§1073. Administration of this chapter
Except as otherwise provided in this chapter, the Secretary of Defense shall administer this chapter, for the armed forces under his jurisdiction, the Secretary of Transportation shall administer this chapter for the Coast Guard when the Coast Guard is not operating as a service in the Navy, and the Secretary of Health and Human Services shall administer this chapter and for the National Oceanic and Atmospheric Administration and the Public Health Service.
(Added
Pub. L. 85–861, §1(25)(B), Sept. 2, 1958, 72 Stat. 1446
; amended
Pub. L. 89–614, §2(1), Sept. 30, 1966, 80 Stat. 862
;
Pub. L. 89–718, §8(a), Nov. 2, 1966, 80 Stat. 1117
;
Pub. L. 96–513, title V, §511(34)(A), (C), (35), (36), Dec. 12, 1980, 94 Stat. 2922
, 2923;
Pub. L. 98–557, §19(2), Oct. 30, 1984, 98 Stat. 2869
.)
The words "armed forces under his jurisdiction" are substituted for the words "Army, Navy, Air Force, and Marine Corps and for the Coast Guard when it is operating as a service in the Navy" to reflect section 101(4) of this title.
Prior Provisions
A prior section 1073, act Aug. 10, 1956, ch. 1041, 70A Stat. 82
, which related to right to vote in war-time presidential and congressional election, was repealed by
Pub. L. 85–861, §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, as superseded by the Federal Voting Assistance Act of 1955 which is classified to subchapter I–D (§1973cc et seq.) of chapter 20 of Title 42, The Public Health and Welfare.
Amendments
1984-Pub. L. 98–557 inserted provisions which transferred authority to administer chapter for the Coast Guard when the Coast Guard is not operating as a service in the Navy from the Secretary of Health and Human Services to the Secretary of Transportation.
1980-Pub. L. 96–513 substituted in section catchline "of this chapter" for "of sections 1071–1087 of this title", and substituted in text "this chapter" for "sections 1071–1087 of this title", "those sections", and "them", "Secretary of Health and Human Services" for "Secretary of Health, Education, and Welfare", and "National Oceanic and Atmospheric Administration" for "Environmental Science Services Administration".
1966-Pub. L. 89–718 substituted "Environmental Science Services Administration" for "Coast and Geodetic Survey".
Pub. L. 89–614 substituted "1087" for "1085" in section catchline and text.
Effective Date of 1980 Amendment
Amendment by Pub. L. 96–513 effective Dec. 12, 1980, see section 701(b)(3) of Pub. L. 96–513, set out as a note under section 101 of this title.
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.
Repeals
The directory language of, but not the amendment made by,
Pub. L. 89–718, §8(a), Nov. 2, 1966, 80 Stat. 1117
, cited as a credit to this section, was repealed by
Pub. L. 97–295, §6(b), Oct. 12, 1982, 96 Stat. 1314
.
Use of Health Maintenance Organization Model as Option for Military Health Care
Pub. L. 103–160, div. A, title VII, §731, Nov. 30, 1993, 107 Stat. 1696
, as amended by
Pub. L. 103–337, div. A, title VII, §715, Oct. 5, 1994, 108 Stat. 2803
, provided that:
"(a) Use of Model.-The Secretary of Defense shall prescribe and implement a health benefit option (and accompanying cost-sharing requirements) for covered beneficiaries eligible for health care under chapter 55 of title 10, United States Code, that is modelled on health maintenance organization plans offered in the private sector and other similar Government health insurance programs. The Secretary shall include, to the maximum extent practicable, the health benefit option required under this subsection as one of the options available to covered beneficiaries in all managed health care initiatives undertaken by the Secretary after December 31, 1994.
