[Congressional Record Volume 142, Number 92 (Thursday, June 20, 1996)]
[Senate]
[Page S6613]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          AMENDMENTS SUBMITTED

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      THE NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 1997

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                 GRAMM (AND OTHERS) AMENDMENT NO. 4083

  Mr. GRAMM (for himself, Mr. Roth, Mr. Inouye, Mr. Lott, Mr. Craig, 
Mrs. Hutchison, Mr. Thurmond, Mr. Reid, Mr. Inhofe, Mr. Robb, Mr. 
McConnell, and Mr. Warner) proposed an amendment to the bill (S. 1745) 
to authorize appropriations for fiscal year 1997 for military 
activities of the Department of Defense, for military construction, and 
for defense activities of the Department of Energy, to prescribe 
personnel strengths for such fiscal year for the Armed Forces, and for 
other purposes; as follows:

       At the end of title VII, add the following:

     SEC. 708. PLANS FOR MEDICARE SUBVENTION DEMONSTRATION 
                   PROGRAMS.

       (A) Program for Enrollment in TRICARE Managed Care 
     Option.--(1) Not later than September 6, 1996, the Secretary 
     of Defense and the Secretary of Health and Human Services 
     shall jointly submit to Congress and the President a report 
     that sets forth a specific plan and the Secretaries' 
     recommendations regarding the establishment of a 
     demonstration program under which--
       (A) military retirees who are eligible for medicare are 
     permitted to enroll in the managed care option of the Tricare 
     program; and
       (B) the Secretary of Health and Human Services reimburses 
     the Secretary of Defense from the medicare program on a 
     capitated basis for the costs of providing health care 
     services to military retirees who enroll.
       (2) The report shall include the following:
       (A) The number of military retirees projected to 
     participate in the demonstration program and the minimum 
     number of such participants necessary to conduct the 
     demonstration program effectively.
       (B) A plan for notifying military retirees of their 
     eligibility for enrollment in the demonstration program and 
     for any other matters connected with enrollment.
       (C) A recommendation for the duration of the demonstration 
     program.
       (D) A recommendation for the geographic regions in which 
     the demonstration program should be conducted.
       (E) The appropriate level of capitated reimbursement, and a 
     schedule for such reimbursement, from the medicare program to 
     the Department of Defense for health care services provided 
     enrollees in the demonstration program.
       (F) An estimate of the amounts to be allocated by the 
     Department for the provision of health care services to 
     military retirees eligible for medicare in the regions in 
     which the demonstration program is proposed to be conducted 
     in the absence of the program and an assessment of revisions 
     to such allocation that would result from the conduct of the 
     program.
       (G) An estimate of the cost to the Department and to the 
     medicare program of providing health care services to 
     medicare eligible military retirees who enroll in the 
     demonstration program.
       (H) An assessment of the likelihood of cost shifting among 
     the Department and the medicare program under the 
     demonstration program.
       (I) A proposal for mechanisms for reconciling and 
     reimbursing any improper payments among the Department and 
     the medicare program under the demonstration program.
       (J) A methodology for evaluating the demonstration program, 
     including cost analyses.
       (K) An assessment of the extent to which the Tricare 
     program is prepared to meet requirements of the medicare 
     program for purposes of the demonstration program and the 
     provisions of law or regulation that would have to be waived 
     in order to facilitate the carrying out of the demonstration 
     program.
       (L) An assessment of the impact of the demonstration 
     program on military readiness.
       (M) Contingency plans for the provision of health care 
     services under the demonstration program in the event of the 
     mobilization of health care personnel.
       (N) A recommendation of the reports that the Department and 
     the Department of Health and Human Services should submit to 
     Congress describing the conduct of the demonstration program.
       (b) Feasability Study for Program for Enrollment in TRICARE 
     Fee-For-Fee-Service Option.--Not later than January 3, 1997, 
     the Secretary of Defense and the Secretary of Health and 
     Human Services shall jointly submit to Congress and the 
     President a report on the feasibility and advisability of 
     expanding the demonstration program referred to in subsection 
     (a) so as to provide the Department with reimbursement from 
     the medicare program on a fee-for-service basis for health 
     care services provided medicare-eligible military retirees 
     who enroll in the demonstration program. The report shall 
     include a proposal for the expansion of the program if the 
     expansion is determined to be advisable.
       (c) Authorization of Appropriations.--Of the amounts 
     authorized to be appropriated in section 301, $75,000,000 
     shall be made available to carry out the demonstration 
     program referred to in subsection (a) if Congress authorizes 
     the program by the end of the Second Session of the 104th 
     Congress.

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