
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 2, 2001]
[Document affected by Public Law 107-107 Section 1048(c)(5)]
[Document affected by Public Law 107-107 Section 701(b)]
[Document affected by Public Law 107-107 Section 701(g)(2)]
[Document affected by Public Law 107-107 Section 703(b)]
[Document affected by Public Law 107-107 Section 707(a),]
[Document affected by Public Law 107-107 Section 707(c)]
[CITE: 10USC1079]

 
                         TITLE 10--ARMED FORCES
 
                    Subtitle A--General Military Law
 
                           PART II--PERSONNEL
 
                   CHAPTER 55--MEDICAL AND DENTAL CARE
 
Sec. 1079. Contracts for medical care for spouses and children: 
        plans
        
    (a) To assure that medical care is available for dependents, as 
described in subparagraphs (A), (D), and (I) of section 1072(2) of this 
title, of members of the uniformed services who are on active duty for a 
period of more than 30 days, the Secretary of Defense, after consulting 
with the other administering Secretaries, shall contract, under the 
authority of this section, for medical care for those persons under such 
insurance, medical service, or health plans as he considers appropriate. 
The types of health care authorized under this section shall be the same 
as those provided under section 1076 of this title, except as follows:
        (1) With respect to dental care, only that care required as a 
    necessary adjunct to medical or surgical treatment may be provided.
        (2) Consistent with such regulations as the Secretary of Defense 
    may prescribe regarding the content of health promotion and disease 
    prevention visits, the schedule of pap smears and mammograms, the 
    schedule and method of colon and prostate cancer screenings, and the 
    types and schedule of immunizations--
            (A) for dependents under six years of age, both health 
        promotion and disease prevention visits and immunizations may be 
        provided; and
            (B) for dependents six years of age or older, health 
        promotion and disease prevention visits may be provided in 
        connection with immunizations or with diagnostic or preventive 
        pap smears and mammograms or colon and prostate cancer 
        screenings.

        (3) Not more than one eye examination may be provided to a 
    patient in any calendar year.
        (4) Under joint regulations to be prescribed by the 
    administering Secretaries, the services of Christian Science 
    practitioners and nurses and services obtained in Christian Science 
    sanatoriums may be provided.
        (5) Durable equipment, such as wheelchairs, iron lungs and 
    hospital beds may be provided on a rental basis.
        (6) Inpatient mental health services may not (except as provided 
    in subsection (i)) be provided to a patient in excess of--
            (A) 30 days in any year, in the case of a patient 19 years 
        of age or older;
            (B) 45 days in any year, in the case of a patient under 19 
        years of age; or
            (C) 150 days in any year, in the case of inpatient mental 
        health services provided as residential treatment care.

        (7) Services in connection with nonemergency inpatient hospital 
    care may not be provided if such services are available at a 
    facility of the uniformed services located within a 40-mile radius 
    of the residence of the patient, except that those services may be 
    provided in any case in which another insurance plan or program 
    provides primary coverage for those services.
        (8) Services of pastoral counselors, family and child 
    counselors, or marital counselors (other than certified marriage and 
    family therapists) may not be provided unless the patient has been 
    referred to the counselor by a medical doctor for treatment of a 
    specific problem with the results of that treatment to be 
    communicated back to the medical doctor who made the referral and 
    services of certified marriage and family therapists may be provided 
    consistent with such rules as may be prescribed by the Secretary of 
    Defense, including credentialing criteria and a requirement that the 
    therapists accept payment under this section as full payment for all 
    services provided.
        (9) Special education may not be provided, except when provided 
    as secondary to the active psychiatric treatment on an institutional 
    inpatient basis.
        (10) Therapy or counseling for sexual dysfunctions or sexual 
    inadequacies may not be provided.
        (11) Treatment of obesity may not be provided if obesity is the 
    sole or major condition treated.
        (12) Surgery which improves physical appearance but is not 
    expected to significantly restore functions (including mammary 
    augmentation, face lifts, and sex gender changes) may not be 
    provided, except that--
            (A) breast reconstructive surgery following a mastectomy may 
        be provided;
            (B) reconstructive surgery to correct serious deformities 
        caused by congenital anomalies or accidental injuries may be 
        provided; and
            (C) neoplastic surgery may be provided.

        (13) Any service or supply which is not medically or 
    psychologically necessary to prevent, diagnose, or treat a mental or 
    physical illness, injury, or bodily malfunction as assessed or 
    diagnosed by a physician, dentist, clinical psychologist, certified 
    marriage and family therapist, optometrist, podiatrist, certified 
    nurse-midwife, certified nurse practitioner, or certified clinical 
    social worker, as appropriate, may not be provided, except as 
    authorized in paragraph (4). Pursuant to an agreement with the 
    Secretary of Health and Human Services and under such regulations as 
    the Secretary of Defense may prescribe, the Secretary of Defense may 
    waive the operation of this paragraph in connection with clinical 
    trials sponsored or approved by the National Institutes of Health if 
    the Secretary of Defense determines that such a waiver will promote 
    access by covered beneficiaries to promising new treatments and 
    contribute to the development of such treatments.
        (14) The prohibition contained in section 1077(b)(3) of this 
    title shall not apply in the case of a member or former member of 
    the uniformed services.
        (15) Electronic cardio-respiratory home monitoring equipment 
    (apnea monitors) for home use may be provided if a physician 
    prescribes and supervises the use of the monitor for an infant--
            (A) who has had an apparent life-threatening event,
            (B) who is a subsequent sibling of a victim of sudden infant 
        death syndrome,
            (C) whose birth weight was 1,500 grams or less, or
            (D) who is a pre-term infant with pathologic apnea,

    in which case the coverage may include the cost of the equipment, 
    hard copy analysis of physiological alarms, professional visits, 
    diagnostic testing, family training on how to respond to apparent 
    life threatening events, and assistance necessary for proper use of 
    the equipment.
        (16) Hospice care may be provided only in the manner and under 
    the conditions provided in section 1861(dd) of the Social Security 
    Act (42 U.S.C. 1395x(dd)).
        (17)(A) The Secretary of Defense may establish a program for the 
    individual case management of a person covered by this section or 
    section 1086 of this title who has extraordinary medical or 
    psychological disorders and, under such a program, may waive benefit 
    limitations contained in paragraphs (5) and (13) of this subsection 
    or section 1077(b)(1) of this title and authorize the payment for 
    comprehensive home health care services, supplies, and equipment if 
    the Secretary determines that such a waiver is cost-effective and 
    appropriate.
        (B) The total amount expended under subparagraph (A) for a 
    fiscal year may not exceed $100,000,000.

    (b) Plans covered by subsection (a) shall include provisions for 
payment by the patient of the following amounts:
        (1) $25 for each admission to a hospital, or the amount the 
    patient would have been charged under section 1078(a) of this title 
    had the care being paid for been obtained in a hospital of the 
    uniformed services, whichever amount is the greater. The Secretary 
    of Defense may exempt a patient from paying such amount if the 
    hospital to which the patient is admitted does not impose a legal 
    obligation on any of its patients to pay for inpatient care.
        (2) Except as provided in clause (3), the first $150 each fiscal 
    year of the charges for all types of care authorized by subsection 
    (a) and received while in an outpatient status and 20 percent of all 
    subsequent charges for such care during a fiscal year. 
    Notwithstanding the preceding sentence, in the case of a dependent 
    of an enlisted member in a pay grade below E-5, the initial 
    deductible each fiscal year under this paragraph shall be limited to 
    $50.
        (3) A family group of two or more persons covered by this 
    section shall not be required to pay collectively more than the 
    first $300 (or in the case of the family group of an enlisted member 
    in a pay grade below E-5, the first $100) each fiscal year of the 
    charges for all types of care authorized by subsection (a) and 
    received while in an outpatient status and 20 percent of the 
    additional charges for such care during a fiscal year.
        (4) $25 for surgical care that is authorized by subsection (a) 
    and received while in an outpatient status and that has been 
    designated (under joint regulations to be prescribed by the 
    administering Secretaries) as care to be treated as inpatient care 
    for purposes of this subsection. Any care for which payment is made 
    under this clause shall not be considered to be care received while 
    in an outpatient status for purposes of clauses (2) and (3).
        (5) An individual or family group of two or more persons covered 
    by this section may not be required by reason of this subsection to 
    pay a total of more than $1,000 for health care received during any 
    fiscal year under a plan under subsection (a).

