
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 2, 2001]
[Document not affected by Public Laws enacted between
  January 2, 2001 and January 28, 2002]
[CITE: 10USC1092]

 
                         TITLE 10--ARMED FORCES
 
                    Subtitle A--General Military Law
 
                           PART II--PERSONNEL
 
                   CHAPTER 55--MEDICAL AND DENTAL CARE
 
Sec. 1092. Studies and demonstration projects relating to 
        delivery of health and medical care
        
    (a)(1) The Secretary of Defense, in consultation with the other 
administering Secretaries, shall conduct studies and demonstration 
projects on the health care delivery system of the uniformed services 
with a view to improving the quality, efficiency, convenience, and cost 
effectiveness of providing health care services (including dental care 
services) under this title to members and former members and their 
dependents. Such studies and demonstration projects may include the 
following:
        (A) Alternative methods of payment for health and medical care 
    services.
        (B) Cost-sharing by eligible beneficiaries.
        (C) Methods of encouraging efficient and economical delivery of 
    health and medical care services.
        (D) Innovative approaches to delivery and financing of health 
    and medical care services.
        (E) Alternative approaches to reimbursement for the 
    administrative charges of health care plans.
        (F) Prepayment for medical care services provided to maintain 
    the health of a defined population.

    (2) The Secretary of Defense shall include in the studies conducted 
under paragraph (1) alternative programs for the provision of dental 
care to the spouses and dependents of members of the uniformed services 
who are on active duty, including a program under which dental care 
would be provided the spouses and dependents of such members under 
insurance or dental plan contracts. A demonstration project may not be 
conducted under this section that provides for the furnishing of dental 
care under an insurance or dental plan contract.
    (b) Subject to the availability of appropriations for that purpose, 
the Secretary of Defense may enter into contracts with public or private 
agencies, institutions, and organizations to conduct studies and 
demonstration projects under subsection (a).
    (c) The Secretary of Defense may obtain the advice and 
recommendations of such advisory committees as the Secretary considers 
appropriate. Each such committee consulted by the Secretary under this 
subsection shall evaluate the proposed study or demonstration project as 
to the soundness of the objectives of such study or demonstration 
project, the likelihood of obtaining productive results based on such 
study or demonstration project, the resources which were required to 
conduct such study or demonstration project, and the relationship of 
such study or demonstration project to other ongoing or completed 
studies and demonstration projects.

(Added Pub. L. 98-94, title IX, Sec. 933(a)(1), Sept. 24, 1983, 97 Stat. 
650; amended Pub. L. 98-557, Sec. 19(14), Oct. 30, 1984, 98 Stat. 2870; 
Pub. L. 105-261, div. A, title X, Sec. 1031(a), Oct. 17, 1998, 112 Stat. 
2123.)


                               Amendments

    1998--Subsec. (a)(3). Pub. L. 105-261 struck out par. (3) which read 
as follows: ``The Secretary of Defense shall submit to Congress from 
time to time written reports on the results of the studies and 
demonstration projects conducted under this subsection and shall include 
in such reports such recommendations for improving the health-care 
delivery systems of the uniformed services as the Secretary considers 
appropriate.''
    1984--Subsec. (a)(1). Pub. L. 98-557 substituted reference to other 
administering Secretaries for reference to Secretary of Health and Human 
Services.


                             Effective Date

    Section 933(b) of Pub. L. 98-94 provided that: ``Section 1092 of 
title 10, United States Code, as added by subsection (a), shall take 
effect on October 1, 1983.''


