[House Report 106-624]
[From the U.S. Government Publishing Office]
106th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 106-624
=======================================================================
PROVIDING FOR THE FURTHER CONSIDERATION OF H.R. 4205, THE NATIONAL
DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2001
_______
May 17, 2000.--Referred to the House Calendar and ordered to be printed
_______
Mrs. Myrick, from the Committee on Rules, submitted the following
R E P O R T
[To accompany H. Res. 504]
The Committee on Rules, having had under consideration
House Resolution 504, by a nonrecord vote, report the same to
the House with the recommendation that the resolution be
adopted.
summary of provisions of the resolution
The resolution provides for further consideration of H.R.
4205, the National Defense Authorization Act for Fiscal Year
2001, under a structured rule.
The rule provides that no further amendment to the
committee amendment in the nature of a substitute shall be in
order except those printed in this report and pro forma
amendments offered by the chairman or ranking minority member
of the Committee on Armed Services for the purpose of debate.
The rule further provides that, except as specified in section
4 of the resolution, each amendment printed in this report
shall be considered only in the order printed in this report,
may be offered only by a Member designated in this report,
shall be considered as read, and shall not be subject to a
demand for division of the question in the House or in the
Committee of the Whole. The rule provides that each amendment
printed in this report shall be debatable for the time
specified in this report equally divided and controlled by the
proponent and an opponent and shall not be subject to amendment
(except as specified in this report and except that the
chairman and ranking minority member of the Committee on Armed
Services may each offer one pro forma amendment for the purpose
of debate on any pending amendment).
The rule waives all points of order against the amendments
printed in this report. The rule allows the Chairman of the
Committee of the Whole to postpone until a time during further
consideration of the bill a request for a recorded vote on any
amendment and to reduce voting time to five minutes on a
postponed question if the vote follows a fifteen minute vote.
The rule further allows the Chairman of the Committee of the
Whole to recognize for the consideration of any amendment
printed in this report out of the order printed, but not sooner
than one hour after the chairman of the Committee on Armed
Services or a designee announces from the floor a request to
that effect. Finally, the rule provides one motion to recommit
with or without instructions.
committee votes
Pursuant to clause 3(b) of House rule XIII the results of
each record vote on an amendment or motion to report, together
with the names of those voting for and against, are printed
below:
Rules Committee record vote No. 100
Date: May 17, 2000.
Measure: H.R. 4205, National Defense Authorization Act for
Fiscal Year 2001.
Motion by: Mr. Moakley.
Summary of motion: To make in order the Allen/McGovern/
Gejdenson amendment to give the Pentagon the flexibility to
retire or dismantle strategic nuclear delivery systems that are
in excess of the military requirements, contingent on a
Presidential certification that such reductions do not
undermine our nuclear deterrent or continued Russian
dismantlement of strategic nuclear delivery systems. The
amendment also extends the certification currently available to
Trident submarines to other delivery systems.
Results: Defeated 1 to 6.
Votes by Members: Goss--Nay; Pryce--Nay; Hastings--Nay;
Sessions--Nay; Reynolds--Nay; Moakley--Yea; Dreier--Nay.
Rules Committee record vote No. 101
Date: May 17, 2000.
Measure: H.R. 4205, National Defense Authorization Act for
Fiscal Year 2001.
Motion by: Mr. Moakley.
Summary of motion: To make in order the Shows amendment
which deletes language in the bill which would extend military
retiree health care test programs and create a commission to
study military retiree health care issues. The amendment
includes providing the option of fully paid FEHBP coverage to
military retirees who entered the service prior to June 7,
1956, and allows all military retirees the option of
participating in FEHBP, or remaining in TRICARE after age 65.
Participation is capped at 300,000 retirees with preference
given to those who are Medicare eligible. The amendment also
addresses cost and funding issues.
Results: Defeated 1 to 6.
Vote by Members: Goss--Nay; Pryce--Nay; Hastings--Nay;
Sessions--Nay; Reynolds--Nay; Moakley--Yea; Dreier--Nay.