    (c) The methods for making payment under subsection (b) shall be 
prescribed under joint regulations issued by the administering 
Secretaries.
    (d) Under joint regulations to be prescribed by the administering 
Secretaries, in the case of a dependent, as described in subparagraph 
(A), (D), or (I) of section 1072(2) of this title, of a member of the 
uniformed services on active duty for a period of more than 30 days, who 
is moderately or severely mentally retarded or who has a serious 
physical handicap, the plans covered by subsection (a) shall, with 
respect to the retardation or handicap of such dependent, include the 
following:
        (1) Diagnosis.
        (2) Inpatient, outpatient, and home treatment.
        (3) Training, rehabilitation, and special education.
        (4) Institutional care in private nonprofit, public and State 
    institutions and facilities and, when appropriate, transportation to 
    and from such institutions and facilities.

    (e) Members shall be required to share in the cost of any benefits 
provided their dependents under subsection (d) as follows:
        (1) Except as provided in clause (3), members in the lowest 
    enlisted pay grade shall be required to pay the first $25 incurred 
    each month and members in the highest commissioned pay grade shall 
    similarly be required to pay $250 per month. The amounts to be 
    similarly paid by members in all other pay grades shall be 
    determined under joint regulations to be prescribed by the 
    administering Secretaries.
        (2) Except as provided in clause (4), the Government's share of 
    the cost of any benefits provided in a particular case under 
    subsection (d) shall not exceed $1,000 per month.
        (3) Members shall also be required to pay each month that 
    amount, if any, remaining after the Government's maximum share has 
    been reached.
        (4) A member who has more than one dependent incurring expenses 
    in a given month under a plan covered by subsection (d) shall not be 
    required to pay an amount greater than he would be required to pay 
    if he had but one such dependent.

    (f) To qualify for the benefits provided by subsection (d), members 
shall be required to use public facilities to the extent they are 
available and adequate as determined under joint regulations of the 
administering Secretaries.
    (g) When a member dies while he is eligible for receipt of hostile 
fire pay under section 310 of title 37 or from a disease or injury 
incurred while eligible for such pay, his dependents who are receiving 
benefits under a plan covered by subsection (d) shall continue to be 
eligible for such benefits until they pass their twenty-first birthday. 
In addition, when a member dies while on active duty for a period of 
more than 30 days, the member's dependents who are receiving benefits 
under a plan covered by subsection (a) shall continue to be eligible for 
such benefits during the three-year period beginning on the date of the 
death of the member.
    (h)(1) Except as provided in paragraphs (2) and (3), payment for a 
charge for services by an individual health care professional (or other 
noninstitutional health care provider) for which a claim is submitted 
under a plan contracted for under subsection (a) shall be equal to an 
amount determined to be appropriate, to the extent practicable, in 
accordance with the same reimbursement rules as apply to payments for 
similar services under title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.). The Secretary of Defense shall determine the appropriate 
payment amount under this paragraph in consultation with the other 
administering Secretaries.
    (2) The Secretary of Defense, in consultation with the other 
administering Secretaries, shall prescribe regulations to provide for 
such exceptions to the payment limitations under paragraph (1) as the 
Secretary determines to be necessary to assure that covered 
beneficiaries retain adequate access to health care services. Such 
exceptions may include the payment of amounts higher than the amount 
allowed under paragraph (1) when enrollees in managed care programs 
obtain covered services from nonparticipating providers. To provide a 
suitable transition from the payment methodologies in effect before the 
date of the enactment of this paragraph to the methodology required by 
paragraph (1), the amount allowable for any service may not be reduced 
by more than 15 percent below the amount allowed for the same service 
during the immediately preceding 12-month period (or other period as 
established by the Secretary of Defense).
    (3) In addition to the authority provided under paragraph (2), the 
Secretary of Defense may authorize the commander of a facility of the 
uniformed services, the lead agent (if other than the commander), and 
the health care contractor to modify the payment limitations under 
paragraph (1) for certain health care providers when necessary to ensure 
both the availability of certain services for covered beneficiaries and 
lower costs than would otherwise be incurred to provide the services. 
With the consent of the health care provider, the Secretary is also 
authorized to reduce the authorized payment for certain health care 
services below the amount otherwise required by the payment limitations 
under paragraph (1).
    (4) The Secretary of Defense, in consultation with the other 
administering Secretaries, shall prescribe regulations to establish 
limitations (similar to the limitations established under title XVIII of 
the Social Security Act (42 U.S.C. 1395 et seq.)) on beneficiary 
liability for charges of an individual health care professional (or 
other noninstitutional health care provider).
    (5) To assure access to care for all covered beneficiaries, the 
Secretary of Defense, in consultation with the other administering 
Secretaries, shall designate specific rates for reimbursement for 
services in certain localities if the Secretary determines that without 
payment of such rates access to health care services would be severely 
impaired. Such a determination shall be based on consideration of the 
number of providers in a locality who provide the services, the number 
of such providers who are CHAMPUS participating providers, the number of 
covered beneficiaries under CHAMPUS in the locality, the availability of 
military providers in the location or a nearby location, and any other 
factors determined to be relevant by the Secretary.
    (i)(1) The limitation in subsection (a)(6) does not apply in the 
case of inpatient mental health services--
        (A) provided under the program for the handicapped under 
    subsection (d);
        (B) provided as partial hospital care; or
        (C) provided pursuant to a waiver authorized by the Secretary of 
    Defense because of medical or psychological circumstances of the 
    patient that are confirmed by a health professional who is not a 
    Federal employee after a review, pursuant to rules prescribed by the 
    Secretary, which takes into account the appropriate level of care 
    for the patient, the intensity of services required by the patient, 
    and the availability of that care.

    (2) Notwithstanding subsection (b) or section 1086(b) of this title, 
the Secretary of Defense (after consulting with the other administering 
Secretaries) may prescribe separate payment requirements (including 
deductibles, copayments, and catastrophic limits) for the provision of 
mental health services to persons covered by this section or section 
1086 of this title. The payment requirements may vary for different 
categories of covered beneficiaries, by type of mental health service 
provided, and based on the location of the covered beneficiaries.
    (3) Except in the case of an emergency, the Secretary of Defense 
shall require preadmission authorization before inpatient mental health 
services may be provided to persons covered by this section or section 
1086 of this title. In the case of the provision of emergency inpatient 
mental health services, approval for the continuation of such services 
shall be required within 72 hours after admission.
    (j)(1) A benefit may not be paid under a plan covered by this 
section in the case of a person enrolled in, or covered by, any other 
insurance, medical service, or health plan, including any plan offered 
by a third-party payer (as defined in section 1095(h)(1) of this title), 
to the extent that the benefit is also a benefit under the other plan, 
except in the case of a plan administered under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.).
    (2)(A) The amount to be paid to a provider of services for services 
provided under a plan covered by this section may be determined under 
joint regulations to be prescribed by the administering Secretaries 
which provide that the amount of such payments shall be determined to 
the extent practicable in accordance with the same reimbursement rules 
as apply to payments to providers of services of the same type under 
title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
    (B) In subparagraph (A), the term ``provider of services'' means a 
hospital, skilled nursing facility, comprehensive outpatient 
rehabilitation facility, home health agency, hospice program (as defined 
in section 1861(dd)(2) of the Social Security Act (42 U.S.C. 
1395x(dd)(2))), or other institutional facility providing services for 
which payment may be made under a plan covered by this section.
    (k) A plan covered by this section may include provision of liver 
transplants (including the cost of acquisition and transportation of the 
donated liver) in accordance with this subsection. Such a liver 
transplant may be provided if--
        (1) the transplant is for a dependent considered appropriate for 
    that procedure by the Secretary of Defense in consultation with the 
    other administering Secretaries and such other entities as the 
    Secretary considers appropriate; and
        (2) the transplant is to be carried out at a health-care 
    facility that has been approved for that purpose by the Secretary of 
    Defense after consultation with the other administering Secretaries 
    and such other entities as the Secretary considers appropriate.