  Demonstration Project for Expanded Access to Mental Health Counselors

    Pub. L. 106-398, Sec. 1 [[div. A], title VII, Sec. 731], Oct. 30, 
2000, 114 Stat. 1654, 1654A-189, provided that:
    ``(a) Requirement To Conduct Demonstration Project.--The Secretary 
of Defense shall conduct a demonstration project under which licensed 
and certified professional mental health counselors who meet eligibility 
requirements for participation as providers under the Civilian Health 
and Medical Program of the Uniformed Services (hereafter in this section 
referred to as `CHAMPUS') or the TRICARE program may provide services to 
covered beneficiaries under chapter 55 of title 10, United States Code, 
without referral by physicians or adherence to supervision requirements.
    ``(b) Duration and Location of Project.--The Secretary shall conduct 
the demonstration project required by subsection (a)--
        ``(1) during the 2-year period beginning October 1, 2001; and
        ``(2) in one established TRICARE region.
    ``(c) Regulations.--The Secretary shall prescribe regulations 
regarding participation in the demonstration project required by 
subsection (a).
    ``(d) Plan for Project.--Not later than March 31, 2001, the 
Secretary shall submit to the Committees on Armed Services of the Senate 
and the House of Representatives a plan to carry out the demonstration 
project. The plan shall include, but not be limited to, a description of 
the following:
        ``(1) The TRICARE region in which the project will be conducted.
        ``(2) The estimated funds required to carry out the 
    demonstration project.
        ``(3) The criteria for determining which professional mental 
    health counselors will be authorized to participate under the 
    demonstration project.
        ``(4) The plan of action, including critical milestone dates, 
    for carrying out the demonstration project.
    ``(e) Report.--Not later than February 1, 2003, the Secretary shall 
submit to Congress a report on the demonstration project carried out 
under this section. The report shall include the following:
        ``(1) A description of the extent to which expenditures for 
    reimbursement of licensed or certified professional mental health 
    counselors change as a result of allowing the independent practice 
    of such counselors.
        ``(2) Data on utilization and reimbursement regarding non-
    physician mental health professionals other than licensed or 
    certified professional mental health counselors under CHAMPUS and 
    the TRICARE program.
        ``(3) Data on utilization and reimbursement regarding physicians 
    who make referrals to, and supervise, mental health counselors.
        ``(4) A description of the administrative costs incurred as a 
    result of the requirement for documentation of referral to mental 
    health counselors and supervision activities for such counselors.
        ``(5) For each of the categories described in paragraphs (1) 
    through (4), a comparison of data for a 1-year period for the area 
    in which the demonstration project is being implemented with 
    corresponding data for a similar area in which the demonstration 
    project is not being implemented.
        ``(6) A description of the ways in which allowing for 
    independent reimbursement of licensed or certified professional 
    mental health counselors affects the confidentiality of mental 
    health and substance abuse services for covered beneficiaries under 
    CHAMPUS and the TRICARE program.
        ``(7) A description of the effect, if any, of changing 
    reimbursement policies on the health and treatment of covered 
    beneficiaries under CHAMPUS and the TRICARE program, including a 
    comparison of the treatment outcomes of covered beneficiaries who 
    receive mental health services from licensed or certified 
    professional mental health counselors acting under physician 
    referral and supervision, other non-physician mental health 
    providers recognized under CHAMPUS and the TRICARE program, and 
    physicians, with treatment outcomes under the demonstration project 
    allowing independent practice of professional counselors on the same 
    basis as other non-physician mental health providers.
        ``(8) The effect of policies of the Department of Defense on the 
    willingness of licensed or certified professional mental health 
    counselors to participate as health care providers in CHAMPUS and 
    the TRICARE program.
        ``(9) Any policy requests or recommendations regarding mental 
    health counselors made by health care plans and managed care 
    organizations participating in CHAMPUS or the TRICARE program.''


