[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1413 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 1413

  To amend title XVIII of the Social Security Act to expand and make 
permanent the Medicare demonstration project for military retirees and 
                              dependents.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             April 14, 1999

 Mr. Hefley (for himself, Mr. Ackerman, Mr. Baldacci, Mr. Bartlett of 
  Maryland, Mr. Bereuter, Mr. Boehlert, Mr. Boucher, Mr. Bryant, Mr. 
   Chambliss, Mr. Clement, Mr. Collins, Mr. Condit, Mr. Cooksey, Mr. 
 DeFazio, Ms. DeGette, Mr. Deutsch, Mr. Diaz-Balart, Mr. Dickey, Mrs. 
     Emerson, Mr. English, Mr. Farr of California, Mr. Filner, Mr. 
 Frelinghuysen, Mr. Frost, Mr. Gallegly, Mr. Goodlatte, Mr. Goodling, 
    Mr. Hansen, Mr. Hilleary, Mrs. Kelly, Mr. LaHood, Mr. Lucas of 
   Oklahoma, Mr. Luther, Mr. McCollum, Mr. McGovern, Mr. McHugh, Mr. 
 McKeon, Mr. Metcalf, Mr. Gary Miller of California, Mr. Norwood, Mr. 
   Oberstar, Mr. Olver, Mr. Packard, Mr. Pallone, Mr. Pascrell, Mr. 
Peterson of Pennsylvania, Mr. Pickering, Mr. Saxton, Mr. Sensenbrenner, 
   Mr. Shows, Mr. Smith of Washington, Mr. Spratt, Mr. Tancredo, Mr. 
 Tanner, Mr. Taylor of North Carolina, Mr. Taylor of Mississippi, Mrs. 
Thurman, Mr. Traficant, Mr. Underwood, Mr. Wamp, Mr. Watts of Oklahoma, 
   Mr. Weller, Mr. Whitfield, Ms. Woolsey, Mr. Young of Alaska, Mr. 
  Stupak, Mr. Stump, and Mr. Capuano) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addition 
     to the Committee on Commerce, for a period to be subsequently 
   determined by the Speaker, in each case for consideration of such 
 provisions as fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To amend title XVIII of the Social Security Act to expand and make 
permanent the Medicare demonstration project for military retirees and 
                              dependents.

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

SECTION 1. MEDICARE SUBVENTION PROJECT FOR MILITARY RETIREES AND 
              DEPENDENTS.

