H. R. 2401—149
SEC. 720. CLARIFICATION 
OF 
CONDITIONS 
ON 
EXPANSION 
OF
CHAMPUS REFORM INITIATIVE TO OTHER LOCATIONS.
(a) IN GENERAL.—Subsection (a) of section 712 of the National
Defense Authorization Act for Fiscal Year 1993 (Public Law 102–
484; 10 U.S.C. 1073 note) is amended—
(1) by inserting ‘‘(1)’’ after ‘‘CONDITION.—’’;
(2) in the second sentence, by inserting after ‘‘cost-effective-
ness of the initiative’’ the following: ‘‘(while assuring that the
combined cost of care in military treatment facilities and under
the Civilian Health and Medical Program of the Uniformed
Services will not be increased as a result of the expansion)’’;
and
(3) by adding at the end the following new paragraph:
‘‘(2) To the extent any revision of the CHAMPUS reform initia-
tive is necessary in order to make the certification required by
this subsection, the Secretary shall assure that enrolled covered
beneficiaries may obtain health care services with reduced out-
of-pocket costs, as compared to standard CHAMPUS.’’.
(b) DEFINITION.—Subsection (d) of such section is amended
by adding at the end the following new paragraph:
‘‘(3) The terms ‘Civilian Health and Medical Program of
the Uniformed Services’ and ‘CHAMPUS’ have the meaning
given the term ‘Civilian Health and Medical Program of the
Uniformed Services’ in section 1072(4) of title 10, United States
Code.’’.
SEC. 721. REPORT REGARDING DEMONSTRATION PROGRAMS FOR
THE SALE OF PHARMACEUTICALS.
Section 702 of the National Defense Authorization Act for Fiscal
Year 1993 (Public Law 102–484; 10 U.S.C. 1079 note) is amended—
(1) by redesignating subsection (f) as subsection (g); and
(2) by inserting after subsection (e) the following new sub-
section:
‘‘(f) ADDITIONAL REPORT REGARDING PROGRAMS.—Not later than
January 1, 1994, the Secretary of Defense shall submit to Congress
a report containing—
‘‘(1) an evaluation of the feasibility and advisability of
increasing the size of those areas determined by the Secretary
under subsection (c)(2) to be adversely affected by the closure
of a health care facility of the uniformed services in order
to increase the number of persons described in such subsection
who will be eligible to participate in the demonstration project
for pharmaceuticals by mail or in the retail pharmacy network
under this section;
‘‘(2) an evaluation of the feasibility and advisability of
expanding the demonstration project and the retail pharmacy
network under this section to include all covered beneficiaries
under chapter 55 of title 10, United States Code, including
those persons currently excluded from participation in the
Civilian Health and Medical Program of the Uniformed Services
by operation of section 1086(d)(1) of such title;
‘‘(3) an estimation of the costs that would be incurred,
and any savings that would be achieved by improving effi-
ciencies of operation, as a result of undertaking the increase
or expansion described in paragraph (1) or (2); and
‘‘(4) such recommendations as the Secretary considers to
be appropriate.’’.
13:24 Nov 18, 1993
VerDate 16-NOV-93
Jkt 059200
PO 00000
Frm 00149
Fmt 6655
Sfmt 6501
E:\BILLS\H2401.ENR
bend06
H. R. 2401—150
Subtitle C—Other Matters
SEC. 731. USE OF HEALTH MAINTENANCE ORGANIZATION MODEL AS
OPTION FOR MILITARY HEALTH CARE.
(a) USE OF MODEL.—The Secretary of Defense shall prescribe
and implement a health benefit option (and accompanying cost-
sharing requirements) for covered beneficiaries eligible for health
care under chapter 55 of title 10, United States Code, that is
modelled on health maintenance organization plans offered in the
private sector and other similar Government health insurance pro-
grams. The Secretary shall include, to the maximum extent prac-
ticable, the health benefit option required under this subsection
as one of the options available to covered beneficiaries in all man-
aged health care initiatives undertaken by the Secretary after the
date of the enactment of this Act.
