HR 6886 RFS 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Health Equity and 
Access for Returning Troops and Servicemembers Act of 
2018’’ or the ‘‘HEARTS Act of 2018’’. 
SEC. 2. MODIFICATION OF REQUIREMENT FOR CERTAIN 
FORMER MEMBERS OF THE ARMED FORCES 
TO ENROLL IN MEDICARE PART B TO BE ELI-
GIBLE FOR TRICARE FOR LIFE. 
(a) TRICARE ELIGIBILITY.— 
(1) IN
GENERAL.—Subsection (d) of section 
1086 of title 10, United States Code, is amended by 
adding at the end the following new paragraph: 
‘‘(6)(A) The requirement in paragraph (2)(A) to en-
roll in the supplementary medical insurance program 
under part B of title XVIII of the Social Security Act (42 
U.S.C. 1395j et seq.) shall not apply to a person described 
in subparagraph (B) during any month in which such per-
son is not entitled to a benefit described in subparagraph 
(A) of section 226(b)(2) of the Social Security Act (42 
U.S.C. 426(b)(2)) if such person has received the coun-
seling and information under subparagraph (C). 
‘‘(B) A person described in this subparagraph is a 
person— 
‘‘(i) who is under 65 years of age; 
‘‘(ii) who is entitled to hospital insurance bene-
fits under part A of title XVIII of the Social Secu-
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rity Act pursuant to subparagraph (A) or (C) of sec-
tion 226(b)(2) of such Act (42 U.S.C. 426(b)(2)); 
‘‘(iii) whose entitlement to a benefit described 
in subparagraph (A) of such section has terminated 
due to performance of substantial gainful activity; 
and 
‘‘(iv) who is retired under chapter 61 of this 
title. 
‘‘(C) The Secretary of Defense shall coordinate with 
the Secretary of Health and Human Services and the 
Commissioner of Social Security to notify persons de-
scribed in subparagraph (B) of, and provide information 
and counseling regarding, the effects of not enrolling in 
the supplementary medical insurance program under part 
B of title XVIII of the Social Security Act (42 U.S.C. 
1395j et seq.), as described in subparagraph (A).’’. 
(2) 
CONFORMING
AMENDMENT.—Paragraph 
(2)(A) of such subsection is amended by striking ‘‘is 
enrolled’’ and inserting ‘‘except as provided by para-
graph (6), is enrolled’’. 
(3) IDENTIFICATION
OF
PERSONS.—Section 
1110a of such title is amended by adding at the end 
the following new subsection: 
‘‘(c) CERTAIN INDIVIDUALS NOT REQUIRED TO EN-
ROLL IN MEDICARE PART B.—In carrying out subsection 
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(a), the Secretary of Defense shall coordinate with the 
Secretary of Health and Human Services and the Commis-
sioner of Social Security to— 
‘‘(1) identify persons described in subparagraph 
(B) of section 1086(d)(6) of this title; and 
‘‘(2) provide information and counseling pursu-
ant to subparagraph (D) of such section.’’. 
(b) NON-APPLICATION OF MEDICARE PART B LATE 
ENROLLMENT PENALTY.—Section 1839(b) of the Social 
Security Act (42 U.S.C. 1395r(b)) is amended, in the sec-
ond sentence, by inserting ‘‘or months for which the indi-
vidual can demonstrate that the individual is an individual 
described in paragraph (6)(B) of section 1086(d) of title 
10, United States Code, who is enrolled in the TRICARE 
program pursuant to such section’’ after ‘‘an individual 
described in section 1837(k)(3)’’. 
(c) REPORT.—Not later than October 1, 2024, the 
Secretary of Defense, the Secretary of Health and Human 
Services, and the Commissioner of Social Security shall 
jointly submit to the Committees on Armed Services of 
the House of Representatives and the Senate, the Com-
mittee on Ways and Means and the Committee on Energy 
and Commerce of the House of Representatives, and the 
Committee on Finance of the Senate a report on the im-
plementation of section 1086(d)(6) of title 10, United 
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States Code, as added by subsection (a). Such report shall 
include, with respect to the period covered by the report— 
(1) the number of individuals enrolled in 
TRICARE for Life who are not enrolled in the sup-
plementary medical insurance program under part B 
of title XVIII of the Social Security Act (42 U.S.C. 
1395j et seq.) by reason of such section 1086(d)(6); 
and 
(2) the number of individuals who— 
(A) are retired from the Armed Forces 
under chapter 61 of title 10, United States 
Code; 
(B) are entitled to hospital insurance bene-
fits under part A of title XVIII of the Social 
Security Act pursuant to receiving benefits for 
24 months as described in subparagraph (A) or 
(C) of section 226(b)(2) of such Act (42 U.S.C. 
426(b)(2)); and 
(C) because of such entitlement, are no 
longer 
enrolled 
in 
TRICARE 
Standard, 
TRICARE 
Prime, 
TRICARE 
Extra, 
or 
TRICARE Select under chapter 55 of title 10, 
United States Code. 
(d) DEPOSIT OF SAVINGS INTO MEDICARE IMPROVE-
MENT FUND.—Section 1898(b)(1) of the Social Security 
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Act (42 U.S.C. 1395iii(b)(1)) is amended by striking 
‘‘during and after fiscal year 2021, $0’’ and inserting 
‘‘during and after fiscal year 2024, $5,000,000’’. 
(e) APPLICATION.—The amendments made by sub-
sections (a) and (b) shall apply with respect to a person 
who, on or after October 1, 2023, is a person described 
in section 1086(d)(6)(B) of title 10, United States Code, 
as added by subsection (a). 
SEC. 3. COVERAGE OF CERTAIN DNA SPECIMEN PROVE-
NANCE ASSAY TESTS UNDER MEDICARE. 
(a) BENEFIT.— 
(1) COVERAGE.—Section 1861 of the Social Se-
curity Act (42 U.S.C. 1395x) is amended— 
(A) in subsection (s)(2)— 
(i) in subparagraph (FF), by striking 
‘‘and’’ at the end; 
(ii) in subparagraph (GG), by insert-
ing ‘‘and’’ at the end; and 
(iii) by adding at the end the fol-
lowing new subparagraph: 
‘‘(HH) a prostate cancer DNA Specimen Prove-
nance Assay test (DSPA test) (as defined in sub-
section (jjj)); and’’; and 
(B) by adding at the end the following new 
subsection: 
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