    (a) Expansion of Sites.--
            (1) Expansion to 16 sites.--Effective January 1, 2000, 
        subsection (b)(2) of section 1896 of the Social Security Act 
        (42 U.S.C. 1395ggg) is amended by striking ``6'' and inserting 
        ``16''.
            (2) Future repeal of limitation on number of sites.--
        Effective October 1, 2002, paragraph (2) of section 1896(b) of 
        such Act is amended to read as follows:
    ``(2) Location of sites.--The program shall be conducted in any 
site designated jointly by the administering Secretaries.''.
    (b) Making Project Permanent; Changes in Project References.--
            (1) Elimination of time limitation.--Paragraph (4) of 
        section 1896(b) of such Act is repealed.
            (2) Treatment of caps.--Subsection (i)(4) of section 1896 
        of such Act is amended by adding at the end the following:
            ``This paragraph shall not apply after calendar year 
        2000.''.
            (3) Conforming changes of references to demonstration 
        project.--Section 1896 of such Act is further amended--
                    (A) in the heading, by striking ``demonstration 
                project'' and inserting ``program'';
                    (B) by amending subsection (a)(2) to read as 
                follows:
    ``(2) Program.--The term `program' means the program carried out 
under this section.'';
                    (C) in the heading to subsection (b), by striking 
                ``Demonstration Project'' and inserting ``Program'';
                    (D) by striking ``demonstration project'' or 
                ``project'' each place either appears and inserting 
                ``program'';
                    (E) in subsection (k)(2)--
                            (i) by striking ``extension and expansion 
                        of demonstration project'' and inserting 
                        ``program''; and
                            (ii) by striking subparagraphs (A) through 
                        (C) and inserting the following:
                    ``(A) whether there is a cost to the health care 
                program under this title in conducting the program 
                under this section; and
                    ``(B) whether the terms and conditions of the 
                program should be modified.''.
            (4) Additional conforming amendment.--Paragraph (5) of 
        section 1896(b) of such Act is repealed.
    (c) Permitting Payment on a Fee-for-Service Basis.--
            (1) In general.--Section 1896 of the Social Security Act is 
        further amended by adding at the end the following new 
        subsection:
    ``(l) Payment on a Fee-for-Service Basis.--Instead of the payment 
method described in subsection (i)(1) and in the case of individuals 
who are not enrolled in the program in the manner described in 
subsection (d)(1), the Secretary may reimburse the Secretary of Defense 
for services provided under the program at a rate that does not exceed 
the rate of payment that would otherwise be made under this title for 
such services if sections 1814(c) and 1835(d), and paragraphs (2) and 
(3) of section 1862(a), did not apply.''.
            (2) Conforming amendments.--Such section is further 
        amended--
                    (A) in subsections (b)(1)(B)(v) and 
                (b)(1)(B)(viii)(I), by inserting ``or subsection (l)'' 
                after ``subsection (i)';
                    (B) in subsection (b)(2), by adding at the end the 
                following: ``If feasible, at least one of the sites 
shall be conducted using the fee-for-service reimbursement method 
described in subsection (l).'';
                    (C) in subsection (d)(1)(A), by inserting 
                ``(insofar as it provides for the enrollment of 
                individuals and payment on the basis described in 
                subsection (i))'' before ``shall meet'';
                    (D) in subsection (d)(1)(A), by inserting ``and the 
                program (insofar as it provides for payment for 
                facility services on the basis described in subsection 
                (l)) shall meet all requirements for such facilities 
                under this title'' after ``medicare payments'';
                    (E) in subsection (d)(2), by inserting ``, insofar 
                as it provides for the enrollment of individuals and 
                payment on the basis described in subsection (i),'' 
                before ``shall comply'';
                    (F) in subsection (g)(1), by inserting ``, insofar 
                as it provides for the enrollment of individuals and 
                payment on the basis described in subsection (i),'' 
                before ``the Secretary of Defense'';
                    (G) in subsection (i)(1), by inserting ``and 
                subsection (l)'' after ``of this subsection'';
                    (H) in subsection (i)(4), by inserting ``and 
                subsection (l)'' after ``under this subsection''; and
                    (I) in subsection (j)(2)(B)(ii), by inserting ``or 
                subsection (l)'' after ``subsection (i)(1)''.
            (3) Effective date.--The amendments made by this subsection 
        take effect on January 1, 2000, and apply to services furnished 
        on or after such date.
    (d) Elimination of Restriction on Eligibility.--Section 1896(b)(1) 
of such Act is amended by adding at the end the following new 
subparagraph:
                    ``(C) Elimination of restrictive policy.--If the 
                enrollment capacity in the program has been reached at 
                a particular site designated under paragraph (2) and 
                the Secretary therefore limits enrollment at the site 
                to medicare-eligible military retirees and dependents 
                who are enrolled in TRICARE Prime (as defined for 
                purposes of chapter 55 of title 10, United States Code) 
                at the site immediately before attaining 65 years of 
                age, participation in the program by a retiree or 
                dependent at such site shall not be restricted based on 
                whether the retiree or dependent has a civilian primary 
                care manager instead of a military primary care 
                manager.''.
    (e) Medigap Protection for Enrollees.--Section 1896 of such Act is 
further amended by adding at the end the following new subsection:
    ``(m) Medigap Protection for Enrollees.--(1) Subject to paragraph 
(2), the provisions of section 1882(s)(3) (other than clauses (i) 
through (iv) of subparagraph (B)) and 1882(s)(4) of the Social Security 
Act shall apply to any enrollment (and termination of enrollment) in 
the program (for which payment is made on the basis described in 
subsection (i)) in the same manner as they apply to enrollment (and 
termination of enrollment) with a Medicare+Choice organization in a 
Medicare+Choice plan.
    ``(2) In applying paragraph (1)--
            ``(A) in the case of enrollments occurring before January 
        1, 2000, any reference in clause (v) or (vi) of section 
        1882(s)(3)(B) of such Act to 12 months is deemed a reference to 
        the period ending on December 31, 2000; and
            ``(B) the notification required under section 1882(s)(3)(D) 
        of such Act shall be provided in a manner specified by the 
        Secretary of Defense in consultation with the Director of the 
        Office of Personnel Management.''.
                                 <all>