    (l)(1) Contracts entered into under subsection (a) shall also 
provide for medical care for dependents of former members of the 
uniformed services who are authorized to receive medical and dental care 
under section 1076(e) of this title in facilities of the uniformed 
services.
    (2) Except as provided in paragraph (3), medical care in the case of 
a dependent described in section 1076(e) shall be furnished under the 
same conditions and subject to the same limitations as medical care 
furnished under this section to spouses and children of members of the 
uniformed services described in the first sentence of subsection (a).
    (3) Medical care may be furnished to a dependent pursuant to 
paragraph (1) only for an injury, illness, or other condition described 
in section 1076(e) of this title.
    (m)(1) Subject to paragraph (2), the Secretary of Defense may, upon 
request, make payments under this section for a charge for services for 
which a claim is submitted under a plan contracted for under subsection 
(a) to a hospital that does not impose a legal obligation on any of its 
patients to pay for such services.
    (2) A payment under paragraph (1) may not exceed the average amount 
paid for comparable services in the geographic area in which the 
hospital is located or, if no comparable services are available in that 
area, in an area similar to the area in which the hospital is located.
    (3) The Secretary of Defense shall periodically review the billing 
practices of each hospital the Secretary approves for payment under this 
subsection to ensure that the hospital's practices of not billing 
patients for payment are not resulting in increased costs to the 
Government.
    (4) The Secretary of Defense may require each hospital the Secretary 
approves for payment under this subsection to provide evidence that it 
has sources of revenue to cover unbilled costs.
    (n) The Secretary of Defense may enter into contracts (or amend 
existing contracts) with fiscal intermediaries under which the 
intermediaries agree to organize and operate, directly or through 
subcontractors, managed health care networks for the provision of health 
care under this chapter. The managed health care networks shall include 
cost containment methods, such as utilization review and contracting for 
care on a discounted basis.
    (o)(1) Health care services provided pursuant to this section or 
section 1086 of this title (or pursuant to any other contract or project 
under the Civilian Health and Medical Program of the Uniformed Services) 
may not include services determined under the CHAMPUS Peer Review 
Organization program to be not medically or psychologically necessary.
    (2) The Secretary of Defense, after consulting with the other 
administering Secretaries, may adopt or adapt for use under the CHAMPUS 
Peer Review Organization program, as the Secretary considers 
appropriate, any of the quality and utilization review requirements and 
procedures that are used by the Peer Review Organization program under 
part B of title XI of the Social Security Act (42 U.S.C. 1320c et seq.).
    (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.

(Added Pub. L. 85-861, Sec. 1(25)(B), Sept. 2, 1958, 72 Stat. 1448; 
amended Pub. L. 89-614, Sec. 2(6), Sept. 30, 1966, 80 Stat. 863; Pub. L. 
92-58, Sec. 1, July 29, 1971, 85 Stat. 157; Pub. L. 95-485, title VIII, 
Sec. 806(a)(1), Oct. 20, 1978, 92 Stat. 1622; Pub. L. 96-342, title 
VIII, Sec. 810(a), (b), Sept. 8, 1980, 94 Stat. 1097; Pub. L. 96-513, 
title V, Secs. 501(13), 511(36), (38), Dec. 12, 1980, 94 Stat. 2908, 
2923; Pub. L. 96-552, Dec. 19, 1980, 94 Stat. 3254; Pub. L. 97-22, 
Sec. 11(a)(2), July 10, 1981, 95 Stat. 137; Pub. L. 97-86, title IX, 
Sec. 906(a)(1), Dec. 1, 1981, 95 Stat. 1117; Pub. L. 98-94, title IX, 
Sec. 931(a), title XII, Sec. 1268(4), Sept. 24, 1983, 97 Stat. 648, 705; 
Pub. L. 98-525, title VI, Sec. 632(a)(1), title XIV, Secs. 1401(e)(4), 
1405(23), Oct. 19, 1984, 98 Stat. 2543, 2617, 2623; Pub. L. 98-557, 
Sec. 19(7), Oct. 30, 1984, 98 Stat. 2869; Pub. L. 99-661, div. A, title 
VI, Sec. 652(d), title VII, Sec. 703, Nov. 14, 1986, 100 Stat. 3889, 
3900; Pub. L. 100-180, div. A, title VII, Secs. 721(a), 726(a), Dec. 4, 
1987, 101 Stat. 1115, 1117; Pub. L. 100-456, div. A, title VI, 
Sec. 646(a), Sept. 29, 1988, 102 Stat. 1989; Pub. L. 101-189, div. A, 
title VII, Sec. 730(a), Nov. 29, 1989, 103 Stat. 1481; Pub. L. 101-510, 
div. A, title VII, Secs. 701(a), 702(a), 703(a), (b), 712(a), title XIV, 
Sec. 1484(g)(1), Nov. 5, 1990, 104 Stat. 1580, 1581, 1583, 1717; Pub. L. 
102-25, title III, Sec. 316(b), Apr. 6, 1991, 105 Stat. 87; Pub. L. 102-
190, div. A, title VII, Secs. 702(b), 711, 712(a), 713, Dec. 5, 1991, 
105 Stat. 1400, 1402, 1403; Pub. L. 102-484, div. A, title VII, 
Sec. 704, title X, Secs. 1052(13), 1053(3), Oct. 23, 1992, 106 Stat. 
2432, 2499, 2501; Pub. L. 103-35, title II, Sec. 202(a)(5), May 31, 
1993, 107 Stat. 101; Pub. L. 103-160, div. A, title VII, Secs. 711, 
716(c), Nov. 30, 1993, 107 Stat. 1688, 1693; Pub. L. 103-337, div. A, 
title VII, Secs. 702(a), 707(a), Oct. 5, 1994, 108 Stat. 2797, 2800; 
Pub. L. 104-106, div. A, title VII, Secs. 701, 731(a)-(d), Feb. 10, 
1996, 110 Stat. 370, 380, 381; Pub. L. 104-201, div. A, title VII, 
Secs. 701(b)(2), 711, 731, 732, 735(c), Sept. 23, 1996, 110 Stat. 2587, 
2590, 2597, 2599; Pub. L. 105-85, div. A, title VII, Sec. 735, Nov. 18, 
1997, 111 Stat. 1813; Pub. L. 106-398, Sec. 1 [[div. A], title VII, 
Secs. 701(c)(1), 704(b), 722(b)(1), 757(a)], Oct. 30, 2000, 114 Stat. 
1654, 1654A-172, 1654A-175, 1654A-185, 1654A-198.)

                                          Historical and Revision Notes
-------------------------------------------------------------------------------
---------------------------------
            Revised section                      Source (U.S. Code)            
   Source (Statutes at Large)
-------------------------------------------------------------------------------
---------------------------------
1079(a)...............................  37:402(a)(2) (as applicable to       Ju
ne 7, 1956, ch. 374, Secs.
                                         37:411(a)).                          1
02(a)(2) (as applicable to Sec.
                                        37:411(a).                            2
01(a)), 201(a), (b), 204, 70
1079(b)...............................  37:411(b).                            S
tat. 250, 252, 253.
                                        37:414.
-------------------------------------------------------------------------------
---------------------------------

    In subsection (a), the words ``appointed, enlisted, inducted or 
called, ordered or conscripted in a uniformed service'', in 37:402(a)(2) 
are omitted as surplusage, since it does not matter how a member became 
a member. The words ``active duty for a period of more than 30 days'' 
are substituted for the words ``active duty or active duty for training 
pursuant to a call or order that does not specify a period of thirty 
days or less'', in 37:402(a)(2), to reflect section 101(22) and (23) of 
this title. The words ``, under the authority of this section,'' are 
substituted for the words ``pursuant to the provisions of this title'' 
to make clear that the section provides independent procurement 
authority. The words ``all'', ``by the hospital'', and ``a period of'', 
in 37:411(a), are omitted as surplusage.
    In subsection (a)(1), the word ``rooms'', in 37:411(a), is 
substituted for the word ``accommodations''.
    In subsection (a)(5), the word ``services'' is substituted for the 
word ``procedures'' and the word ``performed'' is substituted for the 
word ``accomplished'', in 37: 411(a). The words ``or surgeon'' are 
inserted for clarity.
    In subsection (b), the word ``variances'' is substituted for the 
words ``limitations, additions, exclusions''. The words ``or care other 
than that provided for in sections 1076-1078 of this title'' are 
substituted for 37:414. The words ``definitions, and related 
provisions'', in 37:411(b), are omitted as surplusage, since the 
Secretary of an executive department has inherent authority to interpret 
laws and issue regulations.

                       References in Text

    The Social Security Act, referred to in subsecs. (h)(1), (4), 
(j)(1), (2)(A), and (o)(2), is act Aug. 13, 1935, ch. 531, 49 Stat. 620, 
as amended. Part B of title XI of the Act is classified generally to 
part B (Sec. 1320c et seq.) of subchapter XI of chapter 7 of Title 42, 
The Public Health and Welfare. Titles XVIII and XIX of the Act are 
classified generally to subchapters XVIII (Sec. 1395 et seq.) and XIX 
(Sec. 1396 et seq.), respectively, of chapter 7 of Title 42. For 
complete classification of this Act to the Code, see section 1305 of 
Title 42 and Tables.
    The date of the enactment of this paragraph, referred to in subsec. 
(h)(2), is the date of enactment of Pub. L. 104-106, which was approved 
Feb. 10, 1996.


