10 U.S.C. § 1073d (ARMED FORCES)
§ 1073d. Military medical treatment facilities
(a) In General.—
To support the medical readiness of the armed forces and the readiness of medical personnel, the Secretary of Defense, in consultation with the Secretaries of the military departments, shall maintain the military medical treatment facilities described in subsections (b), (c), and (d).
(b) Medical Centers.—
(1) The Secretary of Defense shall maintain medical centers in areas with a large population of members of the armed forces and covered beneficiaries.
(2) Medical centers shall serve as referral facilities for members and covered beneficiaries who require comprehensive health care services that support medical readiness.
(3) Medical centers shall consist of the following:
(A) Inpatient and outpatient tertiary care facilities that incorporate specialty and subspecialty care.
(B) Graduate medical education programs.
(C) Residency training programs.
(D) Level one or level two trauma care capabilities.
(4) The Secretary may designate a medical center as a regional center of excellence for unique and highly specialized health care services, including with respect to polytrauma, organ transplantation, and burn care.
(c) Hospitals.—
(1) The Secretary of Defense shall maintain hospitals in areas where civilian health care facilities are unable to support the health care needs of members of the armed forces and covered beneficiaries.
(2) Hospitals shall provide—
(A) inpatient and outpatient health services to maintain medical readiness; and
(B) such other programs and functions as the Secretary determines appropriate.
(3) Hospitals shall consist of inpatient and outpatient care facilities with limited specialty care that the Secretary determines—
(A) is cost effective; or
(B) is not available at civilian health care facilities in the area of the hospital.
(d) Ambulatory Care Centers.—
(1) The Secretary of Defense shall maintain ambulatory care centers in areas where civilian health care facilities are able to support the health care needs of members of the armed forces and covered beneficiaries.
(2) Ambulatory care centers shall provide the outpatient health services required to maintain medical readiness, including with respect to partnerships established pursuant to section 706 of the National Defense Authorization Act for Fiscal Year 2017.
(3) Ambulatory care centers shall consist of outpatient care facilities with limited specialty care that the Secretary determines—
(A) is cost effective; or
(B) is not available at civilian health care facilities in the area of the ambulatory care center.
(e) Maintenance of Inpatient Capabilities at Military Medical Treatment Facilities Located Outside the United States.—
(1) In carrying out subsection (a), the Secretary of Defense shall ensure that each covered facility maintains, at a minimum, inpatient capabilities that the Secretary determines are similar to the inpatient capabilities of such facility on September 30, 2016.
(2) The Secretary may not eliminate the inpatient capabilities of a covered facility until the day that is 180 days after the Secretary provides a briefing to the Committees on Armed Services of the Senate and the House of Representatives regarding the proposed elimination. During any such briefing, the Secretary shall certify the following:
(A) The Secretary has entered into agreements with hospitals or medical centers in the host nation of such covered facility that—
(i) replace the inpatient capabilities the Secretary proposes to eliminate; and
(ii) ensure members of the armed forces and covered beneficiaries who receive health care from such covered facility, have, within a distance the Secretary determines is reasonable, access to quality health care, including case management and translation services.
(B) The Secretary has consulted with the commander of the geographic combatant command in which such covered facility is located to ensure that the proposed elimination would have no impact on the operational plan for such geographic combatant command.
(C) Before the Secretary eliminates the inpatient capabilities of such covered facility, the Secretary shall provide each member of the armed forces or covered beneficiary who receives health care from the covered facility with—
(i) a transition plan for continuity of health care for such member or covered beneficiary; and
(ii) a public forum to discuss the concerns of the member or covered beneficiary regarding the proposed reduction.
(3) In this subsection, the term “covered facility” means a military medical treatment facility located outside the United States.