                   Teleradiology Demonstration Project

    Pub. L. 106-398, Sec. 1 [[div. A], title VII, Sec. 732], Oct. 30, 
2000, 114 Stat. 1654, 1654A-191, provided that:
    ``(a) Authority To Conduct Project.--(1) The Secretary of Defense 
may conduct a demonstration project for the purposes of increasing 
efficiency of operations with respect to teleradiology at military 
medical treatment facilities, supporting remote clinics, and increasing 
coordination with respect to teleradiology between such facilities and 
clinics. Under the project, a military medical treatment facility and 
each clinic supported by such facility shall be linked by a digital 
radiology network through which digital radiology X-rays may be sent 
electronically from clinics to the military medical treatment facility.
    ``(2) The demonstration project may be conducted at several 
multispecialty tertiary-care military medical treatment facilities 
affiliated with a university medical school. One of such facilities 
shall be supported by at least 5 geographically dispersed remote clinics 
of the Departments of the Army, Navy, and Air Force, and clinics of the 
Department of Veterans Affairs and the Coast Guard. Another of such 
facilities shall be in an underserved rural geographic region served 
under established telemedicine contracts between the Department of 
Defense, the Department of Veterans Affairs, and a local university.
    ``(b) Duration of Project.--The Secretary shall conduct the project 
during the 2-year period beginning on the date of the enactment of this 
Act [Oct. 30, 2000].''


   Joint Telemedicine and Telepharmacy Demonstration Projects by the 
        Department of Defense and Department of Veterans Affairs

    Pub. L. 106-65, div. A, title VII, Sec. 724, Oct. 5, 1999, 113 Stat. 
697, provided that:
    ``(a) In General.--The Secretary of Defense and the Secretary of 
Veterans Affairs may carry out joint demonstration projects for purposes 
of evaluating the feasibility and practicability of using 
telecommunications to provide health care services and pharmacy 
services.
    ``(b) Services To Be Provided.--The services provided under the 
demonstration projects may include the following:
        ``(1) Radiology and imaging services.
        ``(2) Diagnostic services.
        ``(3) Referral services.
        ``(4) Clinical pharmacy services.
        ``(5) Any other health care services or pharmacy services 
    designated by the Secretaries.
    ``(c) Selection of Locations.--(1) The Secretaries may carry out the 
demonstration projects described in subsection (a) at not more than five 
locations selected by the Secretaries from locations in which are 
located both a uniformed services treatment facility and a Department of 
Veterans Affairs medical center that are affiliated with academic 
institutions having a demonstrated expertise in the provision of health 
care services or pharmacy services by means of telecommunications.
    ``(2) Representatives of a facility and medical center selected 
under paragraph (1) shall, to the maximum extent practicable, carry out 
the demonstration project in consultation with representatives of the 
academic institution or institutions with which affiliated.
    ``(d) Period of Demonstration Projects.--The Secretaries may carry 
out the demonstration projects during the three-year period beginning on 
October 1, 1999.
    ``(e) Report.--Not later than December 31, 2002, the Secretaries 
shall jointly submit to Congress a report on the demonstration projects. 
The report shall include--
        ``(1) a description of each demonstration project; and
        ``(2) an evaluation, based on the demonstration projects, of the 
    feasibility and practicability of using telecommunications to 
    provide health care services and pharmacy services, including the 
    provision of such services to field hospitals of the Armed Forces 
    and to Department of Veterans Affairs outpatient health care 
    clinics.''


 Demonstration Program To Train Military Medical Personnel in Civilian 
                           Shock Trauma Units

    Pub. L. 104-106, div. A, title VII, Sec. 744, Feb. 10, 1996, 110 
Stat. 386, provided that:
    ``(a) Demonstration Program.--(1) Not later than April 1, 1996, the 
Secretary of Defense shall implement a demonstration program to evaluate 
the feasibility of providing shock trauma training for military medical 
personnel through one or more public or nonprofit hospitals. The 
Secretary shall carry out the program pursuant to an agreement with such 
hospitals.
    ``(2) Under the agreement with a hospital, the Secretary shall 
assign military medical personnel participating in the demonstration 
program to temporary duty in shock trauma units operated by the 
hospitals that are parties to the agreement.
    ``(3) The agreement shall require, as consideration for the services 
provided by military medical personnel under the agreement, that the 
hospital provide appropriate care to members of the Armed Forces and to 
other persons whose care in the hospital would otherwise require 
reimbursement by the Secretary. The value of the services provided by 
the hospitals shall be at least equal to the value of the services 
provided by military medical personnel under the agreement.
    ``(b) Termination of Program.--The authority of the Secretary of 
Defense to conduct the demonstration program under this section, and any 
agreement entered into under the demonstration program, shall expire on 
March 31, 1998.
    ``(c) Report and Evaluation of Program.--(1) Not later than March 1 
of each year in which the demonstration program is conducted under this 
section, the Secretary of Defense shall submit to Congress a report 
describing the scope and activities of the demonstration program during 
the preceding year.
    ``(2) Not later than May 1, 1998, the Comptroller General of the 
United States shall submit to Congress a report evaluating the 
effectiveness of the demonstration program in providing shock trauma 
training for military medical personnel.''