                            Prior Provisions

    Provisions similar to those in subsec. (a)(7) to (14) of this 
section were contained in the following appropriation acts, with the 
exception of the provisions similar to par. (14) which first appeared in 
Pub. L. 96-154:
    Pub. L. 98-473, title I, Sec. 101(h) [title VIII, Secs. 8031, 8032, 
8045], Oct. 12, 1984, 98 Stat. 1904, 1929, 1931.
    Pub. L. 98-212, title VII, Secs. 737, 738, 752, Dec. 8, 1983, 97 
Stat. 1445, 1447.
    Pub. L. 97-377, title I, Sec. 101(c) [title VII, Secs. 740, 741, 
756], Dec. 21, 1982, 96 Stat. 1833, 1857, 1860.
    Pub. L. 97-114, title VII, Secs. 741, 742, 759, Dec. 29, 1981, 95 
Stat. 1585, 1588.
    Pub. L. 96-527, title VII, Secs. 742, 743, 763, Dec. 15, 1980, 94 
Stat. 3088, 3092.
    Pub. L. 96-154, title VII, Secs. 744, 745, 769, Dec. 21, 1979, 93 
Stat. 1159, 1163.
    Pub. L. 95-457, title VIII, Secs. 844, 845, Oct. 13, 1978, 92 Stat. 
1251.
    Pub. L. 95-111, title VIII, Secs. 843, 844, Sept. 21, 1977, 91 Stat. 
907.
    Pub. L. 94-419, title VII, Secs. 742, 743, Sept. 22, 1976, 90 Stat. 
1298.
    Pub. L. 94-212, title VII, Secs. 750, 751, Feb. 9, 1976, 90 Stat. 
176.
    Provisions similar to those added to subsec. (h)(2) of this section 
by section 1401(e)(4)(B) of Pub. L. 98-525 were contained in the 
following prior appropriation acts:
    Pub. L. 98-473, title I, Sec. 101(h) [title VIII, Sec. 8077], Oct. 
12, 1984, 98 Stat. 1904, 1938.
    Pub. L. 98-212, title VII, Sec. 785, Dec. 8, 1983, 97 Stat. 1453.
    A prior section 1079, act Aug. 10, 1956, ch. 1041, 70A Stat. 84, 
related to establishment of right to vote, prior to repeal by Pub. L. 
85-861, Sec. 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by the 
Federal Voting Assistance Act of 1955 which is classified to subchapter 
I-D (Sec. 1973cc et seq.) of chapter 20 of Title 42, The Public Health 
and Welfare.