Rules Committee record vote No. 102
Date: May 17, 2000.
Measure: H.R. 4205, National Defense Authorization Act for
FY 2001.
Motion by: Mr. Moakley.
Summary of motion: To make in order the McCarthy (NY)
amendment which strikes Section 810 of the bill, which would
prohibit DoD from making preferences of firearms vendors based
on their decision to abide by a certain code of conduct.
Results: Defeated 1 to 6.
Vote by Members: Goss--Nay; Pryce--Nay; Hastings--Nay;
Sessions--Nay; Reynolds--Nay; Moakley--Yea; Dreier--Nay.
Rules Committee record vote No. 103
Date: May 17, 2000.
Measure: H.R. 4205, National Defense Authorization Act for
Fiscal Year 2001.
Motion by: Mr. Moakley.
Summary of motion: To make in order, en bloc, amendments
by: Representative Berkley to compensate employees at DoE for
occupational illnesses; Representative Hill to allow no cost
economic development conveyances for non-BRAC military
installations and to establish fair procedures for communities
that may have lost installations; Representative Hoeffel to
authorize a $1.5 million study to identify DoD technologies
that could be used by civilians; Representative Rodriguez to
authorize a DoD grant program for school construction;
Representative Gonzalez to authorize a DoD loan program for
school construction; Representative Berman to authorize $1
million for Middle East arms control dialogues; Representatives
Andrews and Weldon (PA) to accelerate the tracking and
identification of computer hackers; Representative Baca to
mandate that Congressional Medals of Honor be made of at least
ninety percent gold; and Representatives Frank and DeFazio
expressing the Sense of Congress in support of our European
Allies creating an integrated military force.
Results: Defeated 1 to 6.
Vote by Members: Goss--Nay; Pryce--Nay; Hastings--Nay;
Sessions--Nay; Reynolds--Nay; Moakley--Yea; Dreier--Nay.
summary of amendments made in order under this rule
Sanchez/Morella/Lowey--Restores equal access to health
services at overseas military hospitals to servicemen and women
and their dependents stationed overseas (20 minutes)
Moakley/Campbell/McGovern/Scarborough--Repeals authority
for the School of the Americas and authorizes a Congressional
task force to critically assess training of Latin American
soldiers by the U.S. and report its findings to Congress. (40
minutes)
Cox/Markey--Blocks any United States Government entity from
entering into arrangements to accept liability or extend an
indemnity for nuclear accidents occurring in North Korea. (30
minutes)
Skelton--Strikes Title XV of the bill as reported, and
substitutes language which would authorize the conveyance of
the land at the western end of the island of Vieques, with
certain exceptions, and in accordance with the President's
negotiated position with the government of Puerto Rico. (30
minutes)
Whitfield/Strickland/Kanjorski/Wamp/Gibbons/Udall (CO)--
Expresses the sense of Congress that workers at DoE nuclear
weapons facilities and at vendor site were exposed to
beryllium, radiation, silica and other toxic materials without
their knowledge and that those same workers are now
experiencing increased incidents of illness and death resulting
from that exposure. (20 minutes)
Taylor (MS)/Abercrombie/Bartlett/Jones (NC)--Expands and
makes permanent an existing DoD TRICARE Senior Prime
demonstration program, more commonly known as Medicare
Subvention (30 minutes)
Buyer--Substitute amendment to the Taylor (MS)/Abercrombie/
Bartlett/Jones (NC) amendment. Expands the current Medicare
subvention demonstration program to up to seven additional
sites and up to 13 additional military treatment facilities.
(30 minutes)
text of amendments made in order under the rule
1. An Amendment To Be Offered by Representative Sanchez of California,
or Representative Morella of Maryland, or a Designee, Debatable for 20
Minutes
At the end of title VII (page 247, after line 9), insert the
following new section:
SEC. 7____. RESTORATION OF PRIOR POLICY REGARDING RESTRICTIONS ON USE
OF DEPARTMENT OF DEFENSE MEDICAL FACILITIES.