(b) ELEMENTS OF OPTION.—The Secretary shall offer covered
beneficiaries who enroll in the health benefit option required under
subsection (a) reduced out-of-pocket costs and a benefit structure
that is as uniform as possible throughout the United States. The
Secretary shall allow enrollees to seek health care outside of the
option, except that the Secretary may prescribe higher out-of-pocket
costs than are provided under section 1079 or 1086 of title 10,
United States Code, for enrollees who obtain health care outside
of the option.
(c) GOVERNMENT COSTS.—The health benefit option required
under subsection (a) shall be administered so that the costs incurred
by the Secretary under each managed health care initiative that
includes the option are no greater than the costs that would other-
wise be incurred to provide health care to the covered beneficiaries
who enroll in the option.
(d) COVERED BENEFICIARY DEFINED.—For purposes of this sec-
tion, the term ‘‘covered beneficiary’’ means a beneficiary under
chapter 55 of title 10, United States Code, other than a beneficiary
under section 1074(a) of such title.
(e) REGULATIONS.—Not later than February 1, 1994, the Sec-
retary shall prescribe final regulations to implement the health
benefit option required by subsection (a).
SEC. 732. CLARIFICATION OF AUTHORITY FOR GRADUATE STUDENT
PROGRAM OF THE UNIFORMED SERVICES UNIVERSITY OF
THE HEALTH SCIENCES.
(a) DISTINCTION
BETWEEN
MEDICAL
AND
GRADUATE
STU-
DENTS.—Section 2114 of title 10, United States Code, is amended—
(1) in subsection (a), by striking out ‘‘Students’’ in the
first sentence and inserting in lieu thereof ‘‘Medical students’’;
(2) in subsection (b), by striking out ‘‘Students’’ both places
it appears and inserting in lieu thereof ‘‘Medical students’’;
(3) in subsection (d)—
(A) by striking out ‘‘member of the program’’ in the
first sentence and inserting in lieu thereof ‘‘medical stu-
dent’’; and
(B) by striking out ‘‘any such member’’ in the second
sentence both places it appears and inserting in lieu thereof
‘‘any such student’’; and
(4) by adding at the end the following new subsection:
13:24 Nov 18, 1993
VerDate 16-NOV-93
Jkt 059200
PO 00000
Frm 00150
Fmt 6655
Sfmt 6501
E:\BILLS\H2401.ENR
bend06
H. R. 2401—151
‘‘(g) The Secretary of Defense shall establish such selection
procedures, service obligations, and other requirements as the Sec-
retary considers appropriate for graduate students (other than medi-
cal students) in a postdoctoral, postgraduate, or technological
institute established pursuant to section 2113(h) of this title.’’.
(b) APPLICATION OF AMENDMENTS.—The amendments made by
subsection (a) shall apply with respect to students attending the
Uniformed Services University of the Health Sciences on or after
the date of the enactment of this Act.
SEC. 733. AUTHORITY FOR THE ARMED FORCES INSTITUTE OF
PATHOLOGY TO OBTAIN ADDITIONAL DISTINGUISHED
PATHOLOGISTS AND SCIENTISTS.
Section 176(c) of title 10, United States Code, is amended
by adding at the end the following new sentence: ‘‘The Secretary
of Defense, on a case-by-case basis, may waive the limitation on
the number of distinguished pathologists or scientists with whom
agreements may be entered into under this subsection if the Sec-
retary determines that such waiver is in the best interest of the
Department of Defense.’’.
SEC. 734. AUTHORIZATION 
FOR 
AUTOMATED 
MEDICAL 
RECORD
CAPABILITY TO BE INCLUDED IN MEDICAL INFORMATION
SYSTEM.
(a) AUTOMATED MEDICAL RECORD CAPABILITY.—In carrying out
the acquisition of the Department of Defense medical information
system referred to in section 704 of the National Defense Authoriza-
tion Act for Fiscal Year 1987 (Public Law 99–661; 100 Stat. 3900),
the Secretary of Defense may permit an automated medical record
capability to be included in the system. The Secretary may make
such modifications to existing contracts, and include such specifica-
tions in future contracts, as the Secretary considers necessary to
include such a capability in the system.
