I
104TH CONGRESS
1ST SESSION
H. R. 580
To amend title XVIII of the Social Security Act and title 10, United States
Code, to allow the Secretary of Health and Human Services to reimburse
the Military Health Services System for care provided to Medicare-
eligible military retirees and their spouses in the Military Health Services
System.
IN THE HOUSE OF REPRESENTATIVES
JANUARY 19, 1995
Mr. HEFLEY (for himself, Mr. PETE GEREN of Texas, Mr. BARTON of Texas,
Mr. CONDIT, and Mr. SAM JOHNSON of Texas) introduced the following
bill; which was referred to the Committee on Commerce and, in addition,
to the Committees on Ways and Means and National Security, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the commit-
tee concerned
A BILL
To amend title XVIII of the Social Security Act and title
10, United States Code, to allow the Secretary of Health
and Human Services to reimburse the Military Health
Services System for care provided to Medicare-eligible
military retirees and their spouses in the Military Health
Services System.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. MEDICARE PROGRAM PAYMENTS FOR HEALTH
CARE SERVICES PROVIDED IN THE MILITARY
HEALTH SERVICES SYSTEM.
(a) PAYMENTS UNDER MEDICARE RISK CONTRACTS
PROGRAM.—Section 1876 of the Social Security Act (42
U.S.C. 1395mm) is amended by adding at the end the
following new subsection:
‘‘(k) Notwithstanding any other provision of this sec-
tion, a managed health care plan established by the Sec-
retary of Defense under chapter 55 of title 10, United
States Code, shall be considered an eligible organization
under this section, and the Secretary shall make payments
to such a managed health care plan during a year on be-
half of any individuals entitled to benefits under this title
who are enrolled in such a managed health care plan dur-
ing the year. Such payments shall be made in the same
amounts and under similar terms and conditions under
which the Secretary makes payments to other eligible
organizations with risk sharing contracts under this
section.’’.
(b) TEMPORARY PROVISION FOR WAIVER OF PART
B PREMIUM PENALTY.—Section 1839 of the Social Secu-
rity Act (42 U.S.C. 1395r) is amended by adding at the
end the following new subsection:
‘‘(h) The premium increase required by subsection
(b) shall not apply with respect to a person who is enrolled
with a managed care plan that is established by the Sec-
retary of Defense under chapter 55 of title 10, United
States Code, and is recognized as an eligible organization
pursuant to section 1876(k), if such person first enrolled
in such plan prior to January 1, 1998.’’.
(c) PAYMENTS UNDER PART A OF MEDICARE.—Sec-
tion 1814(c) of the Social Security Act (42 U.S.C.
1395f(c)) is amended—
(1) by redesignating the current matter as
paragraph (1); and
(2) by adding at the end the following new
paragraph:
‘‘(2) Paragraph (1) shall not apply to services
provided by facilities of the uniformed services pur-
suant to chapter 55 of title 10, United States Code,
and subject to the provisions of section 1095 of such
title. With respect to such services, payments under
this title shall be made without regard to whether
the beneficiary under this title has paid the deduct-
ible and copayments amounts generally required by
this title.’’.
(d) PAYMENTS UNDER PART B OF MEDICARE.—Sec-
tion 1835(d) of the Social Security Act (42 U.S.C.
1395n(d)) is amended—
(1) by redesignating the current matter as
paragraph (1); and
(2) by adding at the end the following new
paragraph:
‘‘(2) Paragraph (1) shall not apply to services pro-
vided by facilities of the uniformed services pursuant to
chapter 55 of title 10, United States Code, and subject
to the provisions of section 1095 of such title. With respect
to such services, payments under this title shall be made
without regard to whether the beneficiary under this title
has paid the deductible and copayments amounts generally
required by this title.’’.
(e) CONFORMING AMENDMENTS
TO
THE THIRD
PARTY COLLECTION PROGRAM FOR MILITARY MEDICAL
FACILITIES.—(1) Section 1095(d) of title 10, United
States Code, is amended—
(A) by striking ‘‘XVIII or’’; and
(B) by striking ‘‘1395’’ and inserting ‘‘1396’’.
(2) Section 1095(h)(2) of such title is amended by
inserting after ‘‘includes’’ the following: ‘‘plans adminis-
tered under title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.),’’.
(f) EFFECTIVE DATE.—The amendments made by
this section shall take effect at the end of the 30-day pe-
riod beginning on the date of the enactment of this Act.
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