"(b) Elements of Option.-The Secretary shall offer covered beneficiaries who enroll in the health benefit option required under subsection (a) reduced out-of-pocket costs and a benefit structure that is as uniform as possible throughout the United States. The Secretary shall allow enrollees to seek health care outside of the option, except that the Secretary may prescribe higher out-of-pocket costs than are provided under section 1079 or 1086 of title 10, United States Code, for enrollees who obtain health care outside of the option.
"(c) Government Costs.-The health benefit option required under subsection (a) shall be administered so that the costs incurred by the Secretary under each managed health care initiative that includes the option are no greater than the costs that would otherwise be incurred to provide health care to the covered beneficiaries who enroll in the option.
"(d) Covered Beneficiary Defined.-For purposes of this section, the term 'covered beneficiary' means a beneficiary under chapter 55 of title 10, United States Code, other than a beneficiary under section 1074(a) of such title.
"(e) Regulations.-Not later than December 31, 1994, the Secretary shall prescribe final regulations to implement the health benefit option required by subsection (a).
"(f) Modification of Existing Contracts.-In the case of managed health care contracts in effect or in final stages of acquisition as of December 31, 1994, the Secretary may modify such contracts to incorporate the health benefit option required under subsection (a)."
Managed Health Care Program and Contracts for Military Health Services System
Pub. L. 103–139, title VIII, §8025, Nov. 11, 1993, 107 Stat. 1443
, provided that: "Notwithstanding any other provision of law, to establish region-wide, at-risk, fixed price managed care contracts possessing features similar to those of the CHAMPUS Reform Initiative, the Secretary of Defense shall submit to the Congress a plan to implement a nation-wide managed health care program for the military health services system not later than December 31, 1993: Provided, That the program shall include, but not be limited to: (1) a uniform, stabilized benefit structure characterized by a triple option health benefit feature; (2) a regionally-based health care management system; (3) cost minimization incentives including 'gatekeeping' and annual enrollment procedures, capitation budgeting, and at-risk managed care support contracts; and (4) full and open competition for all managed care support contracts: Provided further, That the implementation of the nation-wide managed care military health services system shall be completed by September 30, 1996: Provided further, That the Department shall competitively award contracts in fiscal year 1994 for at least four new region-wide, at-risk, fixed price managed care support contracts consistent with the nation-wide plan, that one such contract shall include the State of Florida (which may include Department of Veterans Affairs' medical facilities with the concurrence of the Secretary of Veterans Affairs), one such contract shall include the States of Washington and Oregon, and one such contract shall include the State of Texas: Provided further, That any law or regulation of a State or local government relating to health insurance, prepaid health plans, or other health care delivery, administration, and financing methods shall be preempted and shall not apply to any region-wide, at-risk, fixed price managed care contract entered into pursuant to chapter 55 of title 10, United States Code: Provided further, That the Department shall competitively award within 13 months after the date of enactment of this Act [Nov. 11, 1993] two contracts for stand-alone, at-risk managed mental health services in high utilization, high-cost areas, consistent with the management and service delivery features in operation in Department of Defense managed mental health care contracts: Provided further, That the Assistant Secretary of Defense for Health Affairs shall, during the current fiscal year, initiate through competitive procedures a managed health care program for eligible beneficiaries in the area of Homestead Air Force Base with benefits and services substantially identical to those established to serve beneficiary populations in areas where military medical facilities have been terminated, to include retail pharmacy networks available to Medicare-eligible beneficiaries, and shall present a plan to implement this program to the House and Senate Committees on Appropriations not later than January 15, 1994."
