[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 166 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                 S. 166

 To amend section 1086 of title 10, United States Code, to provide for 
   payment under CHAMPUS of certain health care expenses incurred by 
certain members and former members of the uniformed services and their 
   dependents to the extent that such expenses are not payable under 
                   Medicare, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 21, 1997

  Mr. Inouye introduced the following bill; which was read twice and 
              referred to the Committee on Armed Services

_______________________________________________________________________

                                 A BILL


 
 To amend section 1086 of title 10, United States Code, to provide for 
   payment under CHAMPUS of certain health care expenses incurred by 
certain members and former members of the uniformed services and their 
   dependents to the extent that such expenses are not payable under 
                   Medicare, and for other purposes.

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

SECTION 1. EXPANSION OF MEDICARE EXCEPTION TO THE PROHIBITION OF 
              CHAMPUS COVERAGE FOR CARE COVERED BY ANOTHER HEALTH CARE 
              PLAN.

    (a) Amendment and Reorganization of Exceptions.--Subsection (d) of 
section 1086 of title 10, United States Code, is amended to read as 
follows:
    ``(d)(1) Section 1079(j) of this title shall apply to a plan 
contracted for under this section except as follows:
            ``(A) Subject to paragraph (2), a benefit may be paid under 
        such plan in the case of a person referred to in subsection (c) 
        for items and services for which payment is made under title 
        XVIII of the Social Security Act.
            ``(B) No person eligible for health benefits under this 
        section may be denied benefits under this section with respect 
        to care or treatment for any service-connected disability which 
        is compensable under chapter 11 of title 38 solely on the basis 
        that such person is entitled to care or treatment for such 
        disability in facilities of the Department of Veterans Affairs.
    ``(2) If a person described in paragraph (1)(A) receives medical or 
dental care for which payment may be made under both title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.) and a plan contracted for 
under subsection (a), the amount payable for that care under the plan 
may not exceed the difference between--
            ``(A) the sum of any deductibles, coinsurance, and balance 
        billing charges that would be imposed on the person if payment 
        for that care were made solely under that title; and
            ``(B) the sum of any deductibles, coinsurance, and balance 
        billing charges that would be imposed on the person if payment 
        for that care were made solely under the plan.
    ``(3) A plan contracted for under this section shall not be 
considered a group health plan for the purposes of paragraph (2) or (3) 
of section 1862(b) of the Social Security Act (42 U.S.C. 1395y(b)).
    ``(4) A person who, by reason of the application of paragraph (1), 
receives a benefit for items or services under a plan contracted for 
under this section shall provide the Secretary of Defense with any 
information relating to amounts charged and paid for the items and 
services that, after consulting with the other administering 
Secretaries, the Secretary requires. A certification of such person 
regarding such amounts may be accepted for the purposes of determining 
the benefit payable under this section.''.
    (b) Repeal of Superseded Provision.--Such section is further 
amended--
            (1) by striking out subsection (g); and
            (2) by redesignating subsection (h) as subsection (g).

SEC. 2. CONFORMING AMENDMENT.

    Section 1713(d) of title 38, United States Code, is amended by 
striking out ``section 1086(d)(1) of title 10 or''.

SEC. 3. EFFECTIVE DATE.

    The amendments made by this Act shall take effect with respect to 
health care items or services provided on and after the date of 
enactment of this Act.
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