Section 1093 of title 10, United States Code, is amended--
(1) by striking out ``(a) Restriction on Use of
Funds.--''; and
(2) by striking out subsection (b).
----------
2. An Amendment To Be Offered by Representative Moakley of
Massachusetts, or Representative Campbell of California, or a Designee,
Debatable for 40 Minutes
Strike section 908 (page 285, line 6 through page 289, line
8) and insert the following:
SEC. 908. REPEAL OF AUTHORITY FOR UNITED STATES ARMY SCHOOL OF THE
AMERICAS.
(a) Closure of School of the Americas.--The Secretary of the
Army shall close the United States Army School of the Americas.
(b) Repeal.--(1) Section 4415 of title 10, United States
Code, is repealed.
(2) The table of sections at the beginning of chapter 407 of
such title is amended by striking the item relating to section
4415.
(c) Limitation on Establishment of New Education and Training
Facility.--No training or education facility may be established
in the Department of Defense for Latin American military
personnel (as a successor to the United States Army School of
the Americas or otherwise) until the end of the ten-month
period beginning on the date of the enactment of this Act.
(d) Task Force.--(1) There is established a task force to
conduct an assessment of the kind of education and training
that is appropriate for the Department of Defense to provide to
military personnel of Latin American nations.
(2) The task force shall be composed of eight Members of
Congress, of whom two each shall be designated by the Speaker
of the House of Representatives, the minority leader of the
House of Representatives, the majority leader of the Senate,
and the minority leader of the Senate.
(3) Not later than six months after the date of the enactment
of this Act, the task force shall submit to Congress a report
on its assessment as specified in paragraph (1). The report
shall include--
(A) a critical assessment of courses, curriculum and
procedures appropriate for such education and training;
and
(B) an evaluation of the effect of such education and
training on the performance of Latin American military
personnel in the areas of human rights and adherence to
democratic principles and the rule of law.
(4) In this subsection, the term ``Member'' includes a
Delegate to, or Resident Commissioner, in the Congress.
----------
3. An Amendment To Be Offered by Representative Cox of California, or
Representative Markey of Massachusetts, or a Designee, Debatable for 30
Minutes
At the end of title XII (page 338, after line 13), insert the
following new section:
SEC. 1205. PROHIBITION ON ASSUMPTION BY UNITED STATES GOVERNMENT OF
LIABILITY FOR NUCLEAR ACCIDENTS IN NORTH KOREA.
Neither the President nor any department, agency, or
instrumentality of the United States Government may use the
authority of Public Law 85-804 (50 U.S.C. 1431) or any other
provision of law to enter into any contract or other
arrangement, or into any amendment or modification of a
contract or other arrangement, the purpose or effect of which
would be to impose liability on the United States Government,
or otherwise require an indemnity by the United States
Government, for nuclear accidents occurring in North Korea.
----------
4. An Amendment To Be Offered by Representative Skelton of Missouri, or
a Designee, Debatable for 30 Minutes
Strike title XV (page 354, line 6, through page 359, line
16) and insert the following:
TITLE XV--LAND CONVEYANCE REGARDING VIEQUES ISLAND, PUERTO RICO
SEC. 1501. CONVEYANCE OF NAVAL AMMUNITION SUPPORT DETACHMENT, VIEQUES
ISLAND.
(a) Conveyance Required.--
(1) Property to be conveyed.--(1) Subject to
subsection (b), the Secretary of the Navy shall convey,
without consideration, to the Commonwealth of Puerto
Rico all right, title, and interest of the United
States in and to the land constituting the Naval
Ammunition Support detachment located on the western
end of Vieques Island, Puerto Rico.
(2) Time for conveyance.--The Secretary of the Navy
shall complete the conveyance required by paragraph (1)
not later than December 31, 2000.