(b) PLAN.—The Secretary of Defense shall develop a plan to
test the use of automated medical records at one or more military
medical treatment facilities. Not later than January 15, 1994, the
Secretary shall submit the plan to the Committees on Armed Serv-
ices of the Senate and House of Representatives.
(c) DEFINITIONS.—For purposes of this section:
(1) The term ‘‘medical information system’’ means a com-
puter-based information system that—
(A) 
receives 
data 
normally 
recorded 
concerning
patients;
(B) creates and maintains from such data a computer-
ized medical record for each patient; and
(C) provides access to data for patient care, hospital
administration, research, and medical care resource plan-
ning.
(2) The term ‘‘automated medical record’’ means a com-
puter-based information system that—
(A) is available at the time and place of interaction
between a patient and a health care provider;
(B) receives, stores, and provides access to relevant
patient and other medical information in a single, logical
patient record that is appropriately organized for clinical
decisionmaking; and
(C) maintains patient confidentiality in conformance
with all applicable laws and regulations.
13:24 Nov 18, 1993
VerDate 16-NOV-93
Jkt 059200
PO 00000
Frm 00151
Fmt 6655
Sfmt 6501
E:\BILLS\H2401.ENR
bend06
H. R. 2401—152
SEC. 735. REPORT ON THE PROVISION OF PRIMARY AND PREVENTIVE
HEALTH CARE SERVICES FOR WOMEN.
(a) REPORT REQUIRED.—The Secretary of Defense shall prepare
a report evaluating the provision of primary and preventive health
care services through military medical treatment facilities and the
Civilian Health and Medical Program of the Uniformed Services
to female members of the uniformed services and female covered
beneficiaries eligible for health care under chapter 55 of title 10,
United States Code.
(b) CONTENTS.—The report required by subsection (a) shall
contain the following:
(1) A description of the number and types of health care
providers who are providing health care services in military
medical treatment facilities or through the Civilian Health
and Medical Program of the Uniformed Services to female
members and female covered beneficiaries.
(2) A description of the health care programs implemented
(or planned) by the administering Secretaries to assess the
health needs of women or to meet the special health needs
of women.
(3) A description of the demographics of the population
of female members and female covered beneficiaries and the
leading categories of morbidity and mortality among such mem-
bers and beneficiaries.
(4) A description of any actions, including the use of special
pays and incentives, undertaken by the Secretary during fiscal
year 1993—
(A) to ensure the retention of health care providers
who are providing health care services to female members
and female covered beneficiaries;
(B) to recruit additional health care providers to pro-
vide such health care services; and
(C) to replace departing health care providers who
provided such health care services.
(5) A description of any existing or proposed programs
to encourage specialization of health care providers in fields
related to primary and preventive health care services for
women.
(6) An assessment of any difficulties experienced by mili-
tary medical treatment facilities or health care providers under
the Civilian Health and Medical Program of the Uniformed
Services in furnishing primary and preventive health care serv-
ices for women and a description of the actions taken by the
Secretary to resolve such difficulties.
(7) A description of the actions taken by the Secretary
to foster and encourage the expansion of research relating
to health care issues of concern to female members of the
uniformed services and female covered beneficiaries.
(c) STUDY OF THE NEEDS OF FEMALE MEMBERS AND FEMALE
COVERED BENEFICIARIES FOR HEALTH CARE SERVICES.—(1) As part
of the report required by subsection (a), the Secretary shall conduct
a study to determine the needs of female members of the uniformed
services and female covered beneficiaries for health care services,
including primary and preventive health care services for women.
(2) The study shall examine the health care needs of current
female members and female covered beneficiaries and anticipated
future female members and female covered beneficiaries, taking
13:24 Nov 18, 1993
VerDate 16-NOV-93
Jkt 059200
PO 00000
Frm 00152
Fmt 6655
Sfmt 6501
E:\BILLS\H2401.ENR
bend06