I 
114TH CONGRESS 
2D SESSION 
H. R. 6076 
To require the Administrator of the National Aeronautics and Space Adminis-
tration to establish a program for the medical monitoring, diagnosis, 
and treatment of astronauts, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 20, 2016 
Mr. BABIN (for himself, Ms. EDWARDS, Mr. SMITH of Texas, Ms. EDDIE 
BERNICE JOHNSON of Texas, Mr. POSEY, Mr. BRIDENSTINE, and Mr. 
ABRAHAM) introduced the following bill; which was referred to the Com-
mittee on Science, Space, and Technology 
A BILL 
To require the Administrator of the National Aeronautics 
and Space Administration to establish a program for 
the medical monitoring, diagnosis, and treatment of as-
tronauts, 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. SHORT TITLE. 
This Act may be cited as the ‘‘To Research, Evaluate, 
Assess, and Treat Astronauts Act’’ or the ‘‘TREAT Astro-
nauts Act’’. 
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SEC. 2. DEFINITIONS. 
In this Act: 
(1) ADMINISTRATOR.—The term ‘‘Adminis-
trator’’ means the Administrator of NASA. 
(2) CREWMEMBER.—The term ‘‘crewmember’’ 
means an individual certified by the Administrator 
to be— 
(A) a former NASA astronaut or payload 
specialist who has flown on at least one orbital 
space mission; or 
(B) a management NASA astronaut who 
has flown on at least one orbital space mission 
and is currently employed by the Federal Gov-
ernment. 
(3) NASA.—The term ‘‘NASA’’ means the Na-
tional Aeronautics and Space Administration. 
(4) PROGRAM.—The term ‘‘Program’’ means 
the medical monitoring, diagnosis, and treatment 
program established under section 3. 
(5) SPACE FLIGHT-ASSOCIATED MEDICAL CON-
DITION.—The term ‘‘space flight-associated medical 
condition’’ means— 
(A) for purposes of medical monitoring or 
diagnosis under the Program, a psychological or 
medical condition that the Administrator deter-
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mines is potentially associated with human 
space flight; and 
(B) for purposes of medical treatment 
under the Program, a psychological or medical 
condition that the Administrator determines is 
associated with human space flight. 
SEC. 3. PROGRAM FOR THE MEDICAL MONITORING, DIAG-
NOSIS, AND TREATMENT OF ASTRONAUTS. 
(a) ESTABLISHMENT OF PROGRAM.—The Adminis-
trator shall, subject to section 6 and subsections (a)(2) 
and (b)(3) of section 4, establish a program that satisfies 
the requirements described in subsection (b) to provide for 
the medical monitoring, diagnosis, and treatment of crew-
members for space flight-associated medical conditions. 
(b) PROGRAM REQUIREMENTS.—The requirements 
described in this subsection are the following: 
(1) NO
COST
SHARING.—Medical monitoring, 
diagnosis, and treatment shall be provided under the 
Program without any deductibles, copayments, or 
other cost sharing obligation for crewmembers par-
ticipating in the Program. 
(2) ACCESS TO LOCAL SERVICES.—The Admin-
istrator shall design the Program to facilitate rea-
sonable access of a crewmember to medical moni-
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toring, diagnosis, and treatment under the Program, 
including, at the option of the crewmember— 
(A) directly through NASA; or 
(B) from a health care provider who the 
crewmember selects and who enters into an 
agreement with the Administrator, with respect 
to the provision by the provider of medical mon-
itoring, diagnosis, and treatment services, as 
applicable, to such crewmember under the Pro-
gram, under which— 
(i) the provider agrees to comply with 
the protocols issued under subsection (c) 
with respect to such provision of such serv-
ices to such crewmember; 
(ii) the provider agrees to submit data 
with respect to such provision of such serv-
ices to such crewmember, as required by 
the Administrator for purposes of sub-
section (d); 
(iii) the provider agrees to receive 
such training as the Administrator may re-
quire with respect to such medical moni-
toring, treatment, and diagnosis; and 
(iv) the Administrator agrees to pro-
vide payment to such provider for the pro-
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vision of such services to such crewmember 
in accordance with payment rates estab-
lished by the Administrator under the Pro-
gram, which shall be not less than the rea-
sonable costs of such services. 
(3) SECONDARY PAYER.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), payment or reimbursement for (or 
the provision of) medical monitoring, diagnosis, 
or treatment under the Program shall be sec-
ondary to any obligation of the United States 
or any third party (including any State or local 
governmental entity, private insurance carrier, 
or employer) under any other provision of law 
or contractual agreement to pay for or provide 
such medical monitoring, diagnosis, or treat-
ment. Any costs for items and services covered 
under the Program that are not paid for or pro-
vided under such other provision of law or con-
tractual agreement, due to the application of 
deductibles, copayments, coinsurance, other cost 
sharing, or otherwise, are reimbursable under 
the Program to the extent that they are covered 
under the Program. 
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(B) CONDITIONAL PAYMENT.—The Admin-
istrator may, under the Program, provide for 
conditional payments for (or provide) medical 
monitoring, diagnosis, or treatment services 
that is obliged to be paid for or provided by the 
United States or any third party described in 
subparagraph (A) under any other provision of 
law or contractual agreement if— 
(i) payment for (or the provision of) 
such medical monitoring, diagnosis, or 
treatment services has not been made (or 
provided) or cannot reasonably be expected 
to be made (or provided) promptly by the 
United States or such third party, respec-
tively; and 
(ii) such payment (or such provision 
of services) by the Administrator under the 
Program is conditioned on reimbursement 
by the United States or such third party, 
respectively, for such medical monitoring, 
diagnosis, or treatment. 
