A bill to restore health care equity for medicare-eligible uniformed services retirees, and for other purposes.
(Sec. 3) Directs the Secretary of Defense (Secretary) to expand and make permanent a demonstration project which allows individuals eligible for medical care and services under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to obtain pharmaceuticals by mail in order to permit the following individuals to participate in the project: (1) a member or former member of the armed forces; (2) dependents of certain former members; or (3) dependents of members who died while on active duty for a period of more than 30 days, who are entitled to hospital insurance benefits under part A of title XVIII (Medicare) of the Social Security Act. Requires the Secretary to modify each managed health care program which includes a managed care network of community retail pharmacies in order to supply pharmaceuticals to the above individuals.
(Sec. 4) Amends the Social Security Act relating to the Medicare subvention demonstration project for military retirees to: (1) exclude from such project any individual who is covered by a health benefits plan offered through the Federal Employees Health Benefits Program (FEHBP); (2) repeal the current six-site limit for conducting such project; and (3) repeal the January 1, 2001, project termination date, making such project a permanent program. Requires the Secretary of Health and Human Services to reimburse the Secretary for Medicare health care services provided to Medicare-eligible military retirees and dependents at a designated site in an amount of up to 95 percent of the cost of services provided on a fee-for- service basis. Authorizes such reimbursement for Medicare services provided at such sites for individuals not enrolled in the program. Provides Medigap protection for such enrollees.
(Sec. 5) Makes permanent an agreement between the Secretary and the Office of Personnel Management (currently a demonstration project) under which CHAMPUS-eligible beneficiaries who are or become entitled to hospital insurance benefits under part A of Medicare are offered an opportunity to enroll in a health benefits plan offered through the FEHBP. Limits such enrollment to 275,000. Prohibits any individual so electing from continuing to receive CHAMPUS health care, but authorizes such individuals to continue to receive health care in a military medical facility on a space-available basis. Provides limits on other health care coverage for participating individuals. Provides for: (1) required contributions for coverage; (2) participation management; and (3) annual reporting requirements.
(Sec. 6) Eliminates any required copayments, deductibles, and other fees with respect to CHAMPUS medical care provided to a dependent of a member who is enrolled in TRICARE Prime (a Department of Defense managed health care program).
(Sec. 7) Requires CHAMPUS coverage for dependents residing with members who are assigned to certain remote duty locations to be comparable to the coverage and timely access requirements applicable to TRICARE Prime.
(Sec. 8) Establishes in the Treasury the Uniformed Services Retiree Health Care Account to cover costs incurred for the participation of Medicare-eligible beneficiaries in the FEHBP under this Act.
(Sec. 9) Authorizes the Secretary to contract with private entities for the recovery of overpayments made under the TRICARE program.
(Sec. 10) Directs the Secretary to take specified action to enhance the efficiency of administration of the military health care system.
(Sec. 11) Directs the Secretary to issue to covered TRICARE beneficiaries an enrollment card for nationwide participation in such program.
Introduced in Senate
Sponsor introductory remarks on measure. (CR S113-115)
Read twice and referred to the Committee on Armed Services. (text of measure as introduced: CR S115-118)
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