[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 2343 Placed on Calendar Senate (PCS)]

                                                       Calendar No. 536

103d CONGRESS

  2d Session

                                S. 2343

_______________________________________________________________________

                                 A BILL

    To state the sense of the Senate on the TRICARE program of the 
Department of Defense and to facilitate the full implementation of the 
program by authorizing the reimbursement of the program for the cost of 
     care provided under the program to certain medicare-eligible 
                              individuals.

_______________________________________________________________________

               August 1 (legislative day, July 20), 1994

                         Placed on the calendar





                                                       Calendar No. 536
103d CONGRESS
  2d Session
                                S. 2343

    To state the sense of the Senate on the TRICARE program of the 
Department of Defense and to facilitate the full implementation of the 
program by authorizing the reimbursement of the program for the cost of 
     care provided under the program to certain medicare-eligible 
                              individuals.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

               August 1 (legislative day, July 20), 1994

Mr. Nunn, from the Committee on Armed Services, reported the following 
     original bill; which was read twice and placed on the calendar

_______________________________________________________________________

                                 A BILL


 
    To state the sense of the Senate on the TRICARE program of the 
Department of Defense and to facilitate the full implementation of the 
program by authorizing the reimbursement of the program for the cost of 
     care provided under the program to certain medicare-eligible 
                              individuals.

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

SECTION 1. IMPLEMENTATION OF THE TRICARE PROGRAM OF THE DEPARTMENT OF 
              DEFENSE.

    (a) Sense of Senate.--It is the sense of the Senate that--
            (1) the health care program of the Department of Defense, 
        commonly known as TRICARE--
                    (A) reflects a commitment to cooperation between 
                the military departments; and
                    (B) integrates on a regional basis the provision of 
                health care by the military medical treatment 
                facilities under chapter 55 of title 10, United States 
                Code;
            (2) the full implementation of the TRICARE program of the 
        Department will result in the establishment of a system for the 
        delivery of health care by the Department that is cohesive, 
        flexible, and more capable of meeting the requirements of 
        readiness to provide health care in support of military 
        operations and of capacity to provide health care on a routine 
        basis;
            (3) the full implementation of the TRICARE program of the 
        Department will also result in--
                    (A) improved access to health care for individuals 
                eligible to participate in the system; and
                    (B) an enhancement of the capacities of the 
                Department of Defense medical facilities through--
                            (i) control over contractor support of such 
                        facilities;
                            (ii) sharing of resources and 
                        interoperability between the military 
                        departments in the operation of such 
                        facilities; and
                            (iii) cost containment; and
            (4) medicare reimbursement is essential if the TRICARE 
        program of the Department is to compete effectively among 
        providers of health care services nationwide.
    (b) Reimbursement by Medicare for Care Provided to Medicare-
Eligible Individuals.--(1) In the case of a person who is a medicare-
eligible individual and who is provided care in a facility of the 
uniformed services that is certified under subsection (c), the 
Secretary of Health and Human Services shall be responsible for making 
payments to the certified facility under this section on behalf of the 
person.
    (2) The responsibilities of the Secretary of Health and Human 
Services under this subsection shall be in the same amounts and under 
similar terms and conditions under which that Secretary makes payments 
to eligible organizations with a risk-sharing contract under such 
section 1876.
    (3) Upon making payment under this subsection to a certified 
facility on behalf of a person, the obligation of the Secretary of 
Health and Human Services to provide health care services to the person 
shall cease.
    (c) Certification of Facilities.--(1) The Secretary of Defense 
shall certify to the Secretary of Health and Human Services each year--
            (A) a list of all facilities of the uniformed services 
        that--
                    (i) meet or exceed medicare requirements that apply 
                to a public facility; or
                    (ii) fully comply with requirements established by 
                the administering Secretaries that are intended to 
                achieve the same or similar purposes as the 
                requirements referred to in clause (i) and that are no 
                less stringent than such requirements; and
            (B) a list of all health plans conducted by the Secretary 
        of Defense that--
                    (i) meet or exceed medicare HMO requirements that 
                apply to the health plan of a public entity; or
                    (ii) fully comply with requirements established by 
                the administering Secretaries that are intended to 
                achieve the same or similar purposes as the 
                requirements referred to in clause (i) and that are no 
                less stringent than such requirements.
    (2) For purposes of the medicare program--
            (A) a Department health care facility for which there is a 
        certification in effect under paragraph (1)(A) and which 
        provides care to medicare-eligible individuals shall be deemed 
        to be a medicare provider; and
            (B) a health plan for which there is a certification in 
        effect under paragraph (1)(B) and which provides care to 
        medicare-eligible individuals shall be deemed to be a medicare 
        HMO.
    (d) Definitions.--In this section:
            (1) The term ``administering Secretaries'' has the meaning 
        given such term in section 1072(3) of title 10, United States 
        Code.
            (2) The term ``medicare program'' means the health 
        insurance program under title XVIII of the Social Security Act 
        (42 U.S.C. 1395 et seq.).
            (3) The term ``medicare-eligible individual'' means an 
        individual who is entitled to benefits under part A of the 
        medicare program.
            (4) The term ``medicare HMO'' means an eligible 
        organization under section 1876 of the Social Security Act (42 
        U.S.C. 1395mm).
            (5) The term ``medicare provider'' means an individual or 
        entity furnishing items or services for which payments may be 
        made under the medicare program.
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