 Demonstration Project on Management of Health Care in Catchment Areas 
                    and Other Demonstration Projects

    Pub. L. 100-180, div. A, title VII, Sec. 731, Dec. 4, 1987, 101 
Stat. 1117, directed Secretary of Defense to conduct, beginning in 
fiscal year 1988 for at least two years, projects designed to 
demonstrate the alternative health care delivery system under which the 
commander of a medical facility of the uniformed services is responsible 
for all funding and all medical care of the covered beneficiaries in the 
catchment area of the facility and to conduct specific projects for the 
purpose of demonstrating alternatives to providing health care under the 
military health care system, directed Secretary not later than 60 days 
after Dec. 4, 1987, to submit to Congress a report that provides an 
outline and discussion of the manner in which the Secretary intends to 
structure and conduct each demonstration project and to develop and 
submit to Congress a methodology to be used in evaluating the results of 
the demonstration projects, and submit to Congress an interim report on 
each demonstration project after such project has been in effect for at 
least 12 months and a final report on each such project when each 
project is completed.


                        Chiropractic Health Care

    Pub. L. 106-398, Sec. 1 [[div. A], title VII, Sec. 702], Oct. 30, 
2000, 114 Stat. 1654, 1654A-173, provided that:
    ``(a) Plan Required.--(1) Not later than March 31, 2001, the 
Secretary of Defense shall complete development of a plan to provide 
chiropractic health care services and benefits, as a permanent part of 
the Defense Health Program (including the TRICARE program), for all 
members of the uniformed services who are entitled to care under section 
1074(a) of title 10, United States Code.
    ``(2) The plan shall provide for the following:
        ``(A) Access, at designated military medical treatment 
    facilities, to the scope of chiropractic services as determined by 
    the Secretary, which includes, at a minimum, care for neuro-
    musculoskeletal conditions typical among military personnel on 
    active duty.
        ``(B) A detailed analysis of the projected costs of fully 
    integrating chiropractic health care services into the military 
    health care system.
        ``(C) An examination of the proposed military medical treatment 
    facilities at which such services would be provided.
        ``(D) An examination of the military readiness requirements for 
    chiropractors who would provide such services.
        ``(E) An examination of any other relevant factors that the 
    Secretary considers appropriate.
        ``(F) Phased-in implementation of the plan over a 5-year period, 
    beginning on October 1, 2001.
    ``(b) Consultation Requirements.--The Secretary of Defense shall 
consult with the other administering Secretaries described in section 
1073 of title 10, United States Code, and the oversight advisory 
committee established under section 731 of the National Defense 
Authorization Act for Fiscal Year 1995 (Public Law 103-337; 10 U.S.C. 
1092 note) regarding the following:
        ``(1) The development and implementation of the plan required 
    under subsection (a).
        ``(2) Each report that the Secretary is required to submit to 
    Congress regarding the plan.
        ``(3) The selection of the military medical treatment facilities 
    at which the chiropractic services described in subsection (a)(2)(A) 
    are to be provided.
    ``(c) Continuation of Current Services.--Until the plan required 
under subsection (a) is implemented, the Secretary shall continue to 
furnish the same level of chiropractic health care services and benefits 
under the Defense Health Program that is provided during fiscal year 
2000 at military medical treatment facilities that provide such services 
and benefits.
    ``(d) Report Required.--Not later than January 31, 2001, the 
Secretary of Defense shall submit a report on the plan required under 
subsection (a), together with appropriate appendices and attachments, to 
the Committees on Armed Services of the Senate and the House of 
Representatives.
    ``(e) GAO Reports.--The Comptroller General shall monitor the 