(3) Purpose of conveyance.--The conveyance under
paragraph (1) is being made for the benefit of the
Municipality of Vieques, Puerto Rico, as determined by
the Planning Board of the Commonwealth of Puerto Rico.
(b) Reserved Property Not Subject to Conveyance.--
(1) Radar and communications facilities.--The
conveyance required by subsection (a) shall not include
that portion of the Naval Ammunition Support detachment
consisting of the following:
(A) Approximately 100 acres on which is
located the Relocatable Over-the-Horizon Radar
and the Mount Pirata telecommunications
facilities.
(B) Such easements, rights-of-way, and other
interests retained by the Secretary of the Navy
as the Secretary considers necessary--
(i) to provide access to the property
retained under subparagraph (A);
(ii) for the provision of utilities
and security for the retained property;
and
(iii) for the effective maintenance
and operation of the retained property.
(2) Other sites.--The United States may retain such
other interests in the property conveyed under
subsection (a) as--
(A) the Secretary of the Navy considers
necessary, in the discharge of responsibilities
under subsection (d), to protect human health
and the environment; and
(B) the Secretary of the Interior considers
necessary to discharge responsibilities under
subsection (f), as provided in the co-
management agreement referred to in such
subsection.
(c) Description of Property.--The Secretary of the Navy, in
consultation with the Secretary of the Interior on issues
relating to natural resource protection under subsection (f),
shall determine the exact acreage and legal description of the
property required to be conveyed pursuant to subsection (a),
including the legal description of any easements, rights of
way, and other interests that are retained pursuant to
subsection (b).
(d) Environmental Restoration.--
(1) Objective of conveyance.--An important objective
of the conveyance required by this section is to
promote timely redevelopment of the conveyed property
in a manner that enhances employment opportunities and
economic redevelopment, consistent with all applicable
environmental requirements and in full consultation
with the Governor of Puerto Rico, for the benefit of
the residents of Vieques Island.
(2) Conveyance despite response need.--If the
Secretary of the Navy, by December 31, 2000, is unable
to provide the covenant required by section
120(h)(3)(A)(ii)(I) of the Comprehensive Environmental
Response, Compensation and Liability Act of 1980 (42
U.S.C. 9620(h)(3)(A)(ii)(I)) with respect to the
property to be conveyed, the Secretary shall still
complete the conveyance by that date, as required by
subsection (a)(2). The Secretary shall remain
responsible for completing all response actions
required under such Act. The completion of the response
actions shall not be delayed on account of the
conveyance.
(3) Continued navy responsibility.--The Secretary of
the Navy shall remain responsible for the environmental
condition of the property, and the Commonwealth of
Puerto Rico shall not be responsible for any condition
existing at the time of the conveyance.
(4) Savings clause.--All response actions with
respect to the property to be conveyed shall take place
in compliance with current law.
(e) Indemnification.--
(1) Entities and persons covered; extent.--(A) Except
as provided in subparagraph (C), and subject to
paragraph (2), the Secretary of Defense shall hold
harmless, defend, and indemnify in full the persons and
entities described in subparagraph (B) from and against
any suit, claim, demand or action, liability, judgment,
cost or other fee arising out of any claim for personal
injury or property damage (including death, illness, or
loss of or damage to property or economic loss) that
results from, or is in any manner predicated upon, the
release or threatened release of any hazardous
substance or pollutant or contaminant as a result of
Department of Defense activities at those parts of the
Naval Ammunition Support detachment conveyed pursuant
to subsection (a).
(B) The persons and entities described in this
paragraph are the following:
(i) The Commonwealth of Puerto Rico
(including any officer, agent, or employee of
the Commonwealth of Puerto Rico), once Puerto
Rico acquires ownership or control of the Naval
Ammunition Support Detachment by the conveyance
under subsection (a).
(ii) Any political subdivision of the
Commonwealth of Puerto Rico (including any
officer, agent, or employee of the Commonwealth
of Puerto Rico) that acquires such ownership or
control.
