(Sec. 103) Amends a demonstration program offering health care coverage to certain military personnel, spouses, and dependents through the Federal Employees Health Benefits Program to allow eligible beneficiaries who will be at least 65 years of age on December 31, 2002, to enroll, or extend a previous enrollment, during a three-year period of open enrollment for the year 2003. Extends such demonstration program through December 31, 2005. Repeals the ten-site limit for the program.
(Sec. 104) Authorizes the Secretary of Defense to charge an enrollment fee for participation in the TRICARE pharmacy system (a program for providing reduced-cost pharmaceuticals to TRICARE-eligible beneficiaries). Authorizes the Secretary to impose one or more cost-sharing requirements upon such participants. Allows participants to pay required premiums on a monthly or annual basis.
Title II: TRICARE Program - Amends the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) relating to medical and dental care provided to certain members and former members of the armed forces to: (1) make eligible for such services members and former members of the Coast Guard when not operating as a service in the Navy, the National Oceanic and Atmospheric Administration, and the Public Health Service; (2) require coverage for immediate family members of eligible individuals to be comparable to coverage for medical care and standards for timely access to such care under TRICARE Prime; and (3) entitle dependents of members performing duty in remote locations who reside with such member to the same care and waiver of such care under CHAMPUS as the members themselves.
(Sec. 202) Prohibits a member from being charged a copayment for care provided under TRICARE Prime to an immediate family member.
(Sec. 203) Directs the Secretary to improve certain business practices used when administering the access of eligible persons to health care services through the TRICARE program.
Title III: Joint Initiatives With Department of Veterans Affairs - Directs the Secretaries of Defense and Veterans Affairs to jointly: (1) prescribe a centralized process for the reporting, compiling, and analysis of errors in the provision of health care under their respective departments that endanger patients beyond the normal risks associated with such care and treatment; and (2) develop a system for the use of bar codes for the identification of pharmaceuticals. Requires the Secretary of Defense to experiment with the use of such bar codes in the current DOD mail order pharmaceuticals demonstration project.
Title IV: Other Matters - Directs the Secretary to authorize the following persons to obtain prescription pharmaceuticals from DOD by mail: (1) individuals who are eligible for medical care under CHAMPUS; or (2) individuals who would be so eligible except for also being entitled to hospital insurance benefits under Medicare. Directs the Secretary to prescribe an appropriate fee or copayment for pharmaceuticals so obtained.
(Sec. 402) Amends the National Defense Authorization Act for Fiscal Year 2000 to limit to $100 million the annual cost limitation for the CHAMPUS individual case management program.
(Sec. 403) Directs the Secretary to carry out two studies to assess the feasibility and desirability of financing the military health care program for military retirees on an accrual basis.
[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4369 Introduced in House (IH)]
106th CONGRESS
2d Session
H. R. 4369
To amend title 10, United States Code, to improve access to benefits
under the TRICARE program; to extend and improve certain demonstration
programs under the Defense Health Program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 3, 2000
Mr. Lucas of Kentucky introduced the following bill; which was referred
to the Committee on Armed Services, and in addition to the Committees
on Government Reform, Veterans' Affairs, Ways and Means, and 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 10, United States Code, to improve access to benefits
under the TRICARE program; to extend and improve certain demonstration
programs under the Defense Health Program, and for other purposes.
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 ``Veterans' Health Care Improvement
and Prescription Drug Cost Relief Act of 2000''.
TITLE I--SENIOR HEALTH CARE
SEC. 101. EXTENSION OF TRICARE SENIOR SUPPLEMENT DEMONSTRATION PROGRAM.
Section 722(a)(2) of the Strom Thurmond National Defense
Authorization Act for Fiscal Year 1999 (Public Law 105-261; 112 Stat.
2065; 10 U.S.C. 1073 note) is amended by striking ``December 31, 2002''
and inserting ``December 31, 2005''.
SEC. 102. TRICARE SENIOR PRIME DEMONSTRATION PROGRAM.
(a) Extension of Demonstration Program.--Paragraph (4) of section
1896(b) of the Social Security Act (42 U.S.C. 1395ggg(b)) is amended by
striking ``3-year period beginning on January 1, 1998'' and inserting
``period beginning on January 1, 1998, and ending on December 31,
2005''.