Condition on Expansion of CHAMPUS Reform Initiative to Other Locations
Pub. L. 102–484, div. A, title VII, §712, Oct. 23, 1992, 106 Stat. 2435
, as amended by
Pub. L. 103–160, div. A, title VII, §720, Nov. 30, 1993, 107 Stat. 1695
;
Pub. L. 103–337, div. A, title VII, §714(c), Oct. 5, 1994, 108 Stat. 2803
, provided that:
"(a) Condition.-(1) Except as provided in subsection (b), the Secretary of Defense may not expand the CHAMPUS reform initiative underway in the States of California and Hawaii to another location until not less than 90 days after the date on which the Secretary certifies to Congress that expansion of the initiative to that location is the most efficient method of providing health care to covered beneficiaries in that location. In determining whether the expansion of the CHAMPUS reform initiative to a location is the most efficient method of providing health care to covered beneficiaries in that location, the Secretary shall consider the cost-effectiveness of the initiative (while assuring that the combined cost of care in military treatment facilities and under the Civilian Health and Medical Program of the Uniformed Services will not be increased as a result of the expansion) and the effect of the expansion of the initiative on the access of covered beneficiaries to health care and on the quality of health care received by covered beneficiaries.
"(2) To the extent any revision of the CHAMPUS reform initiative is necessary in order to make the certification required by this subsection, the Secretary shall assure that enrolled covered beneficiaries may obtain health care services with reduced out-of-pocket costs, as compared to standard CHAMPUS.
"(b) Exception.-The Secretary of Defense may waive the operation of the condition on the expansion of the CHAMPUS reform initiative specified in subsection (a) in order to expand the initiative to a location adversely affected by the closure or realignment of a military installation in that location, as determined by the Secretary.
"(c) Evaluation of Certification.-The Comptroller General of the United States and the Director of the Congressional Budget Office shall evaluate each certification made by the Secretary of Defense under subsection (a) that expansion of the CHAMPUS reform initiative to another location is the most efficient method of providing health care to covered beneficiaries in that location. They shall submit their findings to Congress if these findings differ substantially from the findings upon which the Secretary made the decision to expand the CHAMPUS reform initiative.
"(d) Definitions.-For purposes of this section:
"(1) The terms 'CHAMPUS reform initiative' and 'initiative' mean the health care delivery project required by section 702 of the National Defense Authorization Act for Fiscal Year 1987 (Public Law 99–661; 10 U.S.C. 1073 note).
"(2) The term 'covered beneficiary' has the meaning given that term in section 1072(5) of title 10, United States Code.
"(3) The terms 'Civilian Health and Medical Program of the Uniformed Services' and 'CHAMPUS' have the meaning given the term 'Civilian Health and Medical Program of the Uniformed Services' in section 1072(4) of title 10, United States Code."
Alternative Health Care Delivery Methodologies
Pub. L. 102–484, div. A, title VII, §713, Oct. 23, 1992, 106 Stat. 2435
, as amended by
Pub. L. 103–160, div. A, title VII, §719, Nov. 30, 1993, 107 Stat. 1694
, provided that:
"(a) Continuation of Health Care Reform Initiatives.-(1) During fiscal years 1993 through 1996, the Secretary of Defense shall continue to conduct a broad array of reform initiatives for furnishing health care to persons who are eligible to receive health care under chapter 55 of title 10, United States Code.
"(2) The health care reform initiatives conducted in accordance with paragraph (1) shall include CHAMPUS alternatives, the CHAMPUS reform initiative, catchment area management, coordinated care, and such other reform initiatives as the Secretary of Defense considers to be appropriate.
"(3) Not later than September 30, 1994, the Secretary shall submit to Congress a report regarding the health care reform initiatives conducted during fiscal years 1993 and 1994. The report shall include a discussion of the cost effectiveness of the initiatives and the extent to which the persons who received health care under such initiatives are satisfied with that health care.
"(b) Continuation of CHAMPUS Reform Initiative in Hawaii and California.-(1) The Secretary of Defense shall ensure that a replacement or successor contract for the CHAMPUS reform initiative contract applicable to the States of California and Hawaii is awarded in sufficient time for the contractor to begin to provide health care in those States under the replacement or successor contract as soon as practicable after the date of the enactment of the National Defense Authorization Act for Fiscal Year 1994 [Nov. 30, 1993].
