< Back to H.R. 4369 (106th Congress, 1999–2000)

Text of the Veterans’ Health Care Improvement and Prescription Drug Cost Relief Act of 2000

This bill was introduced on May 3, 2000, in a previous session of Congress, but was not enacted. The text of the bill below is as of May 3, 2000 (Introduced).

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HR 4369 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.