(iii) Any other person or entity that
acquires such ownership or control.
(iv) Any successor, assignee, transferee,
lender, or lessee of a person or entity
described in clauses (i) through (iii).
(C) To the extent the persons and entities described
in subparagraph (B) contributed to any such release or
threatened release, subparagraph (A) shall not apply.
(2) Conditions on indemnification.--No
indemnification may be afforded under this subsection
unless the person or entity making a claim for
indemnification--
(A) notifies the Secretary of Defense in
writing within two years after such claim
accrues or begins action within six months
after the date of mailing, by certified or
registered mail, of notice of final denial of
the claim by the Secretary of Defense;
(B) furnishes to the Secretary of Defense
copies of pertinent papers the entity receives;
(C) furnishes evidence of proof of any claim,
loss, or damage covered by this subsection; and
(D) provides, upon request by the Secretary
of Defense, access to the records and personnel
of the entity for purposes of defending or
settling the claim or action.
(3) Responsibilities of secretary of defense.--(A) In
any case in which the Secretary of Defense determines
that the Department of Defense may be required to make
indemnification payments to a person under this
subsection for any suit, claim, demand or action,
liability, judgment, cost or other fee arising our of
any claim for personal injury or property damage
referred to in paragraph (1)(A), the Secretary may
settle or defend, on behalf of that person, the claim
for personal injury or property damage.
(B) In any case described in subparagraph (A), if the
person to whom the Department of Defense may be
required to make indemnification payments does not
allow the Secretary of Defense to settle or defend the
claim, the person may not be afforded indemnification
with respect to that claim under this subsection.
(4) Accrual of action.--For purposes of paragraph
(2)(A), the date on which a claim accrues is the date
on which the plaintiff knew (or reasonably should have
known) that the personal injury or property damage
referred to in paragraph (1) was caused or contributed
to by the release or threatened release of a hazardous
substance or pollutant or contaminant as a result of
Department of Defense activities at any part of the
Naval Ammunition Support Detachment conveyed pursuant
to subsection (a).
(5) Relationship to other laws.--Nothing in this
subsection shall be construed as affecting or modifying
in any way subsection 120(h) of the Comprehensive
Environmental Response, Compensation, and Liability Act
of 1980 (42 U.S.C. 9620(h)).
(6) Definitions.--In this subsection, the terms
``hazardous substance'', ``release'', and ``pollutant
or contaminant'' have the meanings given such terms
under paragraphs (9), (14), (22), and (33) of section
101 of the Comprehensive Environmental Response,
Compensation, and Liability Act of 1980 (42 U.S.C.
9601).
(f) Management.--
(1) Co-management of conservation zones.--Those areas
on the western end of the Vieques Island designated as
Conservation Zones in section IV of the 1983 Memorandum
of Understanding between the Commonwealth of Puerto
Rico and the Secretary of the Navy shall be subject to
a co-management agreement among the Commonwealth of
Puerto Rico, the Puerto Rico Conservation Trust and the
Secretary of the Interior. Areas adjacent to these
Conservation Zones shall also be considered for
inclusion under the co-management agreement. Adjacent
areas to be included under the co-management agreement
shall be mutually agreed to by the Commonwealth of
Puerto Rico and the Secretary of the Interior. This
determination of inclusion of lands shall be
incorporated into the co-management agreement process
as set forth in paragraph (2). In addition, the Sea
Grass Area west of Mosquito Pier, as identified in the
1983 Memorandum of Understanding, shall be included in
the co-management plan to be protected under the laws
of the Commonwealth of Puerto Rico.