(b) Addition of Major Medical Centers.--Paragraph (1)(A) of such
section 1895(b) is amended by striking ``in a military treatment
facility'' and inserting ``in a Department of Defense medical center
considered by the Secretary to be a major medical center, in any other
military treatment facility,''.
(c) Designation of Additional Sites.--Paragraph (2) of such section
1896(b) is amended to read as follows:
``(2) Designation of sites.--
``(A) In general.--The project established under
this section shall be conducted at sites designated
jointly by the administering Secretaries after review
of all TRICARE regions.
``(B) Specific sites.--The sites for the project
shall include the 6 sites designated in accordance with
subparagraph (A) before the date of the enactment of
the National Defense Authorization Act for Fiscal Year
2001 and the major medical centers designated after
such date in accordance with that subparagraph.''.
SEC. 103. COVERAGE OF RETIREES OVER AGE 64 BY FEDERAL EMPLOYEES HEALTH
BENEFITS PROGRAM.
(a) Extension of Coverage for Retirees Over Age 64.--(1) Section
1108 of title 10, United States Code, is amended by adding at the end
the following:
``(m) Extension of Coverage for Retirees Over Age 64.--(1) Eligible
beneficiaries referred to in subsection (b)(1) who will be at least 65
years of age on December 31, 2002, shall be permitted to enroll, or to
extend a previous enrollment entered into under subsection (d)(2),
during a period of open enrollment for the year 2003 (conducted in the
fall of 2002).
``(2) Subject to paragraphs (2) and (3) of subsection (f), the
period of enrollment, or extension of enrollment, of an eligible
beneficiary under paragraph (1) shall be three years unless the
beneficiary disenrolls before the termination of the demonstration
project.
``(3) The agreement under subsection (a) shall provide for
continuation of the demonstration project for a total of five contract
years under the Federal Employees Health Benefits program for eligible
beneficiaries referred to in paragraph (1).''.
(2) Subsection (d) of such section is amended--
(A) in paragraph (1), by striking ``three contract years''
and inserting ``six contract years''; and
(B) in paragraph (2), by striking ``December 31, 2002'' in
the second sentence and inserting ``December 31, 2005''.
(3) Subsection (f)(1) of such section is amended by adding at the
end the following: ``A beneficiary may not extend the enrollment unless
eligible to do so under subsection (m)(1).''.
(b) Additional Areas of Coverage.--Subsection (c) of such section
is amended--
(1) by striking ``, but not more than ten,''; and
(2) by striking the third sentence and inserting the
following: ``In establishing the areas, the Secretary and
Director shall include an area that includes the catchment area
of one or more military medical treatment facilities, an area
that is not located in the catchment area of a military medical
treatment facility, an area in which there is a Medicare
Subvention Demonstration project area under section 1896 of
title XVIII of the Social Security Act (42 U.S.C. 1395ggg), and
one area for each TRICARE region. Each area selected after the
date of the enactment of the National Defense Authorization Act
for Fiscal Year 2001 shall be an area that is not located in
the catchment area of a military medical treatment facility.''.
SEC. 104. IMPLEMENTATION OF REDESIGNED PHARMACY SYSTEM.
(a) Enrollment Fee and Deductibles Required.--Subsection (b) of
section 723 of the Strom Thurmond National Defense Authorization Act
for Fiscal Year 1999 (Public Law 105-261; 112 Stat. 2068; 10 U.S.C.
1073 note) is amended to read as follows:
``(b) Enrollment Fees, Deductibles, and Other Charges.--(1) The
Secretary may require each eligible individual described in subsection
(e) who participates in the redesigned pharmacy system to pay an
enrollment fee. The Secretary shall ensure that any such enrollment fee
required after December 31, 2000, is lower than the enrollment fee
charged under this subsection on such date.
``(2) The Secretary may also impose one or more cost-sharing
requirements for each individual referred to in paragraph (1) for
benefits under the redesigned pharmacy system as follows:
``(A) An annual deductible requirement for each such
individual.
``(B) Any premiums, copayments, or other charges that the
Secretary would otherwise collect from individuals similar to
such individual.''.
(b) Periodic Payment of Premiums.--Subsection (b) of such section
is further amended by adding at the end the following:
``(2) An individual may elect to pay a premium charged under this
subsection on a monthly or quarterly basis.''.
(c) Effective Date.--The amendments made by this section shall take
effect on January 1, 2001, and shall apply with respect to
participation in the redesigned pharmacy system under section 723 of
Public Law 105-261 for months beginning on or after that date.