"(2) The Secretary shall use competitive procedures for awarding a replacement or successor contract under paragraph (1).
"(c) Evaluation of CHAMPUS Reform Initiative.-(1) Not later than June 1, 1994, the Secretary of Defense shall enter into a contract with a non-Federal entity under which the entity will perform an evaluation of the performance of the CHAMPUS reform initiative in the States of California and Hawaii. The evaluation shall cover each of the fiscal years during which the initiative is carried out in those States under the replacement or successor contract referred to in subsection (b) and under the predecessor contracts. The evaluation shall include a comparison of the cost savings and claims experience resulting in each such fiscal year from carrying out the CHAMPUS reform initiative in those States.
"(2) Not later than one year after the date on which the contract for evaluation is entered into under paragraph (1), the non-Federal entity making the evaluation shall submit to the Secretary and to Congress a report on the results of the evaluation.
"(d) Definitions.-For purposes of this section:
"(1) The term 'CHAMPUS' means the Civilian Health and Medical Program of the Uniformed Services, as defined in paragraph (4) of section 1072 of title 10, United States Code.
"(2) The term 'covered beneficiary' has the meaning given that term in paragraph (5) of such section.
"(3) The term 'CHAMPUS reform initiative' means the health care delivery project required by section 702 of the National Defense Authorization Act for Fiscal Year 1987 (Public Law 99–661; 10 U.S.C. 1073 note).
"(4) The term 'catchment area management' means the methodology provided for demonstration in accordance with section 731 of the National Defense Authorization Act for Fiscal Years 1988 and 1989 (Public Law 100–180; 10 U.S.C. 1092 note)."
Military Health Care for Persons Reliant on Health Care Facilities at Bases Being Closed or Realigned
Pub. L. 102–484, div. A, title VII, §722, Oct. 23, 1992, 106 Stat. 2439
, provided that:
"(a) Establishment.-The Secretary of Defense shall establish a joint services working group on the provision of military health care to persons who rely for health care on health care facilities at military installations being closed or realigned.
"(b) Membership.-The members of the working group shall include the Assistant Secretary of Defense for Health Affairs, the Surgeon General of the Army, the Surgeon General of the Navy, the Surgeon General of the Air Force, or a designee of each such person, and one independent member appointed by the Secretary of Defense from among private citizens whose interest in matters within the responsibility of the working group qualify that person to represent all personnel entitled to health care under chapter 55 of title 10, United States Code.
"(c) Duties.-(1) In the case of each closure or realignment of a military installation that will adversely affect the accessibility of health care in a facility of the uniformed services for persons entitled to such health care under chapter 55 of title 10, United States Code, the working group shall solicit the views of such persons regarding suitable substitutes for the furnishing of health care to those persons under that chapter.
"(2) In carrying out paragraph (1), the working group-
"(A) shall conduct meetings with persons referred to in that paragraph, or representatives of such persons;
"(B) may use reliable sampling techniques;
"(C) shall visit the areas where closures or realignments of military installations will adversely affect the accessibility of health care in a facility of the uniformed services for persons referred to in paragraph (1) and shall conduct public meetings; and
"(D) shall ensure that members of the uniformed services on active duty, members and former members of the uniformed services entitled to retired or retainer pay, and dependents and survivors of such members and retired personnel are afforded the opportunity to express views.
"(d) Recommendations.-With respect to each closure and realignment of a military installation referred to in subsection (c), the working group shall submit to the Congress and the Secretary of Defense the working group's recommendations regarding the alternative means for continuing to provide accessible health care under chapter 55 of title 10, United States Code, to persons referred to in that subsection.
"(e) Application of Advisory Committee Act.-The provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the joint services working group established pursuant to this section."