(2) Co-management purposes.--All lands covered by the
co-management agreement shall be managed to protect and
preserve the natural resources of these lands in
perpetuity. The Commonwealth of Puerto Rico, the Puerto
Rico Conservation Trust, and the Secretary of the
Interior shall follow all applicable Federal
environmental laws during the creation and any
subsequent amendment of the co-management agreement,
including the National Environmental Policy Act of
1969, the Endangered Species Act of 1973, and the
National Historic Preservation Act. The co-management
agreement shall be completed prior to any conveyance of
the property under subsection (a), but not later than
December 31, 2000. The Commonwealth of Puerto Rico
shall implement the terms and conditions of the co-
management agreement, which can only be amended by
agreement of the Commonwealth of Puerto Rico, the
Puerto Rico Conservation Trust, and the Secretary of
the Interior.
(3) Role of national fish and wildlife foundation.--
Contingent on funds being available specifically for
the preservation and protection of natural resources on
Vieques Island, amounts necessary to carry out the co-
management agreement may be made available to the
National Fish and Wildlife Foundation to establish and
manage an endowment for the management of lands
transferred to the Commonwealth of Puerto Rico and
subject to the co-management agreement. The proceeds
from investment of the endowment shall be available on
an annual basis. The Foundation shall strive to
leverage annual proceeds with non-Federal funds to the
fullest extent possible.
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5. An Amendment To Be Offered by Representative Whitfield of Kentucky,
or Representative Strickland of Ohio, or a Designee, Debatable for 20
Minutes
At the end of title XXXI (page 467, after line 11), insert
the following new section:
SEC. ____. SENSE OF CONGRESS REGARDING COMPENSATION AND HEALTH CARE FOR
PERSONNEL OF THE DEPARTMENT OF ENERGY AND ITS
CONTRACTORS AND VENDORS WHO HAVE SUSTAINED
BERYLLIUM, SILICA, AND RADIATION-RELATED INJURY.
It is the sense of Congress that--
(1) Since World War II Federal nuclear activities
have been explicitly recognized by the United States
Government as an ultra-hazardous activity under Federal
law. Nuclear weapons production and testing involved
unique dangers, including potential catastrophic
nuclear accidents that private insurance carriers would
not cover, as well as chronic exposures to radioactive
and hazardous substances, such as beryllium and silica,
that even in small amounts could cause medical harm.
(2) Since the inception of the nuclear weapons
program and for several decades afterwards, large
numbers of nuclear weapons workers at Department of
Energy and at vendor sites who supplied the Cold War
effort were put at risk without their knowledge and
consent for reasons that, documents reveal, were driven
by fears of adverse publicity, liability, and employee
demands for hazardous duty pay.
(3) Numerous previous secret records documented
unmonitored radiation, beryllium, silica, heavy metals,
and toxic substances' exposures and continuing problems
at the Department of Energy and vendor sites across the
country, where since World War II the Department of
Energy and its predecessors have been self-regulating
with respect to nuclear safety and occupational safety
and health. No other hazardous Federal activity has
been permitted to have such sweeping self-regulatory
powers.
(4) The Department of Energy policy to litigate
occupational illness claims has deterred workers from
filing workers compensation claims and imposed major
financial burdens for workers who sought compensation.
Department of Energy contractors have been held
harmless and the Department of Energy workers were
denied workers compensation coverage for occupational
disease.
(5) Over the past 20 years more than two dozen
scientific findings have emerged that indicate that
certain Department of Energy workers are experiencing
increased risks of dying from cancer and non-malignant
diseases at numerous facilities that provided for the
nation's nuclear deterrent. Several of these studies
also establish a correlation between excess diseases
and exposure to radiation, beryllium, and silica.
(6) While linking exposure to occupational hazards
with the development of occupational disease is
sometimes difficult, scientific evidence supports the
conclusion that occupational exposure to dust particles
or vapor of beryllium, even where there was compliance
with the standards in place at the time, can cause
beryllium sensitivity and chronic beryllium disease.
Furthermore, studies indicate than 98 percent of
radiation induced cancers within the Department of
Energy complex occur at dose levels below existing
maximum safe thresholds. Further, that workers at
Department of Energy sites were exposed to silica,
heavy metals, and toxic substances at levels that will
lead or contribute to illness and diseases.