TITLE II--TRICARE PROGRAM
SEC. 201. ADDITIONAL BENEFICIARIES UNDER TRICARE PRIME REMOTE PROGRAM
IN CONUS.
(a) Coverage of Other Uniformed Services.--(1) Section 1074(c) of
title 10, United States Code, is amended--
(A) by striking ``armed forces'' each place it appears,
except in paragraph (3)(A), and inserting ``uniformed
services'';
(B) in paragraph (1), by inserting after ``military
department'' in the first sentence the following: ``, the
Department of Transportation (with respect to the Coast Guard
when it is not operating as a service in the Navy), or the
Department of Health and Human Services (with respect to the
National Oceanic and Atmospheric Administration and the Public
Health Service)'';
(C) in paragraph (2), by adding at the end the following:
``(C) The Secretary of Defense shall consult with the other
administering Secretaries in the administration of this
paragraph.''; and
(D) in paragraph (3)(A), by striking ``The Secretary of
Defense may not require a member of the armed forces described
in subparagraph (B)'' and inserting ``A member of the uniformed
services described in subparagraph (B) may not be required''.
(2)(A) Subsections (b), (c), and (d)(3) of section 731 of the
National Defense Authorization Act for Fiscal Year 1998 (Public Law
105-85; 111 Stat. 1811; 10 U.S.C. 1074 note) are amended by striking
``Armed Forces'' and inserting ``uniformed services''.
(B) Subsection (b) of such section is further amended by adding at
the end the following:
``(4) The Secretary of Defense shall consult with the other
administering Secretaries in the administration of this subsection.''.
(C) Subsection (f) of such section is amended by adding at the end
the following:
``(3) The terms `uniformed services' and `administering
Secretaries' have the meanings given those terms in section
1072 of title 10, United States Code.''.
(3) Section 706(b) of the National Defense Authorization Act for
Fiscal Year 2000 (Public Law 106-65; 113 Stat. 684) is amended by
striking ``Armed Forces'' and inserting ``uniformed services (as
defined in section 1072(1) of title 10, United States Code)''.
(b) Coverage of Immediate Family.--(1) Section 1079 of title 10,
United States Code, is amended by adding at the end the following:
``(p)(1) Subject to such exceptions as the Secretary of Defense
considers necessary, coverage for medical care under this section for
the dependents referred to in subsection (a) of a member of the
uniformed services referred to in section 1074(c)(3) of this title who
are residing with the member, and standards with respect to timely
access to such care, shall be comparable to coverage for medical care
and standards for timely access to such care under the managed care
option of the TRICARE program known as TRICARE Prime.
``(2) The Secretary of Defense shall enter into arrangements with
contractors under the TRICARE program or with other appropriate
contractors for the timely and efficient processing of claims under
this subsection.
``(3) The Secretary of Defense shall consult with the other
administering Secretaries in the administration of this subsection.''.
(2) Section 731(b) of the National Defense Authorization Act for
Fiscal Year 1998 (Public Law 105-85; 111 Stat. 1811; 10 U.S.C. 1074
note) is amended--
(A) in paragraph (1), by adding at the end the following:
``A dependent of the member, as described in subparagraph (A),
(D), or (I) of section 1072(2) of title 10, United States Code,
who is residing with the member shall have the same entitlement
to care and to waiver of charges as the member.''; and
(B) in paragraph (2), by inserting ``or dependent of the
member, as the case may be,'' after ``(2) A member''.
(c) Effective Date.--(1) The amendments made by subsection (a)(2),
with respect to members of the uniformed services, and the amendments
made by subsection (b)(2), with respect to dependents of members, shall
take effect on the date of the enactment of this Act and shall expire
with respect to a member or the dependents of a member, respectively,
on the later of the following:
(A) The date that is one year after the date of the
enactment of this Act.
(B) The date on which the amendments subsection (a)(1) or
(b)(1) apply with respect to the coverage of medical care for
and provision of such care to the member or dependents,
respectively.
(2) Section 731(b)(3) of Public Law 105-85 does not apply to a
member of the Coast Guard, the National Oceanic and Atmospheric
Administration, or the Commissioned Corps of the Public Health Service,
or to a dependent of a member of a uniformed service.
SEC. 202. ELIMINATION OF COPAYMENTS FOR IMMEDIATE FAMILY.
