[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1778 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 1778

 To amend title 10, United States Code, and title XVIII of the Social 
  Security Act to permit the reimbursement of expenses incurred by a 
    medical facility of the uniformed services or the Department of 
Veterans Affairs in providing health care to persons eligible for care 
                            under medicare.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 21, 1993

 Mr. Cunningham (for himself and Mr. Hunter) introduced the following 
 bill; which was referred jointly to the Committees on Armed Services, 
                Ways and Means, and Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
 To amend title 10, United States Code, and title XVIII of the Social 
  Security Act to permit the reimbursement of expenses incurred by a 
    medical facility of the uniformed services or the Department of 
Veterans Affairs in providing health care to persons eligible for care 
                            under medicare.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Military Retiree and Veteran Health 
Care Act of 1993''.

SEC. 2. DEFINITION OF MEDICARE SUBVENTION FUNDING.

    Section 1072 of title 10, United States Code, is amended by adding 
at the end the following new paragraph:
            ``(6) The term `medicare subvention funding' means funds or 
        funding authority of any program authorized under title XVIII 
        of the Social Security Act (42 U.S.C. 1395 et seq.), which is 
        made available to a department or agency for the provision of 
        health care services, and wherein funds are provided directly 
        to a military treatment facility operated by the Department of 
        Defense or Department of Veterans' Affairs for the purpose of 
        payment for care provided to authorized personnel treated in 
        that particular facility; and further wherein the funds 
        provided would otherwise be utilized for the same purpose in a 
        nonmilitary treatment facility.''.

SEC. 3. MEDICAL AND DENTAL CARE FOR MEMBERS AND CERTAIN FORMER MEMBERS.

    Section 1074(b) of title 10, United States Code, is amended--
            (1) by inserting ``(1)'' after ``(a)''; and
            (2) by adding at the end the following new paragraphs:
    ``(2) If a member or former member eligible for care under 
paragraph (1) is also eligible for health insurance payments under 
title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), the 
member or former member shall be entitled to and given medical and 
dental care in any medical facility of any uniformed service. The 
facility of the uniformed service that provides such care will recover 
the cost for the care provided from medicare subvention funding by 
direct billing of the appropriate program administering the health 
insurance program defined under title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.) and appropriate for the particular recipient 
of the care. Medicare subvention funding payments to the providing 
military treatment facility will be at fixed rates approved by the 
President.
    ``(3) Payments received by a military treatment facility or 
Department of Veterans' Affairs facility for medical services provided, 
whether the funds originated as Department of Defense appropriated 
funds or from medicare subvention funding shall be deposited to the 
credit of the operating and maintenance fund of the particular medical 
facility that provided the service, and as direct reimbursement for 
services rendered; without any requirement of equal or reciprocal 
reduction of the operating and maintenance budget of the providing 
facility.''.

SEC. 4. MEDICAL AND DENTAL CARE FOR DEPENDENTS.

    Section 1076(a) of title 10, United States Code, is amended by 
striking out paragraph (1) and inserting in lieu thereof the following 
new paragraph:
    ``(1) A dependent described in paragraph (2) is entitled, upon 
request, to the medical and dental care prescribed by section 1077 of 
this title in facilities of the uniformed services. If the dependent is 
also entitled to hospital insurance benefits under title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.), then the facility of the 
uniformed service will still provide authorized care, but will recover 
the cost for providing the care from medicare subvention funding by 
direct billing of the appropriate program administering the health 
insurance program defined under that Act, and appropriate for the 
particular recipient of the care. Medicare subvention funding payments 
to the providing military treatment facility will be at fixed rates 
approved by the President; and will be used, deposited, and credited as 
specified in section 1074 of this title.''

SEC. 5. CONFORMING AMENDMENT REGARDING MEDICARE SUBVENTION FUNDING.