(7) Existing information indicates that State
workers' compensation programs are not a uniform means
to provide adequate compensation for the types of
occupational illnesses and diseases related to the
prosecution of the Cold War effort.
(8) The civilian men and women who performed duties
uniquely related to the Department of Energy's nuclear
weapons production and testing programs over the last
50 years should have efficient, uniform, and adequate
compensation for beryllium-related health conditions,
radiation-related health conditions, and silica-related
health conditions in order to assure fairness and
equity.
(9) This situation is sufficiently unique to the
Department of Energy's nuclear weapons production and
testing programs that it is appropriate for
Congressional review this year.
----------
6. An Amendment To Be Offered by Representative Taylor of Mississippi,
or Representative Abercrombie of Hawaii, or a Designee, Debatable for
30 Minutes
Amend section 725 (page 231, line 3, and all that follows
through page 232, line 21) to read as follows:
SEC. 725. 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
the Social Security Act (42 U.S.C. 1395ggg(b)) is amended to
read as follows:
``(2) Location of sites; facilities.--Subject to
annual appropriations, the program shall be conducted
in any site that provides a full range of comprehensive
health care and that is designated jointly by the
administering Secretaries. The program shall be
conducted nationwide by January 1, 2006.''.
(b) Authority to Modify Agreement.--Such section is further
amended in paragraph (1)(A) by inserting ``, which may be
modified if necessary'' before the closing parenthesis.
(c) 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 such 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 (S); and
(D) by inserting after subparagraph (N) the
following new subparagraphs:
``(O) Patient satisfaction with the program.
``(P) The ability of the Department of
Defense to operate an effective and efficient
managed care system for medicare beneficiaries.
``(Q) The ability of the Department of
Defense to meet the managed care access and
quality of care standards under medicare.
``(R) The adequacy of the data systems of the
Department of Defense for providing timely,
necessary, and accurate information required to
properly manage 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) in such paragraph, by striking ``At least
60 days'' and all that follows through
``agreement'' and inserting ``The administering
Secretaries shall also 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:
``(5) 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)).''.
(d) Payments.--
(1) Permitting payments on a fee-for-service basis.--
Section 1896 of such 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'';
and
(H) 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.
(e) 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.''.
(f) 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), effective January 1, 2001, 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)(III) or
(vi) of section 1882(s)(3)(B) of such Act to `within
the first 12 months of such enrollment' or `by not
later than 12 months after the effective date of such
enrollment' is deemed a reference to during calendar
year 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 Secretary of Health and Human Services.''.
(g) Implementation of Utilization Review Procedures.--
Subsection (b) of such section is further amended by adding at
the end the following:
``(6) Utilization review procedures.--The Secretary
of Defense shall develop and implement procedures to
review utilization of health care services by medicare-
eligible military retirees and dependents under this
section in order to enable the Secretary of Defense to
more effectively manage the use of military medical
treatment facilities by such retirees and
dependents.''.
----------
7. A Substitute Amendment To Be Offered by Representative Buyer of
Indiana, or a Designee to the Amendment Numbered 6. The Amendment May
Be Offered Only After Debate Has Concluded on the Amendment Numbered 6,
and Shall Be Debatable for 30 Minutes
Amend section 725 (page 231, line 3, and all that follows
through page 232, line 21) to read as follows:
SEC. 725. MEDICARE SUBVENTION PROJECT FOR MILITARY RETIREES AND
DEPENDENTS.
