H. R. 1119—179
Sec. 766. Notice of use of investigational new drugs or drugs unapproved for their
applied use.
Sec. 767. Report on plans to track location of members in a theater of operations.
Sec. 768. Sense of Congress regarding the deployment of specialized units for
detecting and monitoring chemical, biological, and similar hazards in a
theater of operations.
Sec. 769. Report on effectiveness of research efforts regarding Gulf War illnesses.
Sec. 770. Persian Gulf illness clinical trials program.
Sec. 771. Sense of Congress concerning Gulf War illness.
Subtitle A—Health Care Services
SEC. 701. EXPANSION OF RETIREE DENTAL INSURANCE PLAN TO
INCLUDE SURVIVING SPOUSE AND CHILD DEPENDENTS
OF CERTAIN DECEASED MEMBERS.
Section 1076c(b)(4) of title 10, United States Code, is amended—
(1) in subparagraph (A)—
(A) by striking out ‘‘dies’’ and inserting in lieu thereof
‘‘died’’; and
(B) by striking out ‘‘or’’ at the end of the subparagraph;
(2) by striking out the period at the end of subparagraph
(B) and inserting in lieu thereof ‘‘; or’’; and
(3) by adding at the end the following new subparagraph:
‘‘(C) who died while on active duty for a period of
more than 30 days and whose eligible dependents are not
eligible, or no longer eligible, for dental benefits under
section 1076a of this title pursuant to subsection (i)(2)
of such section.’’.
SEC. 702. PROVISION OF PROSTHETIC DEVICES TO COVERED BENE-
FICIARIES.
(a) INCLUSION AMONG AUTHORIZED CARE.—Subsection (a) of
section 1077 of title 10, United States Code, is amended by adding
at the end the following new paragraph:
‘‘(15) Prosthetic devices, as determined by the Secretary
of Defense to be necessary because of significant conditions
resulting from trauma, congenital anomalies, or disease.’’.
(b) CONFORMING AMENDMENT.—Subsection (b) of such section
is amended by striking out paragraph (2) and inserting in lieu
thereof the following new paragraph:
‘‘(2) Hearing aids, orthopedic footwear, and spectacles,
except that, outside of the United States and at stations inside
the United States where adequate civilian facilities are unavail-
able, such items may be sold to dependents at cost to the
United States.’’.
SEC. 703. STUDY CONCERNING THE PROVISION OF COMPARATIVE
INFORMATION.
(a) STUDY.—The Secretary of Defense shall conduct a study
concerning the provision of the information described in subsection
(b) to beneficiaries under the TRICARE program established under
the authority of chapter 55 of title 10, United States Code, and
prepare and submit to Congress a report concerning such study.
(b) PROVISION
OF COMPARATIVE INFORMATION.—Information
described in this subsection, with respect to a managed care entity
that contracts with the Secretary of Defense to provide medical
assistance under the program described in subsection (a), shall
include the following:
(1) The benefits covered by the entity involved, including—
H. R. 1119—180
(A) covered items and services beyond those provided
under a traditional fee-for-service program;
(B) any beneficiary cost sharing; and
(C) 
any 
maximum 
limitations 
on 
out-of-pocket
expenses.
(2) The net monthly premium, if any, under the entity.
(3) The service area of the entity.
(4) To the extent available, quality and performance indica-
tors for the benefits under the entity (and how they compare
to such indicators under the traditional fee-for-service programs
in the area involved), including—
(A) disenrollment rates for enrollees electing to receive
benefits through the entity for the previous two years
(excluding disenrollment due to death or moving outside
the service area of the entity);
(B) information on enrollee satisfaction;
(C) information on health process and outcomes;
(D) grievance procedures;
(E) the extent to which an enrollee may select the
health care provider of their choice, including health care
providers within the network of the entity and out-of-net-
work health care providers (if the entity covers out-of-
network items and services); and
(F) an indication of enrollee exposure to balance billing
and the restrictions on coverage of items and services pro-
vided to such enrollee by an out-of-network health care
provider.
(5) Whether the entity offers optional supplemental benefits
and the terms and conditions (including premiums) for such
coverage.
(6) An overall summary description as to the method of
compensation of participating physicians.
Subtitle B—TRICARE Program
SEC. 711. ADDITION OF DEFINITION OF TRICARE PROGRAM TO
TITLE 10.
Section 1072 of title 10, United States Code, is amended by
adding at the end the following new paragraph:
‘‘(7) The term ‘TRICARE program’ means the managed
health care program that is established by the Department
of Defense under the authority of this chapter, principally sec-
tion 1097 of this title, and includes the competitive selection
of contractors to financially underwrite the delivery of health
care services under the Civilian Health and Medical Program
of the Uniformed Services.’’.
SEC. 712. PLAN FOR EXPANSION OF MANAGED CARE OPTION OF
TRICARE PROGRAM.
(a) PLAN FOR EXPANSION OF TRICARE PRIME.—The Secretary
of Defense shall prepare a plan for the expansion of the managed
care option of the TRICARE Program, known as TRICARE Prime,
into areas of the United States located outside of the catchment
areas of medical treatment facilities of the uniformed services,
but in which the managed care option is a cost-effective alternative
because of—
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(1) the significant number of members of the uniformed
services and covered beneficiaries under chapter 55 of title
10, United States Code (including retired members of the
Armed Forces and their dependents), who reside in the areas;
and
(2) the presence in the areas of sufficient nonmilitary health
care provider networks.