development and implementation of the plan required under subsection 
(a), including the administration of services and benefits under the 
plan, and periodically submit to the committees referred to in 
subsection (d) written reports on such development and implementation.''
    Pub. L. 103-337, div. A, title VII, Sec. 731, Oct. 5, 1994, 108 
Stat. 2809, as amended by Pub. L. 105-85, div. A, title VII, Sec. 739, 
Nov. 18, 1997, 111 Stat. 1815; Pub. L. 106-65, div. A, title VII, 
Sec. 702(a), Oct. 5, 1999, 113 Stat. 680, provided that:
    ``(a) Requirement for Program.--(1) Not later than 120 days after 
the date of enactment of this Act [Oct. 5, 1994], the Secretary of 
Defense shall develop and carry out a demonstration program to evaluate 
the feasibility and advisability of furnishing chiropractic care through 
the medical care facilities of the Armed Forces. The Secretary of 
Defense shall develop and carry out the program in consultation with the 
Secretaries of the military departments.
    ``(2) In carrying out the program, the Secretary of Defense shall--
        ``(A) subject to paragraph (3), designate the National Naval 
    Medical Center, the Walter Reed Army Medical Center, and not less 
    than 11 other major military medical treatment facilities of the 
    Department of Defense to furnish chiropractic care under the 
    program; and
        ``(B) enter into agreements with such number of chiropractors as 
    the Secretary determines sufficient for the purposes of the program 
    to furnish chiropractic care at such facilities under the program.
    ``(3) The Secretary may not designate under paragraph (2) any 
treatment facility that is located on a military installation scheduled 
for closure or realignment under a base closure law.
    ``(4) During fiscal year 2000, the Secretary shall continue to 
furnish the same chiropractic care in the military medical treatment 
facilities designated pursuant to paragraph (2)(A) as the chiropractic 
care furnished during the demonstration program.
    ``(b) Program Period.--The Secretary shall carry out the 
demonstration program in fiscal years 1995 through 1999.
    ``(c) Reporting Requirements.--(1) Not later than January 30, 1995, 
the Secretary of Defense shall submit to the Committees on Armed 
Services of the Senate and the House of Representatives a report on the 
demonstration program. The report shall--
        ``(A) identify the treatment facilities designated pursuant to 
    subsection (a)(2)(A); and
        ``(B) include a discussion of the plan for the conduct of the 
    program.
    ``(2) Not later than May 1, 1995, the Secretary of Defense shall 
submit to the committees referred to in paragraph (1) a plan for 
evaluating the program, including a schedule for conducting progress 
reviews and for submitting a final report to the committees.
    ``(3) Not later than January 30, 1998, the Secretary of Defense 
shall submit to the Committees on Armed Services of the Senate and the 
House of Representatives a report that identifies the additional 
treatment facilities designated to furnish chiropractic care under the 
program that were not so designated before the report required by 
paragraph (1) was prepared, together with the plan for the conduct of 
the program at the additional treatment facilities.
    ``(4) Not later than May 1, 1998, the Secretary of Defense shall 
modify the plan for evaluating the program submitted pursuant to 
paragraph (2) in order to provide for the evaluation of the program at 
all of the designated treatment facilities under the program, including 
the treatment facilities referred to in paragraph (3).
    ``(5) Not later than January 31, 2000, the Secretary shall submit to 
the committees referred to in paragraph (3) a final report in accordance 
with the plan submitted pursuant to paragraph (2).
    ``(d) Oversight Advisory Committee.--(1) Not later than 30 days 
after the date of the enactment of this Act [Oct. 5, 1994], the 
Secretary of Defense shall establish an oversight advisory committee to 
assist and advise the Secretary with regard to the development and 
conduct of the demonstration program.
    ``(2) The oversight advisory committee shall include the following 
members:
        ``(A) The Comptroller General of the United States, or the 