Authorization for Extension of CHAMPUS Reform Initiative
Pub. L. 102–190, div. A, title VII, §722, Dec. 5, 1991, 105 Stat. 1406
, provided that:
"(a) Authority.-Upon the termination (for any reason) of the contract of the Department of Defense in effect on the date of the enactment of this Act [Dec. 5, 1991] under the CHAMPUS reform initiative established under section 702 of the National Defense Authorization Act for Fiscal Year 1987 [Pub. L. 99–661] (10 U.S.C. 1073 note), the Secretary of Defense may enter into a replacement or successor contract with the same or a different contractor and for such amount as may be determined in accordance with applicable procurement laws and regulations and without regard to any limitation (enacted before, on, or after the date of the enactment of this Act) on the availability of funds for that purpose.
"(b) Treatment of Limitation on Funds for Program.-No provision of law stated as a limitation on the availability of funds may be treated as constituting the extension of, or as requiring the extension of, any contract under the CHAMPUS reform initiative that would otherwise expire in accordance with its terms."
Extension of CHAMPUS Reform Initiative for Certain States
Pub. L. 102–172, title VIII, §8032, Nov. 26, 1991, 105 Stat. 1178
, provided: "That notwithstanding any other provision of law, the CHAMPUS Reform Initiative contract for California and Hawaii shall be extended until February 1, 1994, within the limits and rates specified in the contract: Provided further, That the Department shall competitively award contracts for the geographic expansion of the CHAMPUS Reform Initiative in Florida (which may include Department of Veterans Affairs medical facilities with the concurrence of the Secretary of Veterans Affairs), Washington, Oregon, and the Tidewater region of Virginia: Provided further, That competitive expansion of the CHAMPUS Reform Initiative may occur in any other regions that the Assistant Secretary of Defense for Health Affairs deems appropriate."
Conditions on Expansion of CHAMPUS Reform Initiative
Pub. L. 101–510, div. A, title VII, §715, Nov. 5, 1990, 104 Stat. 1584
, provided that:
"(a) Certification of Cost-Effectiveness.-The Secretary of Defense may not proceed with the proposed expansion of the CHAMPUS reform initiative underway in the States of California and Hawaii until not less than 90 days after the date on which the Secretary certifies to the Congress that-
"(1) such CHAMPUS reform initiative has been demonstrated to be more cost-effective than the Civilian Health and Medical Program of the Uniformed Services or any other health care demonstration program being conducted by the Secretary;
"(2) the contractor selected to underwrite the delivery of health care under the CHAMPUS reform initiative will accomplish the expansion without the disruption of services to beneficiaries under the Civilian Health and Medical Program of the Uniformed Services or delays in the processing of claims; and
"(3) such contractor is currently, and projected to remain, financially able to underwrite the CHAMPUS reform initiative.
"(b) Report on Certification.-Not later than 30 days after the date on which the Secretary of Defense submits the certification required by subsection (a), the Comptroller General of the United States and the Director of the Congressional Budget Office shall jointly submit to Congress a report evaluating such certification.
"(c) CHAMPUS Reform Initiative Defined.-For purposes of this section, the term 'CHAMPUS reform initiative' has the meaning given that term in section 702(d)(1) of the Department of Defense Authorization Act for Fiscal Year 1987 [Pub. L. 99–661] (10 U.S.C. 1073 note)."
Requirements Prior to Termination of Medical Services at Military Medical Treatment Facilities
Pub. L. 101–510, div. A, title VII, §716, Nov. 5, 1990, 104 Stat. 1585
, provided that:
"(a) Prohibition.-During the period beginning on the date of the enactment of this Act [Nov. 5, 1990] and ending on September 30, 1995, the Secretary of a military department may not take any action to close a military medical facility under the jurisdiction of that Secretary or reduce the level of care provided at such a medical facility until 90 days after the date on which the Secretary submits to Congress a report described in subsection (b).
"(b) Elements of Report.-A report referred to in subsection (a) shall include the following:
"(1) The reason for the action.
"(2) The projected savings to the Government from the action.