(a) Expansion of Project.--Section 1896(b) of the Social
Security Act (42 U.S.C. 1395ggg(b)) is amended--
(1) by amending paragraph (2), to read as follows:
``(2) Expansion; location of sites.--Not later than
December 31, 2002, in addition to the sites at which
the project is already being conducted before the date
of the enactment of this paragraph and subject to
annual appropriations, the project shall be conducted
at any site that includes a military treatment facility
that is considered by the Secretary of Defense to be a
major medical center and that is designated jointly by
the administering Secretaries. The total number of
sites at which the project may be carried out shall not
exceed 14, and the total number of military treatment
facilities at which the project may be carried out
shall not exceed 24.'';
(2) in paragraph (4), by striking ``3-year period
beginning on January 1, 1998'' and inserting ``period
beginning on January 1, 1998, and ending on December
31, 2003''; and
(3) by adding at the end the following new paragraph:
``(6) Administration of project.--Not later than
September 30, 2002, the administering Secretaries shall
undertake measures to ensure that the project under
this section is being conducted, and reimbursements are
being made, in accordance with subsection (i),
including discussions regarding renegotiation of the
agreement authorized under subsection (b)(1)(A).''.
(b) Authority to Modify Agreement.--Such section is further
amended--
(1) in paragraph (1)(A), by inserting ``, which may
be modified if necessary'' before the closing
parenthesis; and
(2) in paragraph (5), by striking ``At least 60
days'' and all that follows through ``agreement'' and
inserting ``The administering Secretaries shall also
submit on an annual basis the most current agreement''.
(c) Continuation of provision of care.--Section 1896(b) of
such Act is further amended by adding at the end the following
new paragraph:
``(7) 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)).
Notwithstanding paragraph (2), the administering
Secretaries shall continue to provide health care under
the project at any military treatment center at which
such care was provided before the date of the enactment
of this paragraph.''.
(d) Payments.--Section 1896 of such Act 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.''.
(e) 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 project 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 (within the
meaning of that term as used in chapter 55 of
title 10, United States Code) at the site
immediately before attaining 65 years of age,
participation in the project 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.''.
(f) 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 project (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 an enrollment that occurred
before the date of the enactment of this subsection,
the enrollment (or effective date of the enrollment) is
deemed to have occurred on such date of enactment for
purposes of applying clauses (v)(III) and (vi) of
section 1882(s)(3)(B) of such Act; 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 Secretary of Health and Human Services.''.
(g) Implementation of Utilization Review Procedures.--
Subsection (b) of such section is further amended by adding at
the end the following:
``(8) Utilization review procedures.--The Secretary
of Defense shall develop and implement procedures to
review utilization of health care services by medicare-
eligible military retirees and dependents under this
section in order to enable the Secretary of Defense to
more effectively manage the use of military medical
treatment facilities by such retirees and
dependents.''.
(h) Reports.--(1) Subsection (k)(1) of such section 1896 is
amended--
(A) in the second sentence, by striking ``3\1/2\
years'' and inserting ``4\1/2\ years''; and
(B) by redesignating subparagraph (O) as subparagraph
(T); and
(C) by inserting after subparagraph (N) the following
new subparagraphs:
``(O) Patient satisfaction with the project.
``(P) Which interagency funding mechanisms
would be most appropriate if the project under
this section is made permanent.
``(Q) The ability of the Department of
Defense to operate an effective and efficient
managed care system for medicare beneficiaries.
``(R) The ability of the Department of
Defense to meet the managed care access and
quality of care standards under medicare.
``(S) The adequacy of the data systems of the
Department of Defense for providing timely,
necessary, and accurate information required to
properly manage the demonstration project.''.
(2) Section 724 of the Strom Thurmond National Defense
Authorization Act for Fiscal Year 1999 (Public Law 105-261; 10
U.S.C. 1108 note) is amended by inserting ``the demonstration
project conducted under section 1896 of the Social Security Act
(42 U.S.C. 1395ggg),'' after ``section 722,''.
(3) Not later than July 1, 2002, the Secretary of Defense
shall submit to the independent advisory committee established
in section 722(c) a report on the actions taken to provide that
the project established under section 1896 of the Social
Security Act (42 U.S.C. 1395ggg) is being conducted on a cost-
neutral basis for the Department of Defense.
(4) Not later than December 31, 2002--
(A) the Secretary of Defense shall submit to Congress
a report on such actions; and
(B) the General Accounting Office shall submit to
Congress a report assessing the efforts of the
Department regarding such actions.