H. R. 2401—141
SEC. 703. AUTHORIZATION TO EXPAND ENROLLMENT IN THE DEPEND-
ENTS’ DENTAL PROGRAM TO CERTAIN MEMBERS RETURN-
ING FROM OVERSEAS ASSIGNMENTS.
(a) AUTHORITY TO EXPAND PROGRAM.—After March 31, 1994,
the Secretary of Defense may expand the dependents’ dental pro-
gram established under section 1076a of title 10, United States
Code, to permit a member of the uniformed services described
in subsection (b) to enroll dependents described in subsection (a)
of such section in a dental benefits plan under the program without
regard to the length of the uncompleted portion of the member’s
period of obligated service.
(b) COVERED MEMBERS.—A member referred to in subsection
(a) is a member of the uniformed services who is—
(1) on active duty for a period of more than 30 days (as
defined in section 101(d)(2) of title 10, United States Code);
and
(2) reassigned from a permanent duty station where a
dental benefits plan under the dependents’ dental program
is not available to a permanent duty station where such a
plan is available.
(c) REPORT ON ADVISABILITY OF EXPANSION.—Not later than
February 28, 1994, the Secretary shall submit to Congress a report
evaluating the advisability of expanding the enrollment eligibility
of members of the uniformed services in the dependents’ dental
program in the manner authorized in subsection (a). The report
shall include an analysis of the cost implications for such an expan-
sion to the Federal Government, beneficiaries under the dependents’
dental program, and contractors under the program.
(d) NOTIFICATION OF EXERCISE OF AUTHORITY.—The Secretary
shall notify Congress of any decision to expand the enrollment
eligibility of dependents in the dependents’ dental program as pro-
vided in subsection (a) not later than 30 days before such expansion
takes effect.
SEC. 704. AUTHORIZATION TO APPLY SECTION 1079 PAYMENT RULES
FOR THE SPOUSE AND CHILDREN OF A MEMBER WHO DIES
WHILE ON ACTIVE DUTY.
(a) AUTHORITY TO USE SECTION 1079 PAYMENT RULES.—In
the case of a dependent described in subsection (b) of a member
of a uniformed service who died while on active duty for a period
of more than 30 days, the administering Secretary may apply the
payment provisions set forth in section 1079(b) of title 10, United
States Code (in lieu of the payment provisions set forth in section
1086(b) of such title), with respect to health benefits received by
the dependent under section 1086 of such title in connection with
an illness or medical condition for which the dependent was receiv-
ing treatment under chapter 55 of such title at the time of the
death of the member.
(b) ELIGIBLE DEPENDENTS DESCRIBED.—A dependent referred
to in this section is a dependent who—
(1) is the unremarried widow, unremarried widower, or
child of a member of a uniformed service who died on or
after January 1, 1993, while on active duty for a period of
more than 30 days; and
(2) was a covered beneficiary under chapter 55 of title
10, United States Code, at the time of the death of the member
by reason of being the spouse or child of the member.
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H. R. 2401—142
(c) PERIOD OF APPLICATION OF SPECIAL PAYMENT RULE.—The
special payment rule authorized by subsection (a) for a dependent
described in subsection (b) shall expire upon the earlier of—
(1) the end of the one-year period beginning on the date
of the death of the member; and
(2) the termination of the illness or condition for which
the dependent was receiving treatment under chapter 55 of
title 10, United States Code, at the time of the death of the
member.
(d) DEFINITIONS.—For purposes of this section, the term ‘‘admin-
istering Secretary’’ means—
(1) the Secretary of Defense, with respect to the Armed
Forces under the jurisdiction of the Secretary;
(2) the Secretary of Transportation, with respect to the
Coast Guard when the Coast Guard is not operating as a
service in the Navy; and
(3) the Secretary of Health and Human Services with
respect to the National Oceanic and Atmospheric Administra-
tion and the Public Health Service.
Subtitle B—Changes to Existing Laws
Regarding Health Care Management
SEC. 711. CODIFICATION OF CHAMPUS PEER REVIEW ORGANIZATION
PROGRAM PROCEDURES.
Section 1079 of title 10, United States Code, is amended by
adding at the end the following new subsection:
‘‘(o)(1) Health care services provided pursuant to this section
or section 1086 of this title (or pursuant to any other contract
or project under the Civilian Health and Medical Program of the
Uniformed Services) may not include services determined under
the CHAMPUS Peer Review Organization program to be not medi-
cally or psychologically necessary.
‘‘(2) The Secretary of Defense, after consulting with the other
administering Secretaries, may adopt or adapt for use under the
CHAMPUS Peer Review Organization program, as the Secretary
considers appropriate, any of the quality and utilization review
requirements and procedures that are used by the Peer Review
Organization program under part B of title XI of the Social Security
Act (42 U.S.C. 1320c et seq.).’’.
SEC. 712. INCREASED FLEXIBILITY FOR PERSONAL SERVICE CON-
TRACTS IN MILITARY MEDICAL TREATMENT FACILITIES.
(a) PERSONAL SERVICES CONTRACTS AUTHORIZED.—(1) Section
1091 of title 10, United States Code, is amended to read as follows:
‘‘§ 1091. Personal services contracts
‘‘(a) AUTHORITY.—The Secretary of Defense may enter into per-
sonal services contracts to carry out health care responsibilities
in medical treatment facilities of the Department of Defense, as
determined to be necessary by the Secretary. The authority provided
in this subsection is in addition to any other contract authorities
of the Secretary, including authorities relating to the management
of such facilities and the administration of this chapter.