"(3) The impact on CHAMPUS and MEDICARE costs in the catchment area of the facility.
"(4) The impact on beneficiary cost-sharing.
"(5) An examination of alternative ways to provide care to the persons served by the facility that the Secretary determines would not result in adverse consequences to such persons.
"(6) An explanation of how care will be provided for and the cost, if any, to those persons to receive such care.
"(c) Exception.-Subsection (a) shall not apply with respect to the closing of a military medical facility (or the reduction of the level of care provided at a military medical facility) as a result of a base closure or an operational deployment."
Requirement for Availability of Additional Insurance Coverage; Funding Limitations; Definition
Pub. L. 100–180, div. A, title VII, §732(e)–(g), Dec. 4, 1987, 101 Stat. 1120
, 1121, provided that:
"(e) Requirement for Availability of Additional Insurance Coverage.-(1) The Secretary of Defense shall make every effort to enter into an agreement, similar to the one being negotiated with a private insurer on the date of the enactment of this Act [Dec. 4, 1987], that would provide an insurance plan that meets the requirements described in paragraph (3).
"(2) If an agreement referred to in paragraph (1) is not entered into before a request for proposals with respect to the second phase of the CHAMPUS reform initiative is issued, the Secretary shall provide for an insurance plan which meets the requirements described in paragraph (3) through either of the following means:
"(A) By including, in any request for proposals with respect to the second (and any subsequent) phase of the CHAMPUS reform initiative, a requirement for the contractor to offer an option to elect an insurance plan which meets the requirements described in paragraph (3).
"(B) By including, in any request for proposals for a contract to process claims for CHAMPUS, a requirement for the contractor (known as a fiscal intermediary) to offer an option to elect an insurance plan which meets the requirements described in paragraph (3).
"(3) The insurance plan requirements referred to in paragraphs (1) and (2) are the following:
"(A) At the election of the individual, the plan shall be available to an individual losing eligibility (by reason of discharge, release from active duty, a change in family status (including divorce or annulment, or, in the case of a child, reaching age 22), or other similar reason) to be a covered beneficiary under chapter 55 of title 10, United States Code.
"(B) The plan shall provide for coverage of benefits similar to the coverage of benefits available to the individual under CHAMPUS, regardless of any pre-existing condition.
"(C) The plan shall provide that enrollees in the plan shall pay the full periodic charges for the benefit coverage.
"(f) Funding Limitations.-(1) None of the funds appropriated or otherwise made available to the Department of Defense may be obligated or expended for the purpose of entering into a contract for the demonstration phase of the CHAMPUS reform initiative required by section 702(a)(1) of the National Defense Authorization Act for Fiscal Year 1987 [section 702(a)(1) of Pub. L. 99–661, set out as a note below] until the requirements of section 702(a)(4) of such Act (as added by subsection (a)) are met.
"(2) None of the funds appropriated or otherwise made available to the Department of Defense may be obligated or expended for the purpose of requesting a proposal for the second (or any subsequent) phase of the CHAMPUS reform initiative as described in section 702(c) of the National Defense Authorization Act for Fiscal Year 1987 until the requirements of paragraph (2) of section 702(c) of such Act (as added by subsection (c)) are met.
"(g) CHAMPUS Defined.-In this section, the term 'CHAMPUS' has the meaning given such term by section 1072(4) of title 10, United States Code."
CHAMPUS Reform Initiative
Pub. L. 99–661, div. A, title VII, §702, Nov. 14, 1986, 100 Stat. 3899
, as amended by
Pub. L. 100–180, div. A, title VII, §732(a), (c), Dec. 4, 1987, 101 Stat. 1119
, provided that:
"(a) Demonstration Project.-(1) The Secretary of Defense shall conduct a project designed to demonstrate the feasibility of improving the effectiveness of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) through the competitive selection of contractors to financially underwrite the delivery of health care services under the program.