    Section 1086(d) of title 10, United States Code, is amended by 
adding at the end the following new paragraph:
    ``(4) A covered beneficiary who is entitled to hospital insurance 
benefits under title XVIII of the Social Security Act (42 U.S.C. 1395 
et seq.), and who elects to receive care in a military treatment 
facility, as authorized by section 1076 of this title, may do so. The 
insurance benefits of the Social Security Act may then be utilized to 
reimburse the military treatment facility for the care given, in the 
manner and rate as specified in sections 1074(b) and 1076(a)(1).''.

SEC. 6. COLLECTION FROM THIRD-PARTY PAYERS.

    Section 1095 of title 10, United States Code, is amended by 
striking out subsection (d) and inserting in lieu thereof the following 
new subsection:
    ``(d) Collection may be made from any third-party payer, including 
the appropriate program administering the health insurance program 
defined under title XVIII or XIX of the Social Security Act (42 U.S.C. 
1395 et seq.) pursuant to medicare subvention funding.''.

SEC. 7. DETERMINATION OF INABILITY TO PROVIDE MEDICAL AND DENTAL 
              SERVICES.

    Section 1076 of title 10, United States Code, is amended by 
striking out subsection (c) and inserting in lieu thereof the following 
new subsection:
    ``(c) Medical or dental care may be denied to a person who is 
otherwise eligible for such care at a military treatment facility only 
if the senior officer-in-charge or commanding officer of the military 
treatment facility makes a determination that the treatment facility, 
or subunit thereof, cannot provide the particular care required. This 
determination may be made, if, and only if, that particular military 
treatment facility, or subunit thereof, does not, at that particular 
time, have space or facilities available to provide the treatment due 
solely to the then actual existing requirements to utilize all existing 
space or facilities for active duty members; or does not, at that 
particular time, and under any circumstances, provide the type of care 
required. Authority to make such determination may not be delegated. 
The administering Secretary will be advised immediately in all 
instances where a determination to deny treatment, under this 
subsection, is made, with a verifiable date as to when the restriction 
will be removed.''.

SEC. 8. MEDICARE PROCEDURE FOR PAYMENT OF CLAIMS OF PROVIDERS OF 
              SERVICES.

    (a) In General.--Section 1835 of the Social Security Act (42 U.S.C. 
1395n) is amended by striking out subsection (d) and inserting in lieu 
thereof the following:
    ``(d) Payments to Federal Provider of Services or Other Federal 
Agencies Prohibited.--Subject to sections 1880, 1890, and 1890A, no 
payment may be made under this part (42 U.S.C. 1395j et seq.) to any 
Federal provider of services or other Federal agency, except a provider 
of services which the Secretary determines is providing services to the 
public generally as a community institution or agency; and no such 
payment may be made to any provider of services or other person for any 
item or service which such person or persons is obligated by a law of, 
or a contract with, the United States to render at public expense.''.
    (b) Exception for Military and Veterans Treatment Facilities.--
Title XVIII of the Social Security Act is amended by inserting after 
section 1889 the following:

``SEC. 1890. MILITARY TREATMENT FACILITIES.

    ``(a) Eligibility for Payments; Conditions and Requirements.--A 
military treatment facility operated by a uniformed service of the 
Department of Defense shall be eligible for payments under this title 
notwithstanding sections 1814(c) and 1835(d) if and for so long as that 
military treatment facility meets all of the conditions and 
requirements for such payments which are applicable to hospitals and 
skilled nursing facilities under this title.
    ``(b) Definition.--Such payments under this section shall be 
referred to as medicare subvention funding, as that term is defined in 
section 1072(6) of title 10, United States Code.

``SEC. 1890A. DEPARTMENTS OF VETERANS AFFAIRS MEDICAL TREATMENT 
              FACILITY.

    ``(a) Eligibility for Payments; Conditions and Requirements.--A 
medical treatment facility operated by the Department of Veterans 
Affairs shall be eligible for payments under this title notwithstanding 
sections 1814(c) and 1835(d) if and for so long as that medical 
treatment facility meets all of the conditions and requirements for 
such payments which are applicable to hospitals and skilled nursing 
facilities under this title.
    ``(b) Definition.--Such payments under this section shall be 
referred to as medicare subvention funding, as that term is defined in 
section 1072(6) of title 10, United States Code.''.

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