
amended by striking out paragraph (1) and inserting in
lieu thereof the following new paragraph:
‘‘(1) A dependent described in paragraph (2) is enti-
tled, upon request, to the medical and dental care pre-
scribed by section 1077 of this title in facilities of the uni-
formed services. If the dependent is also entitled to hos-
pital insurance benefits under title XVIII of the Social Se-
curity Act (42 U.S.C. 1395 et seq.), then the facility of
the uniformed service will still provide authorized care, but
will recover the cost for providing the care from medicare
subvention funding by direct billing of the appropriate
program administering the health insurance program de-
fined under that Act, and appropriate for the particular
recipient of the care. Medicare subvention funding pay-
ments to the providing military treatment facility will be
at fixed rates approved by the President; and will be used,
deposited, and credited as specified in section 1074 of this
title.’’
SEC. 5. CONFORMING AMENDMENT REGARDING MEDICARE
SUBVENTION FUNDING.
Section 1086(d) of title 10, United States Code, is
amended by adding at the end the following new para-
graph:
‘‘(4) A covered beneficiary who is entitled to hospital
insurance benefits under title XVIII of the Social Security
Act (42 U.S.C. 1395 et seq.), and who elects to receive
care in a military treatment facility, as authorized by sec-
tion 1076 of this title, may do so. The insurance benefits
of the Social Security Act may then be utilized to reim-
burse the military treatment facility for the care given,
in the manner and rate as specified in sections 1074(b)
and 1076(a)(1) of this title.’’.
SEC. 6. COLLECTION FROM THIRD-PARTY PAYERS.
Section 1095 of title 10, United States Code, is
amended by striking out subsection (d) and inserting in
lieu thereof the following new subsection:
‘‘(d) Collection may be made from any third-party
payer, including the appropriate program administering
the health insurance program defined under title XVIII
or XIX of the Social Security Act (42 U.S.C. 1395 et seq.)
pursuant to medicare subvention funding.’’.
SEC. 7. DETERMINATION OF INABILITY TO PROVIDE MEDI-
CAL AND DENTAL SERVICES.
Section 1076 of title 10, United States Code, is
amended by striking out subsection (c) and inserting in
lieu thereof the following new subsection:
‘‘(c) Medical or dental care may be denied to a person
who is otherwise eligible for such care at a military treat-
ment facility only if the senior officer-in-charge or com-
manding officer of the military treatment facility makes
a determination that the treatment facility, or subunit
thereof, cannot provide the particular care required. This
determination may be made, if, and only if, that particular
military treatment facility, or subunit thereof, does not,
at that particular time, have space or facilities available
to provide the treatment due solely to the then actual ex-
isting requirements to utilize all existing space or facilities
for active duty members; or does not, at that particular
time, and under any circumstances, provide the type of
care required. Authority to make such determination may
not be delegated. The administering Secretary will be ad-
vised immediately in all instances where a determination
to deny treatment, under this subsection, is made, with
a verifiable date as to when the restriction will be re-
moved.’’.