(b) ALTERNATIVES.—As an alternative to expansion of TRICARE
Prime to areas of the United States in which there are few or
no nonmilitary health care provider networks, the Secretary shall
include in the plan required under subsection (a) an evaluation
of the feasibility and cost-effectiveness of providing a member of
the Armed Forces on active duty who is stationed in such an
area, or whose dependents reside in such an area, with one or
both of the following:
(1) A monetary stipend to assist the member in obtaining
health care services for the member or the member’s depend-
ents.
(2) A reduction in the cost-sharing requirements applicable
to the TRICARE program options otherwise available to the
member to match the reduced cost-sharing responsibilities of
the managed care option of the TRICARE program.
(c) SUBMISSION OF PLAN.—Not later than March 1, 1998, the
Secretary shall submit to Congress the plan required under sub-
section (a).
Subtitle C—Uniformed Services Treatment
Facilities
SEC. 721. IMPLEMENTATION OF DESIGNATED PROVIDER AGREEMENTS
FOR UNIFORMED SERVICES TREATMENT FACILITIES.
(a) COMMENCEMENT OF HEALTH CARE SERVICES UNDER AGREE-
MENT.—Subsection (c) of section 722 of the National Defense
Authorization Act for Fiscal Year 1997 (Public Law 104–201, 10
U.S.C. 1073 note) is amended—
(1) by redesignating paragraphs (1) and (2) as subpara-
graphs (A) and (B);
(2) by inserting ‘‘(1)’’ before ‘‘Unless’’; and
(3) by adding at the end the following new paragraph:
‘‘(2) The Secretary may modify the effective date established
under paragraph (1) for an agreement to permit a transition period
of not more than six months between the date on which the agree-
ment is executed by the parties and the date on which the des-
ignated provider commences the delivery of health care services
under the agreement.’’.
(b) TEMPORARY
CONTINUATION
OF
EXISTING
PARTICIPATION
AGREEMENTS.—Subsection (d) of such section is amended by insert-
ing before the period at the end the following: ‘‘, including any
transitional period provided by the Secretary under paragraph (2)
of such subsection’’.
SEC. 722. CONTINUED ACQUISITION OF REDUCED-COST DRUGS.
Section 722 of the National Defense Authorization Act for Fiscal
Year 1997 (Public Law 104–201; 10 U.S.C. 1073 note) is amended
by adding at the end the following new subsection:
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‘‘(g) CONTINUED ACQUISITION OF REDUCED-COST DRUGS.—A des-
ignated provider shall be treated as part of the Department of
Defense for purposes of section 8126 of title 38, United States
Code, in connection with the provision by the designated provider
of health care services to covered beneficiaries pursuant to the
participation agreement of the designated provider under section
718(c) of the National Defense Authorization Act for Fiscal Year
1991 (Public Law 101–510; 42 U.S.C. 248c note) or pursuant to
the agreement entered into under subsection (b).’’.
SEC. 723. LIMITATION ON TOTAL PAYMENTS.
Section 726(b) of the National Defense Authorization Act for
Fiscal Year 1997 (Public Law 104–201; 10 U.S.C. 1073 note) is
amended by adding at the end the following new sentence: ‘‘In
establishing the ceiling rate for enrollees with the designated
providers who are also eligible for the Civilian Health and Medical
Program of the Uniformed Services, the Secretary of Defense shall
take into account the health status of the enrollees.’’.
Subtitle D—Other Changes to Existing
Laws Regarding Health Care Management
SEC. 731. IMPROVEMENTS IN HEALTH CARE COVERAGE AND ACCESS
FOR MEMBERS ASSIGNED TO CERTAIN DUTY LOCATIONS
FAR FROM SOURCES OF CARE.
(a) SUPPLEMENTAL CARE PROGRAM.—(1) Section 1074(c) of title
10, United States Code, is amended—
(A) by inserting ‘‘(1)’’ after ‘‘(c)’’; and
(B) by adding at the end the following new paragraphs:
‘‘(2)(A) Subject to such exceptions as the Secretary of Defense
considers necessary, coverage for medical care for members of the
armed forces under this subsection, and standards with respect
to timely access to such care, shall be comparable to coverage
for medical care and standards for timely access to such care
under the managed care option of the TRICARE program known
as TRICARE Prime.
‘‘(B) The Secretary of Defense shall enter into arrangements
with contractors under the TRICARE program or with other appro-
priate contractors for the timely and efficient processing of claims
under this subsection.
‘‘(3)(A) The Secretary of Defense may not require a member
of the armed forces described in subparagraph (B) to receive routine
primary medical care at a military medical treatment facility.
‘‘(B) A member referred to in subparagraph (A) is a member
of the armed forces on active duty who is entitled to medical
care under this subsection and who—
‘‘(i) receives a duty assignment described in subparagraph
(C); and
‘‘(ii) pursuant to the assignment of such duty, resides at
a location that is more than 50 miles, or approximately one
hour of driving time, from the nearest military medical treat-
ment facility adequate to provide the needed care.
‘‘(C) A duty assignment referred to in subparagraph (B) means
any of the following:
‘‘(i) Permanent duty as a recruiter.