                               Amendments

    2000--Subsec. (a)(17). Pub. L. 106-398, Sec. 1 [[div. A], title VII, 
Sec. 701(c)(1)], designated existing provisions as subpar. (A) and added 
subpar. (B).
    Subsec. (g). Pub. L. 106-398, Sec. 1 [[div. A], title VII, 
Sec. 704(b)], substituted ``three-year period'' for ``one-year period''.
    Subsec. (h)(5). Pub. L. 106-398, Sec. 1 [[div. A], title VII, 
Sec. 757(a)], added par. (5).
    Subsec. (p). Pub. L. 106-398, Sec. 1 [[div. A], title VII, 
Sec. 722(b)(1)], added subsec. (p).
    1997--Subsec. (h)(1). Pub. L. 105-85, Sec. 735(a), added par. (1) 
and struck out former par. (1) which read as follows: ``Payment for a 
charge for services by an individual health care professional (or other 
noninstitutional health care provider) for which a claim is submitted 
under a plan contracted for under subsection (a) may not exceed the 
lesser of--
        ``(A) the amount equivalent to the 80th percentile of billed 
    charges made for similar services in the same locality during the 
    base period; or
        ``(B) an amount determined to be appropriate, to the extent 
    practicable, in accordance with the same reimbursement rules as 
    apply to payments for similar services under title XVIII of the 
    Social Security Act (42 U.S.C. 1395 et seq.).''
    Subsec. (h)(2). Pub. L. 105-85, Sec. 735(c)(2), redesignated par. 
(4) as (2).
    Pub. L. 105-85, Sec. 735(a), struck out par. (2) which read as 
follows: ``For the purposes of paragraph (1)(A), the 80th percentile of 
charges shall be determined by the Secretary of Defense, in consultation 
with the other administering Secretaries, and the base period shall be a 
period of twelve calendar months. The Secretary of Defense shall adjust 
the base period as frequently as he considers appropriate.''
    Subsec. (h)(3). Pub. L. 105-85, Sec. 735(c)(2), redesignated par. 
(5) as (3).
    Pub. L. 105-85, Sec. 735(a), struck out par. (3) which read as 
follows: ``For the purposes of paragraph (1)(B), the appropriate payment 
amount shall be determined by the Secretary of Defense, in consultation 
with the other administering Secretaries.''
    Subsec. (h)(4). Pub. L. 105-85, Sec. 735(c)(2), redesignated par. 
(4) as (2).
    Subsec. (h)(5). Pub. L. 105-85, Sec. 735(c)(2), redesignated par. 
(5) as (3).
    Pub. L. 105-85, Sec. 735(b), (c)(1), substituted ``paragraph (2), 
the Secretary of Defense'' for ``paragraph (4), the Secretary'' and 
inserted at end ``With the consent of the health care provider, the 
Secretary is also authorized to reduce the authorized payment for 
certain health care services below the amount otherwise required by the 
payment limitations under paragraph (1).''
    Subsec. (h)(6). Pub. L. 105-85, Sec. 735(c)(2), redesignated par. 
(6) as (4).
    1996--Subsec. (a). Pub. L. 104-201, Sec. 731(b)(1), substituted 
``except as follows:'' for ``except that--'' in introductory provisions.
    Subsec. (a)(1). Pub. L. 104-201, Sec. 731(b)(2), (3), capitalized 
first letter of first word and substituted a period for the semicolon at 
end.
    Subsec. (a)(2). Pub. L. 104-201, Sec. 731(b)(2), (3), capitalized 
first letter of first word and substituted a period for the semicolon at 
end.
    Pub. L. 104-201, Sec. 701(b)(2), inserted ``the schedule and method 
of colon and prostate cancer screenings,'' after ``pap smears and 
mammograms,'' in introductory provisions and ``or colon and prostate 
cancer screenings'' after ``pap smears and mammograms'' in subpar. (B).
    Pub. L. 104-106, Sec. 701, added par. (2) and struck out former par. 
(2) which read as follows: ``routine physical examinations and 
immunizations of dependents over two years of age may only be provided 
when required in the case of dependents who are traveling outside the 
United States as a result of a member's duty assignment and such travel 
is being performed under orders issued by a uniformed service, except 
that pap smears and mammograms may be provided on a diagnostic or 
preventive basis;''.
    Subsec. (a)(3) to (12). Pub. L. 104-201, Sec. 731(b)(2), (3), 
capitalized first letter of first word and substituted a period for the 
semicolon at end.
    Subsec. (a)(13). Pub. L. 104-201, Sec. 731(a), (b)(2), substituted 
``Any service'' for ``any service'' and ``paragraph (4).'' for 
``paragraph (4);'' and inserted at end ``Pursuant to an agreement with 
the Secretary of Health and Human Services and under such regulations as 
the Secretary of Defense may prescribe, the Secretary of Defense may 
waive the operation of this paragraph in connection with clinical trials 
sponsored or approved by the National Institutes of Health if the 
Secretary of Defense determines that such a waiver will promote access 
by covered beneficiaries to promising new treatments and contribute to 
the development of such treatments.''
    Subsec. (a)(14), (15). Pub. L. 104-201, Sec. 731(b)(2), (3), 
capitalized first letter of first word and substituted a period for the 
semicolon at end.
    Subsec. (a)(16). Pub. L. 104-201, Sec. 731(b)(2), (4), capitalized 
first letter of first word and substituted a period for ``; and'' at 
end.
    Subsec. (a)(17). Pub. L. 104-201, Sec. 731(b)(2), capitalized first 
letter of first word.
    Subsec. (h)(1). Pub. L. 104-106, Sec. 731(a), added par. (1) and 
struck out former par. (1) which read as follows: ``Payment for a charge 
for services by an individual health-care professional (or other 
noninstitutional health-care provider) for which a claim is submitted 
under a plan contracted for under subsection (a) may be denied only to 
the extent that the charge exceeds the amount equivalent to the 80th 
percentile of billed charges made for similar services in the same 
locality during the base period.''
    Subsec. (h)(2). Pub. L. 104-106, Sec. 731(d), substituted 
``paragraph (1)(A)'' for ``paragraph (1)''.
    Subsec. (h)(3). Pub. L. 104-106, Sec. 731(b), added par. (3).
    Subsec. (h)(4). Pub. L. 104-201, Sec. 711, struck out ``emergency'' 
before ``services from nonparticipating providers.''
    Pub. L. 104-106, Sec. 731(c), added par. (4).
    Subsec. (h)(5). Pub. L. 104-201, Sec. 732(2), added par. (5). Former 
par. (5) redesignated (6).
    Pub. L. 104-106, Sec. 731(c), added par. (5).
    Subsec. (h)(6). Pub. L. 104-201, Sec. 732(1), redesignated par. (5) 
as (6).
    Subsec. (j)(1). Pub. L. 104-201, Sec. 735(c), inserted ``, including 
any plan offered by a third-party payer (as defined in section 
1095(h)(1) of this title),'' after ``or health plan''.
    1994--Subsec. (a). Pub. L. 103-337, Sec. 702(a)(1), substituted 
``dependents, as described in subparagraphs (A), (D), and (I) of section 
1072(2) of this title,'' for ``spouses and children''.
    Subsec. (d). Pub. L. 103-337, Sec. 702(a)(2), substituted ``as 
described in subparagraph (A), (D), or (I) of section 1072(2)'' for ``as 
defined in section 1072(2)(A) or (D)''.
    Subsec. (g). Pub. L. 103-337, Sec. 707(a), inserted at end ``In 
addition, when a member dies while on active duty for a period of more 
than 30 days, the member's dependents who are receiving benefits under a 
plan covered by subsection (a) shall continue to be eligible for such 
benefits during the one-year period beginning on the date of the death 
of the member.''
    1993--Subsec. (a)(7). Pub. L. 103-160, Sec. 716(c), substituted 
``except that those services may be provided in any case in which 
another insurance plan or program provides primary coverage for those 
services;'' for ``except that--
        ``(A) those services may be provided in any case in which 
    another insurance plan or program provides primary coverage for 
    those services; and
        ``(B) the Secretary of Defense may waive the 40-mile radius 
    restriction with regard to the provision of a particular service 
    before October 1, 1993, if the Secretary determines that the use of 
    a different geographical area restriction will result in a more 
    cost-effective provision of the service;''.
    Subsec. (a)(15). Pub. L. 103-35 made technical amendment to 
directory language of Pub. L. 102-484, Sec. 704(1). See 1992 Amendment 
note below.
    Subsec. (o). Pub. L. 103-160, Sec. 711, added subsec. (o).
    1992--Subsec. (a)(15). Pub. L. 102-484, Sec. 1053(3), made technical 
amendment to directory language of Pub. L. 102-190, Sec. 702(b)(1)(C). 
See 1991 Amendment note below.
    Pub. L. 102-484, Sec. 704(1), as amended by Pub. L. 103-35, struck 
out ``and'' at end of par. (15).
    Subsec. (a)(16). Pub. L. 102-484, Sec. 704(2), substituted ``; and'' 
for period at end.
    Subsec. (a)(17). Pub. L. 102-484, Sec. 704(3), added par. (17).
    Subsec. (j)(2)(B). Pub. L. 102-484, Sec. 1052(13), inserted a close 
parenthesis after ``1395x(dd)(2)''.
    1991--Subsec. (a)(6). Pub. L. 102-25, Sec. 316(b), revived par. (6) 
as in effect on Feb. 14, 1991, thus negating amendment to par. (6) by 
Pub. L. 101-510, Sec. 703(a), from its original effective date (Feb. 15, 
1991) to the effective date as amended (Oct. 1, 1991). See 1990 
Amendment note and Effective Date of 1990 Amendment note below.
    Subsec. (a)(7). Pub. L. 102-190, Sec. 711, substituted ``except 
that--'' and subpars. (A) and (B), for ``except that such services may 
be provided in any case in which another insurance plan or program 
provides primary coverage for the services;''.
    Subsec. (a)(13). Pub. L. 102-190, Sec. 702(b)(1)(A), substituted 
``paragraph (4)'' for ``clause (4)''.
    Subsec. (a)(14). Pub. L. 102-190, Sec. 702(b)(1)(B), struck out 
``and'' at end.
    Subsec. (a)(15). Pub. L. 102-190, Sec. 702(b)(1)(C), as amended by 
Pub. L. 102-484, Sec. 1053(3), substituted ``; and'' for period at end.
    Subsec. (a)(16). Pub. L. 102-190, Sec. 702(b)(1)(D), added par. 
(16).
    Subsec. (i). Pub. L. 102-25, Sec. 316(b), revived subsec. (i) as in 
effect on Feb. 14, 1991, thus negating amendment to subsec. (i) by Pub. 
L. 101-510, Sec. 703(b), from its original effective date (Feb. 15, 
1991) to the effective date as amended (Oct. 1, 1991). See 1990 
Amendment note and Effective Date of 1990 Amendment note below.
    Subsec. (j)(1). Pub. L. 102-190, Sec. 713, inserted ``, or covered 
by,'' after ``person enrolled in''.
    Subsec. (j)(2)(B). Pub. L. 102-190, Sec. 702(b)(2), inserted 
``hospice program (as defined in section 1861(dd)(2) of the Social 
Security Act (42 U.S.C. 1395x(dd)(2)),''.
    Subsec. (n). Pub. L. 102-190, Sec. 712(a), added subsec. (n).
    1990--Subsec. (a)(2). Pub. L. 101-510, Sec. 701(a), inserted before 
the semicolon ``, except that pap smears and mammograms may be provided 
on a diagnostic or preventive basis''.
    Subsec. (a)(6). Pub. L. 101-510, Sec. 703(a), substituted ``in 
excess of--'' for ``in excess of 60 days in any year;'' and added 
subpars. (A) to (C).
    Subsec. (a)(8). Pub. L. 101-510, Sec. 702(a)(1), inserted ``(other 
than certified marriage and family therapists)'' after ``marital 
counselors'' and inserted before semicolon ``and services of certified 
marriage and family therapists may be provided consistent with such 
rules as may be prescribed by the Secretary of Defense, including 
credentialing criteria and a requirement that the therapists accept 
payment under this section as full payment for all services provided''.
    Subsec. (a)(13). Pub. L. 101-510, Sec. 702(a)(2), inserted 
``certified marriage and family therapist,'' after ``psychologist,''.
    Subsec. (b)(2). Pub. L. 101-510, Sec. 712(a)(1), substituted 
``$150'' for ``$50'' and inserted at end ``Notwithstanding the preceding 
sentence, in the case of a dependent of an enlisted member in a pay 
grade below E-5, the initial deductible each fiscal year under this 
paragraph shall be limited to $50.''
    Subsec. (b)(3). Pub. L. 101-510, Sec. 712(a)(2), substituted ``$300 
(or in the case of the family group of an enlisted member in a pay grade 
below E-5, the first $100)'' for ``$100''.
    Subsec. (i). Pub. L. 101-510, Sec. 703(b), amended subsec. (i) 
generally. Prior to amendment, subsec. (i) read as follows: ``The 
limitation in subsection (a)(6) does not apply in the case of inpatient 
mental health services--
        ``(1) provided under the program for the handicapped under 
    subsection (d);
        ``(2) provided as residential treatment care;
        ``(3) provided as partial hospital care; or
        ``(4) provided pursuant to a waiver authorized by the Secretary 
    of Defense because of extraordinary medical or psychological 
    circumstances that are confirmed by review by a non-Federal health 
    professional pursuant to regulations prescribed by the Secretary of 
    Defense.''
    Subsec. (j)(2)(B). Pub. L. 101-510, Sec. 1484(g)(1), inserted ``the 
term'' after ``In subparagraph (A),''.
    1989--Subsec. (h)(1), (2). Pub. L. 101-189 substituted ``80th 
percentile'' for ``90th percentile''.
    1988--Subsec. (b)(1). Pub. L. 100-456, Sec. 646(a)(1), inserted 
provisions authorizing Secretary of Defense to exempt a patient from 
paying such amount if the hospital to which the patient is admitted does 
not impose a legal obligation on any of its patients to pay for 
inpatient care.
    Subsec. (m). Pub. L. 100-456, Sec. 646(a)(2), added subsec. (m).
    1987--Subsec. (a)(15). Pub. L. 100-180, Sec. 726(a), added par. 
(15).
    Subsec. (b)(5). Pub. L. 100-180, Sec. 721(a), added par. (5).
    1986--Subsec. (a)(7). Pub. L. 99-661, Sec. 703, substituted 
``provides primary coverage for the services'' for ``pays for at least 
75 percent of the services''.
    Subsec. (l). Pub. L. 99-661, Sec. 652(d), added subsec. (l).
    1984--Subsec. (a). Pub. L. 98-557, Sec. 19(7)(B), substituted 
reference to other administering Secretaries for reference to Secretary 
of Health and Human Services in provisions preceding cl. (1).
    Subsec. (a)(3). Pub. L. 98-525, Sec. 632(a)(1), substituted ``not 
more than one eye examination may be provided to a patient in any 
calendar year'' for ``eye examinations may not be provided''.
    Subsec. (a)(4). Pub. L. 98-557, Sec. 19(7)(A), substituted reference 
to the administering Secretaries for reference to the Secretary of 
Defense and the Secretary of Health and Human Services.
    Subsec. (a)(7) to (14). Pub. L. 98-525, Sec. 1401(e)(4)(A), added 
cls. (7) to (14).
    Subsecs. (b)(4), (c), (d). Pub. L. 98-557, Sec. 19(7)(A), 
substituted reference to the administering Secretaries for reference to 
the Secretary of Defense and the Secretary of Health and Human Services.
    Subsec. (e). Pub. L. 98-525, Sec. 1405(23), substituted ``under 
subsection (d) as follows:'' for ``under subsection (d).'' in provisions 
preceding cl. (1).
    Subsecs. (e)(1), (f). Pub. L. 98-557, Sec. 19(7)(A), substituted 
reference to the administering Secretaries for reference to the 
Secretary of Defense and the Secretary of Health and Human Services.
    Subsec. (h)(2). Pub. L. 98-557, Sec. 19(7)(B), substituted reference 
to other administering Secretaries for reference to Secretary of Health 
and Human Services.
    Pub. L. 98-525, Sec. 1401(e)(4)(B), substituted ``The Secretary of 
Defense shall adjust the base period as frequently as he considers 
appropriate'' for ``The base period shall be adjusted at least once a 
year''.
    Subsec. (j)(2)(A). Pub. L. 98-557, Sec. 19(7)(A), substituted 
reference to the administering Secretaries for reference to the 
Secretary of Defense and the Secretary of Health and Human Services.
    Subsec. (k)(1), (2). Pub. L. 98-557, Sec. 19(7)(B), substituted 
reference to other administering Secretaries for reference to Secretary 
of Health and Human Services.
    1983--Subsec. (a). Pub. L. 98-94, Sec. 1268(4)(A), substituted 
``30'' for ``thirty'' in provisions preceding par. (1).
    Subsec. (a)(6). Pub. L. 98-94, Sec. 931(a)(1), added par. (6).
    Subsec. (d). Pub. L. 98-94, Sec. 1268(4)(A), substituted ``30'' for 
``thirty''.
    Subsec. (g). Pub. L. 98-94, Sec. 1268(4)(B), struck out ``of this 
section'' after ``subsection (d)''.
    Subsecs. (i) to (k). Pub. L. 98-94, Sec. 931(a)(2), added subsecs. 
(i) to (k).
    1981--Subsec. (b)(4). Pub. L. 97-22 substituted ``Secretary of 
Health and Human Services'' for ``Secretary of Health, Education, and 
Welfare''.
    Subsec. (h). Pub. L. 97-86 substituted reference to services of 
individual health-care professionals for former reference to physician 
services, struck out provisions that had used the concept of a 
predetermined charge level based upon customary charges, and inserted 
provisions requiring a readjustment of the base period at least once a 
year.
    1980--Subsec. (a). Pub. L. 96-513, Sec. 511(36), (38)(A), 
substituted ``Secretary of Health and Human Services'' for ``Secretary 
of Health, Education, and Welfare'' wherever appearing, and ``that--'' 
for ``that:''.
    Subsec. (a)(2). Pub. L. 96-342, Sec. 810(a)(1), inserted ``of 
dependents over two years of age'' after ``immunizations''.
    Subsec. (a)(3). Pub. L. 96-342, Sec. 810(a)(2), struck out ``routine 
care of the newborn, well-baby care, and'' after ``(3)''.
    Subsec. (b)(4). Pub. L. 96-552 added par. (4).
    Pub. L. 96-513, Sec. 511(38)(B), substituted ``percent'' for ``per 
centum'' wherever appearing.
    Subsec. (c). Pub. L. 96-513, Sec. 511(36), substituted ``Secretary 
of Health and Human Services'' for ``Secretary of Health, Education, and 
Welfare''.
    Subsec. (d). Pub. L. 96-513, Secs. 501(13), 511(36), substituted 
``section 1072(2)(A) or (D) of this title'' for ``section 1072(2)(A), 
(C), or (E) of this title'', and ``Secretary of Health and Human 
Services'' for ``Secretary of Health, Education, and Welfare''.
    Subsec. (e). Pub. L. 96-513, Sec. 511(36), (38)(C), substituted 
``Secretary of Health and Human Services'' for ``Secretary of Health, 
Education, and Welfare'', and ``(d) as follows:'' for ``(d).''.
    Subsec. (e)(2). Pub. L. 96-342, Sec. 810(b), substituted ``$1,000'' 
for ``$350''.
    Subsec. (f). Pub. L. 96-513, Sec. 511(36), substituted ``Secretary 
of Health and Human Services'' for ``Secretary of Health, Education, and 
Welfare''.
    Subsec. (g). Pub. L. 96-513, Sec. 511(38)(D), struck out ``, United 
States Code,'' after ``37''.
    Subsec. (h). Pub. L. 96-513, Sec. 511(36), substituted ``Secretary 
of Health and Human Services'' for ``Secretary of Health, Education, and 
Welfare''.
    1978--Subsec. (h). Pub. L. 95-485 added subsec. (h).
    1971--Subsec. (g). Pub. L. 92-58 added subsec. (g).
    1966--Subsec. (a). Pub. L. 89-614 struck out ``dependent'' before 
``spouses and children'' and substituted sentence providing that ``The 
types of health care authorized under this section, shall be the same as 
those provided under section 1076 of this title'', enumerating 
exceptions in pars. (1) to (5) for former provisions which required the 
insurance, medical service, or health plans to include (1) 
hospitalization in semiprivate rooms for not more than 365 days for each 
admission, (2) medical and surgical care incident to hospitalization, 
(3) obstetrical and maternity service, including prenatal and postnatal 
care, (4) services of physician or surgeon before or after 
hospitalization for bodily injury or surgical operation, (5) diagnostic 
tests and services incident to hospitalization, and (6) payments by 
patient of hospital expenses, now incorporated in subsec. (b)(1).
    Subsec. (b). Pub. L. 89-614 incorporated existing provisions of 
subsec. (a)(6) in par. (1) and added pars. (2) and (3). Former subsec. 
(b) authorized the Secretary of Defense to make variances from subsec. 
(a) requirements as appropriate other than outpatient care or care other 
than provided for in sections 1076 to 1078 of this title.
    Subsecs. (c) to (f). Pub. L. 89-614 added subsecs. (c) to (f).