‘‘(b) LIMITATION ON AMOUNT OF COMPENSATION.—In no case
may the total amount of compensation paid to an individual in
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H. R. 2401—143
any year under a personal services contract entered into under
subsection (a) exceed the amount of annual compensation (excluding
the allowances for expenses) specified in section 102 of title 3.
‘‘(c) PROCEDURES.—(1) The Secretary shall establish by regula-
tion procedures for entering into personal services contracts with
individuals under subsection (a). At a minimum, such procedures
shall assure—
‘‘(A) the provision of adequate notice of contract opportuni-
ties to individuals residing in the area of the medical treatment
facility involved; and
‘‘(B) consideration of interested individuals solely on the
basis of the qualifications established for the contract and the
proposed contract price.
‘‘(2) Upon the establishment of the procedures under paragraph
(1), the Secretary may exempt contracts covered by this section
from the competitive contracting requirements specified in section
2304 of this title or any other similar requirements of law.
‘‘(d) EXCEPTIONS.—The procedures and exemptions provided
under subsection (c) shall not apply to personal services contracts
entered into under subsection (a) with entities other than individ-
uals or to any contract that is not an authorized personal services
contract under subsection (a).’’.
(2) The item relating to section 1091 in the table of sections
at the beginning of chapter 55 of title 10, United States Code,
is amended to read as follows:
‘‘1091. Personal services contracts.’’.
(b) REPORT REQUIRED.—Not later than 30 days after the end
of the 180-day period beginning on the date on which the Secretary
of Defense first uses the authority provided under section 1091
of title 10, United States Code (as amended by subsection (a)(1)),
the Secretary shall submit to Congress a report specifying—
(1) the compensation, by medical specialty, provided by
the Secretary to individuals agreeing to enter into a personal
services contract under such section during that period;
(2) the extent to which the amounts of such compensation
exceed the amounts previously provided by the Secretary for
individuals in such medical specialties;
(3) the total number and medical specialties of individuals
serving in military medical treatment facilities during that
period pursuant to such a contract; and
(4) the number of such individuals (and their medical
specialties) who are receiving compensation under such a con-
tract in an amount in excess of the maximum amount author-
ized under such section, as such section was in effect on the
day before the date of the enactment of this Act.
SEC. 713. EXPANSION OF THE PROGRAM FOR THE COLLECTION OF
HEALTH CARE COSTS FROM THIRD-PARTY PAYERS.
(a) COLLECTION CHANGES.—Subsection (g) of section 1095 of
title 10, United States Code, is amended—
(1) by inserting after ‘‘collected under this section from
a third party payer’’ the following: ‘‘or under any other provision
of law from any other payer’’; and
(2) by inserting before the period the following: ‘‘and shall
not be taken into consideration in establishing the operating
budget of the facility’’.
(b) DEFINITIONS.—Subsection (h) of such section is amended—
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H. R. 2401—144
(1) in paragraph (2), by inserting after ‘‘includes’’ the follow-
ing: ‘‘a preferred provider organization and’’; and
(2) by adding at the end the following new paragraph:
‘‘(3) The term ‘health care services’ includes products
provided or purchased through a facility of the uniformed
services.’’.
(c) REPORT ON COLLECTIONS.—Subsection (g) of such section
(as amended by subsection (a)) is further amended—
(1) by inserting ‘‘(1)’’ after ‘‘(g)’’; and
(2) by adding at the end the following new paragraph:
‘‘(2) Not later than February 15 of each year, the Secretary
of Defense shall submit to Congress a report specifying for each
facility of the uniformed services the amount credited to the facility
under this subsection during the preceding fiscal year.’’.
SEC. 714. ALTERNATIVE RESOURCE ALLOCATION METHOD FOR MEDI-
CAL FACILITIES OF THE UNIFORMED SERVICES.
(a) INCLUSION OF CAPITATION METHOD.—Section 1101 of title
10, United States Code, is amended—
(1) in subsection (a)—
(A) by striking out ‘‘DRGS’’ in the subsection heading
and inserting in lieu thereof ‘‘CAPITATION
OR
DRG
METHOD’’; and
(B) by inserting ‘‘capitation or’’ before ‘‘diagnosis-
related groups’’;
(2) in subsection (b), by striking out ‘‘Diagnosis-related
groups’’ and inserting in lieu thereof ‘‘Capitation or diagnosis-
related groups’’; and
(3) in subsection (c)—
(A) by striking out ‘‘shall’’ both places it appears and
inserting in lieu thereof ‘‘may’’; and
(B) by adding at the end the following new paragraph:
‘‘(4) An appropriate method for calculating or estimating
the annual per capita costs of providing comprehensive health
care services to members of the uniformed services on active
duty and covered beneficiaries.’’.
(b) CLERICAL AMENDMENTS.—(1) The heading of such section
is amended to read as follows:
‘‘§ 1101. Resource allocation methods: capitation or diag-
nosis-related groups’’.
(2) The item relating to such section in the table of sections
at the beginning of chapter 55 of such title is amended to read
as follows:
‘‘1101. Resource allocation methods: capitation or diagnosis-related groups.’’.
SEC. 715. FEDERAL PREEMPTION REGARDING CONTRACTS FOR MEDI-
CAL AND DENTAL CARE.
(a) PREEMPTION.—Section 1103 of title 10, United States Code,
is amended to read as follows:
‘‘§ 1103. Contracts for medical and dental care: State and
local preemption
‘‘(a) OCCURRENCE OF PREEMPTION.—A law or regulation of a
State or local government relating to health insurance, prepaid
health plans, or other health care delivery or financing methods
shall not apply to any contract entered into pursuant to this chapter
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