I
103D CONGRESS
1ST SESSION
H. R. 1778
To amend title 10, United States Code, and title XVIII of the Social Security
Act to permit the reimbursement of expenses incurred by a medical
facility of the uniformed services or the Department of Veterans Affairs
in providing health care to persons eligible for care under medicare.
IN THE HOUSE OF REPRESENTATIVES
APRIL 21, 1993
Mr. CUNNINGHAM (for himself and Mr. HUNTER) introduced the following
bill; which was referred jointly to the Committees on Armed Services,
Ways and Means, and Energy and Commerce
A BILL
To amend title 10, United States Code, and title XVIII
of the Social Security Act to permit the reimbursement
of expenses incurred by a medical facility of the uni-
formed services or the Department of Veterans Affairs
in providing health care to persons eligible for care under
medicare.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Military Retiree and
Veteran Health Care Act of 1993’’.
SEC. 2. DEFINITION OF MEDICARE SUBVENTION FUNDING.
Section 1072 of title 10, United States Code, is
amended by adding at the end the following new para-
graph:
‘‘(6) The term ‘medicare subvention funding’
means funds or funding authority of any program
authorized under title XVIII of the Social Security
Act (42 U.S.C. 1395 et seq.), which is made avail-
able to a department or agency for the provision of
health care services, and wherein funds are provided
directly to a military treatment facility operated by
the Department of Defense or Department of Veter-
ans’ Affairs for the purpose of payment for care pro-
vided to authorized personnel treated in that par-
ticular facility; and further wherein the funds pro-
vided would otherwise be utilized for the same pur-
pose in a nonmilitary treatment facility.’’.
SEC. 3. MEDICAL AND DENTAL CARE FOR MEMBERS AND
CERTAIN FORMER MEMBERS.
Section 1074(b) of title 10, United States Code, is
amended—
(1) by inserting ‘‘(1)’’ after ‘‘(a)’’; and
(2) by adding at the end the following new
paragraphs:
‘‘(2) If a member or former member eligible for care
under paragraph (1) is also eligible for health insurance
payments under title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.), the member or former member shall
be entitled to and given medical and dental care in any
medical facility of any uniformed service. The facility of
the uniformed service that provides such care will recover
the cost for the care provided from medicare subvention
funding by direct billing of the appropriate program ad-
ministering the health insurance program defined under
title XVIII of the Social Security Act (42 U.S.C. 1395
et seq.) and appropriate for the particular recipient of the
care. Medicare subvention funding payments to the provid-
ing military treatment facility will be at fixed rates ap-
proved by the President.
‘‘(3) Payments received by a military treatment facil-
ity or Department of Veterans’ Affairs facility for medical
services provided, whether the funds originated as Depart-
ment of Defense appropriated funds or from medicare sub-
vention funding shall be deposited to the credit of the op-
erating and maintenance fund of the particular medical
facility that provided the service, and as direct reimburse-
ment for services rendered; without any requirement of
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).’’.
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-