                    Effective Date of 2000 Amendment

    Pub. L. 106-398, Sec. 1 [[div. A], title VII, Sec. 701(c)(3)], Oct. 
30, 2000, 114 Stat. 1654, 1654A-172, provided that: ``The amendments 
made by paragraphs (1) and (2) [amending this section and provisions set 
out as a note under section 1077 of this title] shall apply to fiscal 
years after fiscal year 1999.''
    Amendment by section 1 [[div. A], title VII, Sec. 722(b)(1)] of Pub. 
L. 106-398 effective Oct. 1, 2001, see section 1 [[div. A], title VII, 
Sec. 722(c)(1)] of Pub. L. 106-398, set out as a note under section 1074 
of this title.


                    Effective Date of 1994 Amendment

    Pub. L. 103-337, div. A, title VII, Sec. 707(c), Oct. 5, 1994, 108 
Stat. 2801, provided that: ``The amendments made by subsections (a) and 
(b) [amending this section and section 1076a of this title] shall apply 
with respect to the dependents described in such amendments of a member 
of a uniformed service who dies on or after October 1, 1993, while on 
active duty for a period of more than 30 days.''


                    Effective Date of 1993 Amendment

    Amendment by Pub. L. 103-35 applicable as if included in the 
enactment of Pub. L. 102-484, see section 202(b) of Pub. L. 103-35, set 
out as a note under section 155 of this title.