(a) No Copayment for Immediate Family.--Section 1097a of title 10,
United States Code, is amended--
(1) by redesignating subsection (e) as subsection (f); and
(2) by inserting after subsection (d) the following new
subsection (e):
``(e) No Copayment for Immediate Family.--No copayment shall be
charged a member for care provided under TRICARE Prime to a dependent
of a member of the uniformed services described in subparagraph (A),
(D), or (I) of section 1072 of this title.''.
(b) Effective Date.--The amendments made by subsection (a) shall
take effect on October 1, 2000, and shall apply with respect to care
provided on or after that date.
SEC. 203. IMPROVEMENT IN BUSINESS PRACTICES IN THE ADMINISTRATION OF
THE TRICARE PROGRAM.
(a) Requirement.--Not later than October 1, 2001, the Secretary of
Defense shall take actions that the Secretary considers appropriate to
improve the business practices used in administering the access of
eligible persons to health care services through the TRICARE program
under chapter 55 of title 10, United States Code, including the
practices relating to the following:
(1) The availability and scheduling of appointments.
(2) The filing, processing, and payment of claims.
(3) Public relations efforts that are focused on outreach
to eligible persons.
(4) The continuation of enrollments without expiration.
(5) The portability of enrollments nationwide.
(b) Consultation.--The Secretary of Defense shall consult with the
other administering Secretaries in the development of the actions to be
taken under subsection (a).
(c) Report.--Not later than March 15, 2001, the Secretary of
Defense shall submit to the Committees on Armed Services of the Senate
and House of Representatives a report on the actions to be taken under
subsection (a).
(d) Definitions.--In this section the terms ``administering
Secretaries'' and ``TRICARE program'' shall have the meanings given
such terms in section 1072 of title 10, United States Code.
TITLE III--JOINT INITIATIVES WITH DEPARTMENT OF VETERANS AFFAIRS
SEC. 301. TRACKING PATIENT SAFETY IN MILITARY AND VETERANS HEALTH CARE
SYSTEMS.
(a) Centralized Tracking Process.--The Secretary of Defense and the
Secretary of Veterans Affairs shall jointly prescribe a centralized
process for the reporting, compiling, and analysis of errors in the
provision of health care under the Defense Health Program and the
Department of Veterans Affairs health care system that endanger
patients beyond the normal risks associated with the care and treatment
of the patients.
(b) Safety Indicators, Et Cetera.--The process shall include such
indicators, standards, and protocols as the Secretary of Defense and
the Secretary of Veterans Affairs consider necessary for the
establishment and administration of an effective process.
SEC. 302. PHARMACEUTICAL IDENTIFICATION TECHNOLOGY.
(a) Bar Code Identification Technology.--The Secretary of Defense
and the Secretary of Veterans Affairs shall jointly develop a system
for the use of bar codes for the identification of pharmaceuticals.
(b) Use in National Mail Order Pharmaceuticals Demonstration
Project.--The Secretary of Defense, in consultation with the Secretary
of Veterans Affairs, shall experiment with the use of bar code
identification of pharmaceuticals in the administration of the mail
order pharmaceutical demonstration project being carried out under
section 702 of the National Defense Authorization Act for Fiscal Year
1993 (Public Law 102-484; 106 Stat. 2431; 10 U.S.C. 1079 note).
TITLE IV--OTHER MATTERS
SEC. 401. PERMANENT AUTHORITY FOR CERTAIN PHARMACEUTICAL BENEFITS.
(a) Authority.--(1) Chapter 55 of title 10, United States Code, is
amended by adding at the end the following:
``Sec. 1110. Pharmaceutical benefits
``(a) Pharmaceuticals by Mail.--The Secretary of Defense shall
authorize eligible persons to obtain prescription pharmaceuticals by
mail in connection with medical care furnished to such persons under
this chapter.
``(b) Retail Pharmacy Network.--To the maximum extent practicable,
the Secretary of Defense shall include in each managed health care
program under this chapter, a program to supply prescription
pharmaceuticals to eligible persons through a managed care network
of community retail pharmacies in the area covered by the managed
health care program.
``(c) Eligible Persons.--A person is eligible to obtain
pharmaceuticals under the program of pharmaceuticals by mail under
subsection (a) or through a retail pharmacy network included in a
managed health care program under subsection (b) as follows:
``(1) A person who is eligible for medical care under a
contract for medical care entered into by the Secretary of
Defense under section 1079 or 1086 of this title.