(C) CONSULTATION.—In carrying out this 
paragraph, the Administrator may consult with 
other Federal officials with experience coordi-
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nating health care payments with third-party 
payers. 
(4) VOLUNTARY PARTICIPATION IN PROGRAM.— 
(A) IN
GENERAL.—Participation by a 
crewmember under the Program, including with 
respect to the provision of medical monitoring, 
diagnosis, and treatment to such crewmember, 
shall be voluntary and pursuant to the written 
consent of such crewmember. Such consent pro-
vided by a crewmember shall constitute consent 
of the crewmember for the Administrator to use 
or disclose data acquired in the course of med-
ical monitoring, diagnosis, and treatment of 
such crewmember under the Program in accord-
ance with subsection (d). 
(B) CONSENT NOT A CONDITION FOR EM-
PLOYMENT OR BENEFITS.—Providing any con-
sent under subparagraph (A) shall not be a 
condition for— 
(i) employment with NASA; or 
(ii) receiving any salary or benefits, 
either for current or former crewmembers. 
For purposes of clause (ii), medical monitoring, 
diagnosis, and treatment under the Program 
shall not be considered a benefit. 
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(c) PROTOCOLS.—The Administrator shall issue such 
uniform protocols for the provision of medical monitoring, 
diagnosis, and treatment furnished under the Program. 
(d) DATA COLLECTION, USAGE, AND DISCLOSURES; 
PRIVACY PROTECTIONS.— 
(1) UNIFORM DATA COLLECTION.—Under the 
Program, subject to paragraph (3), the Adminis-
trator shall provide— 
(A) for the uniform collection of data, in-
cluding data on space flight-associated medical 
conditions and the identification of new space 
flight-associated conditions; 
(B) that such data shall be collected with 
respect to all crewmembers provided medical 
monitoring, diagnosis, or treatment under the 
Program for such conditions; 
(C) for the integration of such data into 
the medical monitoring, diagnosis, and treat-
ment activities under the Program; 
(D) for the analysis of, and regular reports 
to the Administrator on, such data; and 
(E) notwithstanding section 7(a), that the 
Administrator may retain access to such data. 
(2) USES
AND
DISCLOSURES
OF
INFORMA-
TION.—The Administrator may, subject to para-
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graph (3), use or disclose data acquired in the 
course of medical monitoring, diagnosis, and treat-
ment of any crewmember under the Program for the 
following purposes: 
(A) The medical monitoring, diagnosis, 
and treatment of such crewmember under the 
Program. 
(B) Other medical monitoring, diagnosis, 
or treatment under the Program. 
(C) Other scientific and research purposes. 
(D) For purposes of analysis and reports 
under section 4. 
(E) Any other purpose deemed appropriate 
by the Administrator. 
(3) PRIVACY PROTECTIONS.—The data collec-
tion, analysis, integration, use, disclosure, and reten-
tion under this subsection shall be conducted (and 
such data maintained) in a manner that protects the 
confidentiality of individually identifiable health in-
formation consistent with applicable Federal law, in-
cluding regulations. 
SEC. 4. REPORTS AND COST ESTIMATE. 
(a) ANNUAL REPORTS.— 
(1) REQUIREMENT.—Consistent with applicable 
privacy protections under Federal law, including reg-
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ulations, for each fiscal year of the Program, the 
Administrator shall prepare and publish a report on 
activities conducted under the Program, as well as 
plans for activities to be conducted under the Pro-
gram during the subsequent fiscal year. Each such 
report shall include detailed cost accounting of such 
activities and five-year budget estimates. Each re-
port for a fiscal year shall be submitted, not later 
than the date of submission of the President’s an-
nual budget request for such fiscal year, to the Com-
mittee on Science, Space, and Technology of the 
House of Representatives and the Committee on 
Commerce, Science, and Transportation of the Sen-
ate. 
(2) FAILURE TO SUBMIT REPORT.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), no funds are authorized to be appro-
priated for a fiscal year to carry out the Pro-
gram unless the Administrator has submitted 
the report required under paragraph (1) for 
that fiscal year by the deadline established 
under such paragraph. 
(B) TREATMENT
OF
ONGOING
PROCE-
DURES.—In the case of a fiscal year (after the 
first fiscal year for which the Program has been 
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implemented) with respect to which no funds 
would be authorized to carry out the Program 
pursuant to subparagraph (A), notwithstanding 
subparagraph (A), there are authorized to be 
appropriated, subject to section 6, for such fis-
cal year such sums as may be necessary to pro-
vide that any crewmember receiving under the 
Program diagnosis services or a course of treat-
ment that began on a date prior to the first day 
of such fiscal year shall continue to be provided 
such diagnosis services or course of treatment, 
respectively (and payment under the Program 
for such diagnosis services or course of treat-
ment, respectively, shall continue) after such 
date until completion of such diagnosis services 
or course of treatment, respectively. 
(b) COST ESTIMATE.— 
(1) REQUIREMENT.—Not later than 90 days 
after the date of enactment of this Act, the Adminis-
trator shall enter into an arrangement with an inde-
pendent external organization to undertake an inde-
pendent cost estimate of the cost to NASA and the 
Federal Government to implement and administer 
the Program. The independent external organization 
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