[Congressional Record Volume 167, Number 190 (Thursday, October 28, 2021)]
[Senate]
[Page S7517]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 4057. Mr. CRUZ submitted an amendment intended to be proposed to 
amendment SA 3867 submitted by Mr. Reed and intended to be proposed to 
the bill H.R. 4350, to authorize appropriations for fiscal year 2022 
for military activities of the Department of Defense, for military 
construction, and for defense activities of the Department of Energy, 
to prescribe military personnel strengths for such fiscal year, and for 
other purposes; which was ordered to lie on the table; as follows:

        At the end of subtitle B of title VII, add the following:

     SEC. 728. IMPROVEMENTS TO PROCESSES TO REDUCE FINANCIAL HARM 
                   CAUSED TO CIVILIANS FOR CARE PROVIDED AT 
                   MILITARY MEDICAL TREATMENT FACILITIES.

       (a) Clarification of Fee Waiver Process.--Section 1079b of 
     title 10, United States Code, is amended--
       (1) by amending subsection (b) to read as follows:
       ``(b) Waiver of Fees.--Each commander (or director, as 
     applicable) of a military medical treatment facility shall 
     issue a waiver for a fee that would otherwise be charged 
     under the procedures implemented under subsection (a) to a 
     civilian provided medical care at the facility who is not a 
     covered beneficiary if the provision of such care enhances 
     the knowledge, skills, and abilities of health care 
     providers, as determined by the respective commander or 
     director.''; and
       (2) by redesignating subsection (c) as subsection (d).
       (b) Modified Payment Plan for Certain Civilians.--
       (1) In general.--Such section is further amended by 
     inserting after subsection (b), as amended by subsection (a), 
     the following:
       ``(c) Modified Payment Plan for Certain Civilians.--(1)(A) 
     If a civilian specified in subsection (a) is covered by a 
     third-party payer, insurance, medical service, or health plan 
     (as those terms are defined in section 1095(h) of this title 
     and in this subsection referred to as a `Payer') at the time 
     care covered by this section is provided, the civilian is 
     only responsible to pay for any services not covered by their 
     Payer, copays, coinsurance, deductibles, or nominal fees.
       ``(B)(i) The Secretary of Defense may bill only the Payer 
     for care provided to a civilian described in subparagraph 
     (A).
       ``(ii) Payment received by the Secretary from the Payer of 
     a civilian for care covered by this section that is provided 
     to the civilian shall be considered payment in full for such 
     care.
       ``(2) If a civilian specified in subsection (a) does not 
     meet the criteria under paragraph (1), is underinsured, or 
     has a remaining balance and is at risk of financial harm, the 
     Secretary of Defense shall reduce each fee that would 
     otherwise be charged to the civilian under this section 
     according to a sliding fee discount program.
       ``(3) If a civilian specified in subsection (a) does not 
     meet the criteria under paragraph (1) or (2), the Secretary 
     of Defense shall implement an additional catastrophic waiver 
     to prevent financial harm.
       ``(4) The modified payment plan under this subsection may 
     not be administered by a Federal agency other than the 
     Department of Defense.''.
       (2) Effective date for payment plan.--The Secretary of 
     Defense shall implement the payment plan established under 
     subsection (c) of section 1079b of title 10, United States 
     Code, as added by paragraph (1), not later than 180 days 
     after the date of the enactment of this Act.
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