(Added Pub. L. 114–328, div. A, title VII, § 703(a)(1), Dec. 23, 2016, 130 Stat. 2197; amended Pub. L. 115–91, div. A, title VII, § 711, Dec. 12, 2017, 131 Stat. 1436.)
heading: Editorial Notes
heading: References in Text
text: Section 706 of the National Defense Authorization Act for Fiscal Year 2017, referred to in subsec. (d)(2), is section 706 of Pub. L. 114–328, which is set out as a note under section 1096 of this title.
heading: Amendments
text: 2017—Subsec. (e). Pub. L. 115–91 added subsec. (e).
heading: Statutory Notes and Related Subsidiaries
heading: Establishment of Centers of Excellence for Enhanced Treatment of Ocular Injuries
text: Pub. L. 117–81, div. A, title VII, § 721, Dec. 27, 2021, 135 Stat. 1791, provided that:
“(a) In General.—
Not later than October 1, 2023, the Secretary of Defense, acting through the Director of the Defense Health Agency, shall establish within the Defense Health Agency not fewer than four regional centers of excellence for the enhanced treatment of—
“(1) ocular wounds or injuries; and
“(2) vision dysfunction related to traumatic brain injury.
“(b) Location of Centers.—
Each center of excellence established under subsection (a) shall be located at a military medical center that provides graduate medical education in ophthalmology and related subspecialties and shall be the primary center for providing specialized medical services for vision for members of the Armed Forces in the region in which the center of excellence is located.
“(c) Policies for Referral of Beneficiaries.—
Not later than October 1, 2023, the Director of the Defense Health Agency shall publish on a publicly available internet website of the Department of Defense policies for the referral of eligible beneficiaries of the Department to centers of excellence established under subsection (a) for evaluation and treatment.
“(d) Identification of Medical Personnel Billets and Staffing.—
The Secretary of each military department, in conjunction with the Joint Staff Surgeon and the Director of the Defense Health Agency, shall identify specific medical personnel billets essential for the evaluation and treatment of ocular sensory injuries and ensure that centers of excellence established under subsection (a) are staffed with such personnel at the level required for the enduring medical support of each such center.
“(e) Briefing.—
Not later than December 31, 2023, the Secretary of Defense shall provide to the Committees on Armed Services of the Senate and the House of Representatives a briefing that—
“(1) describes the establishment of each center of excellence established under subsection (a), to include the location, capability, and capacity of each such center;
“(2) describes the referral policy published by the Defense Health Agency under subsection (c);
“(3) identifies the medical personnel billets identified under subsection (d); and
“(4) provides a plan for the staffing of personnel at such centers to ensure the enduring medical support of each such center.
“(f) Military Medical Center Defined.—
In this section, the term ‘military medical center’ means a medical center described in section 1073d(b) of title 10, United States Code.”
heading: Satellite Centers
text: Pub. L. 114–328, div. A, title VII, § 703(a)(3), Dec. 23, 2016, 130 Stat. 2198, provided that:
“In addition to the centers of excellence designated under section 1073d(b)(4) of title 10, United States Code, as added by paragraph (1), the Secretary of Defense may establish satellite centers of excellence to provide specialty care for certain conditions, including with respect to—
“(A) post-traumatic stress;
“(B) traumatic brain injury; and
“(C) such other conditions as the Secretary considers appropriate.”
heading: Limitation on Restructure and Realignment of Military Medical Treatment Facilities
text: Pub. L. 114–328, div. A, title VII, § 703(b), (e), Dec. 23, 2016, 130 Stat. 2198, 2200, provided that:
“(b) Exception.—
In carrying out section 1073d of title 10, United States Code, as added by subsection (a)(1), the Secretary of Defense may not restructure or realign the infrastructure of, or modify the health care services provided by, a military medical treatment facility unless the Secretary determines that, if such a restructure, realignment, or modification will eliminate the ability of a covered beneficiary to access health care services at a military medical treatment facility, the covered beneficiary will be able to access such health care services through the purchased care component of the TRICARE program.”
“(e) Definitions.—In this section [enacting this section and provisions set out as notes under this section], the terms ‘covered beneficiary’ and ‘TRICARE program’ have the meaning given those terms in section 1072 of title 10, United States Code.”