    designee of such person from within the General Accounting Office.
        ``(B) The Assistant Secretary of Defense for Health Affairs, or 
    the designee of such person.
        ``(C) The Surgeons General of the Army, the Air Force, and the 
    Navy, or the designees of such persons.
        ``(D) No fewer than four independent representatives of the 
    chiropractic health care profession, appointed by the Secretary of 
    Defense.
    ``(3) The oversight advisory committee shall assist the Secretary of 
Defense regarding--
        ``(A) issues involving the professional credentials of the 
    chiropractors participating in the program;
        ``(B) the granting of professional practice privileges for the 
    chiropractors at the treatment facilities participating in the 
    program;
        ``(C) the preparation of the reports required under subsection 
    (c);
        ``(D) the evaluation of the program; and
        ``(E) if the Secretary submits an implementation plan pursuant 
    to subsection (e), the preparation of such plan.
    ``(4) The Federal Advisory Committee Act (5 U.S.C. App.) shall not 
apply to the oversight advisory committee.
    ``(5) The Secretary shall--
        ``(A) make full use of the oversight advisory committee in 
    preparing--
            ``(i) the final report on the demonstration program 
        conducted under this section; and
            ``(ii) the implementation plan described in subsection (e); 
        and
        ``(B) provide opportunities for members of the committee to 
    provide views as part of such final report and plan.
    ``(e) Implementation Plan.--If the Secretary of Defense recommends 
in the final report submitted under subsection (c) that chiropractic 
health care services should be offered in medical care facilities of the 
Armed Forces or as a health care service covered under the TRICARE 
program, the Secretary shall, not later than March 31, 2000, submit to 
the Committees on Armed Services of the House of Representatives and the 
Senate an implementation plan for the full integration of chiropractic 
health care services into the military health care system of the 
Department of Defense, including the TRICARE program. Such 
implementation plan shall include--
        ``(1) a detailed analysis of the projected costs of fully 
    integrating chiropractic health care services into the military 
    health care system;
        ``(2) the proposed scope of practice for chiropractors who would 
    provide services to covered beneficiaries under chapter 55 of title 
    10, United States Code;
        ``(3) the proposed military medical treatment facilities at 
    which such services would be provided;
        ``(4) the military readiness requirements for chiropractors who 
    would provide services to such covered beneficiaries; and
        ``(5) any other relevant factors that the Secretary considers 
    appropriate.
    ``(f) Definition.--For purposes of this section, the term `base 
closure law' means each of the following:
        ``(1) The Defense Base Closure and Realignment Act of 1990 (part 
    A of title XXIX of Public Law 101-510; 10 U.S.C. 2687 note).
        ``(2) Title II of the Defense Authorization Amendments and Base 
    Closure and Realignment Act (Public Law 100-526; 10 U.S.C. 2687 
    note).
        ``(3) Section 2687 of title 10, United States Code.''
    Pub. L. 98-525, title VI, Sec. 632(b), Oct. 19, 1984, 98 Stat. 2543, 
provided that: ``The Secretary of Defense, in consultation with the 
Secretary of Health and Human Services, shall conduct demonstration 
projects under section 1092 of title 10, United States Code, for the 
purpose of evaluating the cost-effectiveness of chiropractic care. In 
the conduct of such demonstration projects, chiropractic care (including 
manual manipulation of the spine and other routine chiropractic 
procedures authorized under joint regulations prescribed by the 
Secretary of Defense and the Secretary of Health and Human Services and 
not otherwise prohibited by law) may be provided as appropriate under 
chapter 55 of title 10, United States Code.''

                  Section Referred to in Other Sections

    This section is referred to in sections 1072, 1100 of this title.
