[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3655 Introduced in House (IH)]







106th CONGRESS
  2d Session
                                H. R. 3655

    To make certain improvements to the military health care system.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           February 15, 2000

 Mr. Abercrombie (for himself, Mr. Skelton, Mr. Taylor of Mississippi, 
 Mr. Larson, Mr. Reyes, Mr. Thompson of California, Mrs. Tauscher, Mr. 
Maloney of Connecticut, Ms. McKinney, Mr. Turner, Mr. Kennedy of Rhode 
Island, Mr. Ortiz, Ms. Sanchez, Mr. Rodriguez, Mr. Smith of Washington, 
 Mr. Underwood, and Mr. Sisisky) introduced the following bill; which 
was referred to the Committee on Ways and Means, and in addition to the 
 Committees on Armed Services, Commerce, and Government Reform, 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 make certain improvements to the military health care system.

    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 ``Improved Medical Care for Troops and 
Retirees Act''.

SEC. 2. MEDICARE SUBVENTION PROJECT FOR MILITARY RETIREES AND 
              DEPENDENTS.

    (a) Future Repeal of Limitation on Number of Sites.--Effective 
January 1, 2001, paragraph (2) of section 1896(b) of section 1896 of 
the Social Security Act (42 U.S.C. 1395ggg) is amended to read as 
follows:
    ``(2) Location of Sites.--The program shall be conducted in any 
site designated jointly by the administering Secretaries, and shall be 
conducted nationwide by January 1, 2006.''.
    (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        section 1896(b) of such Act is repealed.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 
        2001.''.
            (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) Reports.--Subsection (k)(1) of section 1896 is amended 
        in the second sentence--
                    (A) by striking ``the demonstration project'' and 
                inserting ``the program'';
                    (B) by striking ``, and the'' and all that follows 
                through ``date'';
                    (C) by redesignating subparagraph (O) as 
                subparagraph (P); and
                    (D) by inserting after subparagraph (N) the 
                following new subparagraph:
                    ``(O) Patient satisfaction with the program.''.
            (5) Additional conforming amendments.--Section 1896(b) of 
        such Act is further amended--
                    (A) by redesignating paragraph (5) as paragraph 
                (4); and
                    (B) by striking ``At least 60 days'' and all that 
                follows through ``agreement'' and inserting ``The 
                administering Secretaries shall submit on an annual 
                basis the most current agreement''.
            (6) Continuation of provision of care.--Section 1896(b) of 
        such Act is further amended by adding at the end the following 
        new paragraph:
            ``(6) Continuation of provision of care.--With respect to 
        any individual who receives health care benefits under this 
        section before the date of the enactment of this paragraph, the 
        administering Secretaries shall not terminate such benefits 
        unless the individual ceases to fall within the definition of 
        the term `medicare-eligible military retiree or dependent' (as 
        defined in subsection (a)).''.
    (c) Payments.--
            (1) Permitting payments on a fee-for-service basis.--
        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) Payments to military treatment facilities.--Such 
        section is further amended by adding at the end the following 
        new subsection:
    ``(m) Payments to Military Treatment Facilities.--The Secretary of 
Defense shall reimburse military treatment facilities for the provision 
of health care under this section.''.
            (3) 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, 2001, 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, 2001, 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, 2001; 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.''.
    (f) Reimbursement Rates.--Section 1896 of such Act is further 
amended in subsection (i)(1) by striking ``95 percent of''.

SEC. 3. EXTENSION OF FEHBP DEMONSTRATION PROGRAM.

    Section 1108 of title 10, United States Code, is amended--
            (1) in subsection (b), by adding at the end the following 
        new paragraph:
    ``(6) With respect to any individual who enrolls in the program 
under this section and does not elect to discontinue enrollment, the 
Secretary shall not terminate the enrollment of such individual after 
the termination of the demonstration project unless the individual 
ceases to meet the requirements described in subsection (b)(1).'';
            (2) in subsection (d)--
                    (A) in paragraph (1), by striking ``three'' and 
                inserting ``four''; and
                    (B) in paragraph (2), by striking ``2002'' and 
                inserting ``2003'';
            (3) in subsection (f)(1), by striking ``three'' and 
        inserting ``four'';
            (4) in subsections (j)(1) and (k), by striking ``2002'' and 
        inserting ``2003''; and
            (5) in subsection (l)(2), by striking ``36 months'' and 
        inserting ``48 months''.