``(2) A person who would be eligible for medical care under
a contract for medical care entered into under section 1086 of
this title except for the operation of subsection (d)(1) of
such section.
``(d) Pharmaceuticals Offered.--The Secretary of Defense shall
determine the pharmaceuticals that may be obtained by eligible persons
under subsection (a) or (b).
``(e) Fees.--The Secretary of Defense shall prescribe an
appropriate fee, charge, or copayment to be paid by persons for
pharmaceuticals obtained under subsection (a) or (b).
``(f) Consultation Requirement.--The Secretary of Defense shall
consult with the other administering Secretaries in the administration
of this section.''.
(2) The table of sections at the beginning of such chapter is
amended by adding at the end the following:
``1110. Pharmaceutical benefits.''.
(b) Repeal of Superseded Authority.--Section 702 of the National
Defense Authorization Act for Fiscal Year 1993 (Public Law 102-484; 106
Stat. 2431; 10 U.S.C. 1079 note) is repealed.
(c) Effective Date.--This section and the amendments made by this
section shall take effect on January 1, 2001.
SEC. 402. PROVISION OF DOMICILIARY AND CUSTODIAL CARE FOR CHAMPUS
BENEFICIARIES.
(a) Continuation of Care for Certain CHAMPUS Beneficiaries.--
Section 703(a)(1) of the National Defense Authorization Act for Fiscal
Year 2000 (Public Law 106-65; 113 Stat. 682; 10 U.S.C. 1077 note) is
amended by inserting before the period at the end the following: ``or
by the prohibition in section 1086(d)(1) of such title''.
(b) Cost Limitation for Individual Case Management Program.--(1)
Section 1079(a)(17) of title 10, United States Code, is amended--
(A) by inserting ``(A)'' after ``(17)''; and
(B) by adding at the end the following:
``(B) The total amount expended under subparagraph (A) for
a fiscal year may not exceed $100,000,000.''.
(2) Section 703 of the National Defense Authorization Act for
Fiscal Year 2000 is amended by adding at the end the following:
``(e) Cost Limitation.--The total amount paid for services for
eligible beneficiaries under subsection (a) for a fiscal year (together
with the costs of administering the authority under that subsection)
shall be included in the expenditures limited by section 1079(a)(17)(B)
of title 10, United States Code.''.
(2) The amendments made by paragraphs (1) and (2) shall apply to
fiscal years after fiscal year 1999.
SEC. 403. STUDIES OF ACCRUAL FINANCING FOR HEALTH CARE FOR MILITARY
RETIREES.
(a) Studies Required.--The Secretary of Defense shall carry out two
studies to assess the feasibility and desirability of financing the
military health care program for retirees of the uniformed services on
an accrual basis.
(b) Sources of Studies.--The Secretary shall provide for--
(1) one of the studies under subsection (a) to be conducted
by one or more Department of Defense organizations designated
by the Secretary; and
(2) the other study to be conducted by an organization that
is independent of the Department of Defense and has expertise
in financial programs and health care.
(c) Reports.--(1) The Secretary shall provide for the submission of
a final report on each study to the Secretary within such time as the
Secretary determines necessary to satisfy the requirement in paragraph
(2).
(2) The Secretary shall transmit the final reports on the studies
to Congress not later than February 8, 2001. The Secretary may include
in the transmittal any comments on the reports or on the matters
studied that the Secretary considers appropriate.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Armed Services, and in addition to the Committees on Government Reform, Veterans' Affairs, Ways and Means, and 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.
Referred to the Committee on Armed Services, and in addition to the Committees on Government Reform, Veterans' Affairs, Ways and Means, and 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.
Referred to the Committee on Armed Services, and in addition to the Committees on Government Reform, Veterans' Affairs, Ways and Means, and 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.
Referred to the Committee on Armed Services, and in addition to the Committees on Government Reform, Veterans' Affairs, Ways and Means, and 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.
Referred to the Committee on Armed Services, and in addition to the Committees on Government Reform, Veterans' Affairs, Ways and Means, and 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.
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Referred to the Committee on Armed Services, and in addition to the Committees on Government Reform, Veterans' Affairs, Ways and Means, and 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.
Referred to the Subcommittee on Civil Service.
Referred to the Subcommittee on Health and Environment.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Military Personnel.
Executive Comment Requested from DOD.
Referred to the Subcommittee on Health.