                    Effective Date of 1992 Amendment

    Section 1053(3) of Pub. L. 102-484 provided that the amendment made 
by that section is effective Dec. 5, 1991.


                    Effective Date of 1991 Amendment

    Section 316(b) of Pub. L. 102-25 provided that the amendment made by 
that section is effective Feb. 15, 1991.


                    Effective Date of 1990 Amendment

    Section 701(b) of Pub. L. 101-510 provided that: ``The amendment 
made by subsection (a) [amending this section] shall apply to the 
provision of pap smears and mammograms under section 1079 or 1086 of 
title 10, United States Code, on or after the date of the enactment of 
this Act [Nov. 5, 1990].''
    Section 702(b) of Pub. L. 101-510 provided that: ``The amendments 
made by subsection (a) [amending this section] shall apply with respect 
to the services of certified marriage and family therapists provided 
under section 1079 or 1086 of title 10, United States Code, on or after 
the date of the enactment of this Act [Nov. 5, 1990].''
    Section 703(d) of Pub. L. 101-510, as amended by Pub. L. 102-25, 
title III, Sec. 316(a)(1), Apr. 6, 1991, 105 Stat. 87, provided that: 
``This section and the amendments made by this section [amending this 
section] shall take effect on October 1, 1991, and shall apply with 
respect to mental health services provided under section 1079 or 1086 of 
title 10, United States Code, on or after that date.''
    Section 712(c) of Pub. L. 101-510 provided that: ``The amendments 
made by this section [amending this section and section 1086 of this 
title] shall apply with respect to health care provided under sections 
1079 and 1086 of title 10, United States Code, on or after April 1, 
1991.''


                    Effective Date of 1989 Amendment

    Section 730(b) of Pub. L. 101-189 provided that: ``The amendment 
made by subsection (a) [amending this section] shall apply to services 
provided on or after October 1, 1989.''


                    Effective Date of 1988 Amendment

    Section 646(c) of Pub. L. 100-456 provided that: ``The amendments 
made by subsections (a) and (b) [amending this section and section 1086 
of this title] shall apply with respect to medical care received after 
September 30, 1988.''


                    Effective Date of 1987 Amendment

    Section 721(c) of Pub. L. 100-180 provided that: ``Paragraph (5) of 
section 1079(b) of title 10, United States Code, as added by subsection 
(a), and paragraph (4) of section 1086(b) of such title, as added by 
subsection (b), shall apply with respect to fiscal years beginning after 
September 30, 1987.''
    Section 726(b) of Pub. L. 100-180 provided that: ``Paragraph (15) of 
section 1079(a) of such title, as added by subsection (a), shall apply 
with respect to costs incurred for home monitoring equipment after the 
date of the enactment of this Act [Dec. 4, 1987].''


                    Effective Date of 1986 Amendment

    Section 652(e)(4) of Pub. L. 99-661 provided that: ``The amendment 
made by subsection (d) [amending this section] shall apply only with 
respect to care furnished under section 1079 of title 10, United States 
Code, on or after the date of the enactment of this Act [Nov. 14, 
1986].''


                    Effective Date of 1984 Amendment

    Section 632(a)(3) of Pub. L. 98-525 provided that: ``The amendments 
made by this subsection [amending this section and section 1086 of this 
title] shall apply only to health care furnished after September 30, 
1984.''
    Amendment by section 1401(e)(4) of Pub. L. 98-525 effective Oct. 1, 
1985, see section 1404 of Pub. L. 98-525, set out as an Effective Date 
note under section 520b of this title.


                    Effective Date of 1983 Amendment

    Section 931(c) of Pub. L. 98-94 provided that: ``The amendments made 
by this section [amending this section and section 1086 of this title] 
shall take effect on October 1, 1983, except that--
        ``(1) clause (6) of section 1079(a) of title 10, United States 
    Code, as added by subsection (a)(1), shall not apply in the case of 
    inpatient mental health services provided to a patient admitted 
    before January 1, 1983, for so long as that patient remains 
    continuously in inpatient status for medically or psychologically 
    necessary reasons; and
        ``(2) subsection (k) of section 1079 of such title, as added by 
    subsection (a)(1), shall apply with respect to liver transplant 
    operations performed on or after July 1, 1983.''


                    Effective Date of 1981 Amendment

    Section 906(b) of Pub. L. 97-86 provided that: ``The amendments made 
by subsection (a) [amending this section and section 1086 of this title] 
shall apply with respect to claims submitted for payment for services 
provided after the end of the 30-day period beginning on the date of the 
enactment of this Act [Dec. 1, 1981].''


                    Effective Date of 1980 Amendments

    Amendment by section 501(13) of Pub. L. 96-513 effective Sept. 15, 
1981, see section 701 of Pub. L. 96-513, set out as a note under section 
101 of this title.
    Amendment by section 511 of Pub. L. 96-513 effective Dec. 12, 1980, 
see section 701(b)(3) of Pub. L. 96-513.
    Section 810(c) of Pub. L. 96-342 provided that: ``The amendments 
made by this section [amending this section] shall apply to medical care 
provided after September 30, 1980.''


                    Effective Date of 1978 Amendment

    Section 806(b) of Pub. L. 95-485 provided that: ``the amendments 
made by subsection (a) [amending this section and section 1086 of this 
title] shall apply with respect to claims submitted for payment for 
services provided on or after the first day of the first calendar year 
beginning after the date of enactment of this Act [Oct. 20, 1978].''


                    Effective Date of 1971 Amendment

    Section 2 of Pub. L. 92-58 provided that: ``This Act [amending this 
section] becomes effective as of January 1, 1967. However, no person is 
entitled to any benefits because of this Act for any period before the 
date of enactment [July 29, 1971].''


                    Effective Date of 1966 Amendment

    For effective date of amendment by Pub. L. 89-614, see section 3 of 
Pub. L. 89-614, set out as a note under section 1071 of this title.


       Report on Actions To Establish Special Reimbursement Rates

    Pub. L. 106-398, Sec. 1 [[div. A], title VII, Sec. 757(b)(1)], Oct. 
30, 2000, 114 Stat. 1654, 1654A-199, provided that: ``Not later than 
March 31, 2001, the Secretary of Defense shall submit to the Committees 
on Armed Services of the Senate and the House of Representatives and the 
General Accounting Office a report on actions taken to carry out section 
1079(h)(5) of title 10, United States Code (as added by subsection (a)) 
and section 1097b of such title.''