SEC. 4. COVERAGE OF FAMILY MEMBERS UNDER SUPPLEMENTAL CARE PROGRAM FOR 
              MEMBERS ASSIGNED TO CERTAIN DUTY LOCATIONS FAR FROM 
              SOURCES OF CARE.

    Section 731(b) of the National Defense Authorization Act for Fiscal 
Year 1998 (Public Law 105-85; 10 U.S.C. 1074 note) is amended by adding 
at the end the following new paragraph:
            ``(4) A family member of a member described in subsection 
        (c) shall also be eligible to receive the care described in 
        subsection (a). For purposes of this subsection, the term 
        `family member' shall have the same meaning as the term 
        `dependent', as defined for purposes of title 10, United States 
        Code.''.

SEC. 5. EXPANSION OF PHARMACY PROGRAM.

    Section 723 of the Strom Thurmond National Defense Authorization 
Act for Fiscal Year 1999 (Public Law 105-261; 10 U.S.C. 1073 note) is 
amended--
            (1) in subsection (a), by striking ``who reside in an area 
        selected under subsection (f)'';
            (2) by amending subsection (f) to read as follows:
    ``(f) Benefits To Be Offered.--The pharmacy benefits provided under 
the redesigned system implemented under this section shall be at least 
equivalent to the pharmacy benefits provided under section 702 of the 
National Defense Authorization Act for Fiscal Year 1993 (Public Law 
102-484; 10 U.S.C. 1079 note).''; and
            (3) by adding at the end the following new subsection:
    ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section--
            ``(1) $455,000,000 for fiscal year 2001; and
            ``(2) $485,000,000 for fiscal year 2002.''.

SEC. 6. IMPROVEMENTS UNDER THE TRICARE PROGRAM.

    (a) Elimination of Copayments Under TRICARE Prime.--(1) Chapter 55 
of title 10, United States Code, is amended in section 1095d by adding 
at the end the following new subsection:
    ``(c) Termination of Copayments for Certain Covered 
Beneficiaries.--The Secretary may not require a member of the uniformed 
services on active duty, or the dependent of such a member, to pay a 
copayment for health care services received under TRICARE Prime.''.
    (2) The heading of such section is amended to read as follows:
``Sec. 1095d. TRICARE program: waiver of certain deductibles and 
              copayments''.
    (3) The item relating to section 1095d in the table of sections at 
the beginning of such chapter 55 is amended to read as follows:

``1095d. TRICARE program: waiver of certain deductibles and 
                            copayments.''.
    (b) Elimination of Non-Availability Statement Requirement; 
Reduction of Catastrophic Cap.--Chapter 55 of title 10, United States 
Code, is amended by inserting after section 1095e the following new 
section:
``Sec. 1095f. TRICARE Program: non-availability statement; catastrophic 
              cap
    ``(a) Prohibition on Requirement To Obtain Non-Availability 
Statement.--The Secretary shall not require a covered beneficiary to 
obtain a non-availability statement in order to receive health care 
services under TRICARE Standard.
    ``(b) Reduction of Catastrophic Cap.--The Secretary shall reduce 
the catastrostrophic cap for covered beneficiaries under TRICARE 
Standard and TRICARE Extra to $3,000.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 1095e the 
following new item:

``1095f. TRICARE Program: Non-Availability Statement; Catastrophic 
                            Cap.''.

SEC. 7. REIMBURSEMENT FOR CERTAIN TRAVEL EXPENSES.

    (a) In General.--Chapter 55 of title 10, United States Code, is 
amended by inserting after section 1074g the following new section:
``Sec. 1074h. Reimbursement for certain travel expenses
    ``In any case in which a covered beneficiary is referred by a 
primary care physician to a specialty care provider who provides 
services more than 100 miles from the location in which the primary 
care provider provides services to the member, the Secretary shall 
provide reimbursement for reasonable travel expenses for the covered 
beneficiary.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end the following new item:

``1074h. Reimbursement for certain travel expenses.''.
                                 <all>