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S. 2343 (103rd): An original bill to state the sense of the Senate on the TRICARE program of the Department of Defense and to facilitate the full implementation of the program by authorizing the reimbursement of the program for the cost of care provided under the program to certain medicare-eligible individuals.

The text of the bill below is as of Aug 1, 1994 (Placed on Calendar in the Senate).


S 2343 PCS

Calendar No. 536

103d CONGRESS

2d Session

S. 2343

To state the sense of the Senate on the TRICARE program of the Department of Defense and to facilitate the full implementation of the program by authorizing the reimbursement of the program for the cost of care provided under the program to certain medicare-eligible individuals.

IN THE SENATE OF THE UNITED STATES

AUGUST 1 (legislative day, JULY 20), 1994

Mr. NUNN, from the Committee on Armed Services, reported the following original bill; which was read twice and placed on the calendar


A BILL

To state the sense of the Senate on the TRICARE program of the Department of Defense and to facilitate the full implementation of the program by authorizing the reimbursement of the program for the cost of care provided under the program to certain medicare-eligible individuals.

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. IMPLEMENTATION OF THE TRICARE PROGRAM OF THE DEPARTMENT OF DEFENSE.

    (a) SENSE OF SENATE- It is the sense of the Senate that--

      (1) the health care program of the Department of Defense, commonly known as TRICARE--

        (A) reflects a commitment to cooperation between the military departments; and

        (B) integrates on a regional basis the provision of health care by the military medical treatment facilities under chapter 55 of title 10, United States Code;

      (2) the full implementation of the TRICARE program of the Department will result in the establishment of a system for the delivery of health care by the Department that is cohesive, flexible, and more capable of meeting the requirements of readiness to provide health care in support of military operations and of capacity to provide health care on a routine basis;

      (3) the full implementation of the TRICARE program of the Department will also result in--

        (A) improved access to health care for individuals eligible to participate in the system; and

        (B) an enhancement of the capacities of the Department of Defense medical facilities through--

          (i) control over contractor support of such facilities;

          (ii) sharing of resources and interoperability between the military departments in the operation of such facilities; and

          (iii) cost containment; and

      (4) medicare reimbursement is essential if the TRICARE program of the Department is to compete effectively among providers of health care services nationwide.

    (b) REIMBURSEMENT BY MEDICARE FOR CARE PROVIDED TO MEDICARE-ELIGIBLE INDIVIDUALS- (1) In the case of a person who is a medicare-eligible individual and who is provided care in a facility of the uniformed services that is certified under subsection (c), the Secretary of Health and Human Services shall be responsible for making payments to the certified facility under this section on behalf of the person.

    (2) The responsibilities of the Secretary of Health and Human Services under this subsection shall be in the same amounts and under similar terms and conditions under which that Secretary makes payments to eligible organizations with a risk-sharing contract under such section 1876.

    (3) Upon making payment under this subsection to a certified facility on behalf of a person, the obligation of the Secretary of Health and Human Services to provide health care services to the person shall cease.

    (c) CERTIFICATION OF FACILITIES- (1) The Secretary of Defense shall certify to the Secretary of Health and Human Services each year--

      (A) a list of all facilities of the uniformed services that--

        (i) meet or exceed medicare requirements that apply to a public facility; or

        (ii) fully comply with requirements established by the administering Secretaries that are intended to achieve the same or similar purposes as the requirements referred to in clause (i) and that are no less stringent than such requirements; and

      (B) a list of all health plans conducted by the Secretary of Defense that--

        (i) meet or exceed medicare HMO requirements that apply to the health plan of a public entity; or

        (ii) fully comply with requirements established by the administering Secretaries that are intended to achieve the same or similar purposes as the requirements referred to in clause (i) and that are no less stringent than such requirements.

    (2) For purposes of the medicare program--

      (A) a Department health care facility for which there is a certification in effect under paragraph (1)(A) and which provides care to medicare-eligible individuals shall be deemed to be a medicare provider; and

      (B) a health plan for which there is a certification in effect under paragraph (1)(B) and which provides care to medicare-eligible individuals shall be deemed to be a medicare HMO.

    (d) DEFINITIONS- In this section:

      (1) The term ‘administering Secretaries’ has the meaning given such term in section 1072(3) of title 10, United States Code.

      (2) The term ‘medicare program’ means the health insurance program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).

      (3) The term ‘medicare-eligible individual’ means an individual who is entitled to benefits under part A of the medicare program.

      (4) The term ‘medicare HMO’ means an eligible organization under section 1876 of the Social Security Act (42 U.S.C. 1395mm).

      (5) The term ‘medicare provider’ means an individual or entity furnishing items or services for which payments may be made under the medicare program.