              Programs Relating to Sale of Pharmaceuticals

    Section 702 of Pub. L. 102-484, as amended by Pub. L. 103-160, div. 
A, title VII, Sec. 721, Nov. 30, 1993, 107 Stat. 1695; Pub. L. 103-337, 
div. A, title VII, Sec. 706, Oct. 5, 1994, 108 Stat. 2800; Pub. L. 106-
398, Sec. 1 [[div. A], title VII, Sec. 711(b)], Oct. 30, 2000, 114 Stat. 
1654, 1654A-176, provided that:
    ``(a) Demonstration Project for Pharmaceuticals by Mail.--Not later 
than 18 months after the date of the enactment of this Act [Oct. 23, 
1992], the Secretary of Defense, in consultation with the administering 
Secretaries, shall--
        ``(1) establish a demonstration project that permits eligible 
    persons described in subsection (c) to obtain prescription 
    pharmaceuticals by mail in connection with medical care furnished to 
    such persons under chapter 55 of title 10, United States Code; and
        ``(2) conduct the demonstration project in two or more regions 
    selected by the Secretary, each of which consists of two or more 
    States.
    ``(b) Retail Pharmacy Network.--To the maximum extent practicable, 
the Secretary of Defense shall include in each managed health care 
program initiated, awarded, or renewed by the Secretary after January 1, 
1993, a program to supply prescription pharmaceuticals to eligible 
persons described in subsection (c) through a managed care network of 
community retail pharmacies in the area covered by the managed health 
care program.
    ``(c) Eligible Persons.--A person eligible to obtain pharmaceuticals 
under the demonstration project established under subsection (a) or the 
retail pharmacy network included in a managed health care program under 
subsection (b) is any person living in the area covered by the 
demonstration project or managed health care program--
        ``(1) 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 title 10, United States Code; or
        ``(2) who--
            ``(A) would be eligible for medical care under a contract 
        for medical care entered into under section 1086 of such title 
        except for operation of subsection (d)(1) of such section; and
            ``(B) either--
                ``(i) resides in an area that is adversely affected (as 
            determined by the Secretary) by the closure of a health care 
            facility of the uniformed services as a result of the 
            closure or realignment of the military installation at which 
            such facility is located; or
                ``(ii) can demonstrate to the satisfaction of the 
            Secretary that the person relied upon a health care facility 
            referred to in clause (i) before the closure of the facility 
            to obtain the person's pharmaceuticals.
    ``(d) Pharmaceuticals Offered; Purchase Fees.--(1) The Secretary of 
Defense, in consultation with the administering Secretaries, shall--
        ``(A) determine the pharmaceuticals that may be obtained by 
    eligible persons under the demonstration project established under 
    subsection (a) or the retail pharmacy network included in a managed 
    health care program under subsection (b); and
        ``(B) establish an appropriate fee, charge, or copayment to be 
    paid by such persons for pharmaceuticals obtained under the 
    demonstration project or managed health care program.
    ``(2) In the case of persons eligible to participate in the 
demonstration project for pharmaceuticals or the retail pharmacy network 
by reason of clause (ii) of subsection (c)(2)(B), the Secretary of 
Defense may increase the fees, charges, and copayments established under 
paragraph (1)(B) and otherwise applicable to such persons by an amount 
necessary to cover any additional costs incurred by the administering 
Secretaries as a result of making pharmaceuticals available to such 
persons under this section.
    ``(e) Report Regarding Demonstration Project.--Not later than two 
years after the establishment of the demonstration project under 
subsection (a), the Secretary of Defense shall submit to Congress a 
report--
        ``(1) describing the results of the demonstration project 
    required by subsection (a);
        ``(2) containing such recommendations for revision of the 
    demonstration project as the Secretary considers to be necessary; 
    and
        ``(3) containing a plan (including a schedule) for implementing 
    the demonstration project throughout the United States.
    ``(f) Additional Report Regarding Programs.--Not later than January 
1, 1994, the Secretary of Defense shall submit to Congress a report 
containing--
        ``(1) an evaluation of the feasibility and advisability of 
    increasing the size of those areas determined by the Secretary under 
    subsection (c)(2) to be adversely affected by the closure of a 
    health care facility of the uniformed services in order to increase 
    the number of persons described in such subsection who will be 
    eligible to participate in the demonstration project for 
    pharmaceuticals by mail or in the retail pharmacy network under this 
    section;
        ``(2) an evaluation of the feasibility and advisability of 
    expanding the demonstration project and the retail pharmacy network 
    under this section to include all covered beneficiaries under 
    chapter 55 of title 10, United States Code, including those persons 
    currently excluded from participation in the Civilian Health and 
    Medical Program of the Uniformed Services by operation of section 
    1086(d)(1) of such title;
        ``(3) an estimation of the costs that would be incurred, and any 
    savings that would be achieved by improving efficiencies of 
    operation, as a result of undertaking the increase or expansion 
    described in paragraph (1) or (2); and
        ``(4) such recommendations as the Secretary considers to be 
    appropriate.
    ``(g) Definitions.--In this section, the terms `uniformed services' 
and `administering Secretaries' have the meanings given those terms in 
section 1072 of title 10, United States Code.
    ``(h) Termination.--This section shall cease to apply to the 
Secretary of Defense on the date after the implementation of section 711 
of the Floyd D. Spence National Defense Authorization Act for Fiscal 
Year 2001 [section 1 [[div. A], title VII, Sec. 711] of Pub. L. 106-398, 
amending this note and provisions set out as a note under section 1073 
of this title] that the Secretary determines appropriate, with a view to 
minimizing instability with respect to the provision of pharmacy 
benefits, but in no case later than the date that is one year after the 
date of the enactment of such Act [Oct. 30, 2000].''


   Correction of Omission in Delay of Increase of CHAMPUS Deductibles 
                    Related to Operation Desert Storm

    Section 721 of Pub. L. 102-484 provided that:
    ``(a) Lower CHAMPUS Annual Deductible.--In the case of health care 
provided under section 1079 or 1086 of title 10, United States Code, 
during the period beginning on April 1, 1991, and ending on September 
30, 1991, to a CHAMPUS beneficiary described in subsection (b), the 
annual deductibles specified in such sections applicable to that care 
may not exceed the annual deductibles in effect under such sections on 
November 4, 1990.
    ``(b) Eligible CHAMPUS Beneficiaries.--A CHAMPUS beneficiary 
referred to in subsection (a) is a covered beneficiary of the Civilian 
Health and Medical Program of the Uniformed Services who, during any 
portion of the period specified in that subsection--
        ``(1) was a member or former member of a uniformed service 
    entitled to retired or retainer pay and served on active duty in the 
    Persian Gulf theater of operations in connection with Operation 
    Desert Storm; or
        ``(2) was a dependent of a member of a uniformed service who 
    served on active duty in the Persian Gulf theater of operations in 
    connection with Operation Desert Storm.
    ``(c) Credit or Reimbursement of Excess.--Subject to the 
availability of appropriated funds to the Secretary of Defense, the 
Secretary shall provide--
        ``(1) for the reimbursement of the amount of any deductible paid 
    under section 1079 or 1086 of title 10, United States Code, during 
    the period specified in subsection (a) in excess of the amount 
    required to be paid by operation of that subsection; or
        ``(2) for a credit against the annual deductible required under 
    such sections for a fiscal year equal to the amount of the excess 
    deductible paid.
    ``(d) Definitions.--For purposes of this section, the term 
`Operation Desert Storm' has the meaning given that term in section 3(1) 
of the Persian Gulf Conflict Supplemental Authorization and Personnel 
Benefits Act of 1991 (Public Law 102-25; 10 U.S.C. 101 note).''


 Temporary CHAMPUS Provisions for Dependents of Operation Desert Shield/
                   Desert Storm Active Duty Personnel

    Pub. L. 102-172, title VIII, Sec. 8085, Nov. 26, 1991, 105 Stat. 
1192, provided that: ``Any CHAMPUS (Civilian Health and Medical Program 
of the Uniformed Services) health care provider may voluntarily waive 
the patient copayment for medical services provided from August 2, 1990, 
until the termination of Operation Desert Shield/Desert Storm for 
dependents of active duty personnel: Provided, That the Government's 
share of medical services is not increased during the specified time 
period.''
    Similar provisions were contained in Pub. L. 102-28, Sec. 105, Apr. 
10, 1991, 105 Stat. 165.
    Section 312 of Pub. L. 102-25 provided that:
    ``(a) Delay in the Increase of Annual Deductibles under CHAMPUS.--
The annual deductibles specified in subsection (b) of section 1079 of 
title 10, United States Code (as in effect on November 4, 1990), shall 
apply until October 1, 1991, in the case of health care provided under 
that section to the dependents of a member of the uniformed services who 
serves or served on active duty in the Persian Gulf theater of 
operations in connection with Operation Desert Storm.
    ``(b) Waiver of Copayment Requirements.--(1) Any civilian health 
care provider furnishing health care pursuant to a plan contracted for 
under the authority of section 1079 or 1086 of title 10, United States 
Code, may waive, in whole or in part, any requirement for payment under 
subsection (b) of that section by a patient described in paragraph (2) 
for health care furnished the patient by such health care provider 
during the Persian Gulf conflict.
    ``(2) A patient referred to in paragraph (1) is a dependent of a 
member of the uniformed services who serves on active duty in the 
Persian Gulf theater of operations in connection with Operation Desert 
Storm.
    ``(3) If a health care provider waives a payment for health care 
under paragraph (1), the health care provider shall certify to the 
Secretary of Defense that the amount charged the Federal Government for 
such health care was not increased above the amount that the health care 
provider would have charged the Federal Government for such health care 
had the payment not been waived. The Secretary of Defense may require a 
health care provider to provide information to the Secretary to show the 
compliance of the health care provider with this paragraph.''


  Transitional Health Care for Members, or Dependents of Members, Upon 
 Release of Member From Active Duty in Connection With Operation Desert 
                                  Storm

    For provision authorizing transitional health care, including health 
benefits contracted for under subsec. (a) of this section, for members, 
or dependents of members, upon release of member from active duty in 
connection with Operation Desert Storm, see section 313 of Pub. L. 102-
25, set out as a note under section 1076 of this title.

                  Section Referred to in Other Sections

    This section is referred to in sections 1072, 1074b, 1074g, 1080, 
1081, 1082, 1083, 1086, 1086a, 1095, 1096, 1097b, 1098, 1100, 1104, 
1105, 1145 of this title; title 42 sections 300e-1, 1395cc.