"(2) The demonstration project required by paragraph (1)-
"(A) shall begin not later than September 30, 1988, and continue for not less than one year;
"(B) shall include not more than one-third of covered beneficiaries; and
"(C) shall include a health care enrollment system that meets the requirements specified in section 1099 of title 10, United States Code (as added by section 701(a)(1)).
"(3)(A) The Secretary shall submit to the Committees on Armed Services of the Senate and House of Representatives a report on the development of the demonstration project required by paragraph (1). Such report shall include-
"(i) a description of the scope and structure of the project;
"(ii) an estimate of the costs of the care to be provided under the project; and
"(iii) a description of the health care enrollment system included in the project.
"(B) The report required by subparagraph (A) shall be submitted-
"(i) not later than 60 days before the initiation of the project, if the project is to be restricted to a contiguous area of the United States; or
"(ii) not later than 60 days before a solicitation for bids or proposals with respect to such project is issued, if the project will not be restricted to a contiguous area of the United States.
"(4) The Secretary of Defense shall develop a methodology to be used in evaluating the results of the demonstration project required by paragraph (1) and shall submit to the Committees on Armed Services of the Senate and the House of Representatives [now Committee on Armed Services of the Senate and Committee on National Security of the House of Representatives] a report on such methodology.
"(b) Study of Health Care Alternatives.-(1) The demonstration project required by subsection (a)(1) shall include a study of-
"(A) methods to guarantee the maintenance of competition among providers of health care to persons under the jurisdiction of the Secretary;
"(B) the merits of the use of a voucher system or a fee schedule for provision of health care to such persons; and
"(C) methods to guarantee that community hospitals are given equal consideration with other health care providers for provision of health care services under contracts with the Department of Defense.
"(2) The Secretary shall submit to Congress a report discussing the matters evaluated in the study required by paragraph (1) before the end of the 90-day period beginning on the date of the enactment of this Act [Nov. 14, 1986].
"(c) Phased Implementation of CHAMPUS Reform Initiative.-(1) The Secretary of Defense may proceed with implementation of the CHAMPUS reform initiative, to be carried out in two phases during a period of not less than two years, if-
"(A) the Secretary determines, based on the results of the demonstration project required by subsection (a)(1), that such initiative should be implemented;
"(B) not less than one year elapses after the date on which the demonstration project required by subsection (a)(1) is initiated; and
"(C) 90 days elapse after the date on which the Secretary submits to the Committees on Armed Services of the Senate and House of Representatives [now Committee on Armed Services of the Senate and Committee on National Security of the House of Representatives] a report that includes-
"(i) a description of the results of the demonstration project, evaluated in accordance with the methodology developed under subsection (a)(4);
"(ii) a description of any changes the Secretary intends to make in the initiative during the proposed implementation; and
"(iii) a comparison of the costs of providing health care under CHAMPUS with the costs of providing health care under the demonstration project and the estimated costs of providing health care under the CHAMPUS reform initiative if fully implemented.
"(2) The Secretary may not issue a request for proposals with respect to the second (or any subsequent) phase of the CHAMPUS reform initiative until-
"(A) all principal features of the demonstration project, including networks of providers of health care, have been in operation for not less than one year; and
"(B) the expiration of 60 days after the date on which the report described in paragraph (1)(C) has been received by the committees referred to in such paragraph.
"(d) Definitions.-In this section:
"(1) The term 'CHAMPUS reform initiative' means the competitive selection of contractors to financially underwrite the delivery of health care services under the Civilian Health and Medical Program of the Uniformed Services.
"(2) The term 'Civilian Health and Medical Program of the Uniformed Services' has the meaning given such term in section 1072(4) of title 10, United States Code (as added by section 701(b)).
"(3) The term 'covered beneficiary' has the meaning given such term in section 1072(5) of title 10, United States Code (as added by section 701(b))."
Section Referred to in Other Sections
This section is referred to in section 1072 of this title.