§248c. Continued use of former Public Health Service facilities

(a) Facilities providing medical or dental care to members and former members of uniformed services and dependents

Any Public Health Service hospital or other station which was transferred to a public or nonprofit private entity pursuant to the provisions of section 248b of this title shall be deemed to be a facility of the uniformed services for the purposes of chapter 55 of title 10, if such hospital or other station was, on the day before the date of the transfer, a facility approved under such chapter to provide medical and dental care to members and former members of the uniformed services and their dependents.

(b) Termination of approved status

The Secretary of Defense, the Secretary of Health and Human Services, and the Secretary of Transportation when the Coast Guard is not operating as a service in the Navy may terminate, for purposes of chapter 55 of title 10, the approved status, of any facility described in subsection (a) of this section to furnish medical or dental care to members and former members of the uniformed services and their dependents as provided for in section 248d(e) of this title.

(c) Reimbursement of approved facilities for medical and dental care provided to members and former members of uniformed services and dependents

The Secretary of Defense, the Secretary of Health and Human Services, and the Secretary of Transportation when the Coast Guard is not operating as a service in the Navy shall reimburse any facility described in subsection (a) of this section for medical and dental care provided by such facility to members and former members of the uniformed services and their dependents who receive such care under chapter 55 of title 10. The rates of reimbursement shall be negotiated and agreed upon by the Secretary of Defense, the Secretary of Health and Human Services, the Secretary of Transportation when the Coast Guard is not operating as a service in the Navy, and the appropriate officials representing the facility concerned. The rates of reimbursement shall be based upon medical and dental care costs in the area in which the facility concerned is located.

( Pub. L. 97–99, title IX, §911, Dec. 23, 1981, 95 Stat. 1386 ; Pub. L. 98–94, title XII, §1252(g), formerly §1252(f), Sept. 24, 1983, 97 Stat. 699 , renumbered §1252(g), Pub. L. 101–510, div. A, title VII, §718(b)(1), Nov. 5, 1990, 104 Stat. 1586 ; Pub. L. 98–557, §17(f)(1), Oct. 30, 1984, 98 Stat. 2868 .)

Codification

Section was enacted as part of the Military Construction Authorization Act, 1982, and not as part of the Public Health Service Act which comprises this chapter.

Amendments

1984-Subsecs. (b), (c). Pub. L. 98–557 inserted references to the Secretary of Transportation when the Coast Guard is not operating as a service in the Navy.

1983-Subsec. (b). Pub. L. 98–94 substituted reference to section 248d(e) of this title for a description of the procedure for terminating the approved status of facilities described in subsec. (a) for the former provision which had referred to the termination of the approved status of such facilities at any time after the expiration of three years after the date of the transfer of such facility under section 248b of this title, with the termination of such status in the case of any such facility to be effected only by an order jointly issued by the Secretary of Defense and the Secretary of Health and Human Services which identified the facility whose approved status was being terminated and specified the date on which such status was being terminated.

Administration of Managed-Care Model of Uniformed Services Treatment Facilities

Pub. L. 102–190, div. A, title VII, §721, Dec. 5, 1991, 105 Stat. 1405 , provided that:

"(a) Designation of Satellite Facilities as Uniformed Services Treatment Facilities.-(1) Subject to paragraph (3), the Secretary of Defense may designate a satellite facility described in paragraph (2) as a facility of the uniformed services for the purposes of chapter 55 of title 10, United States Code.

"(2) A satellite facility referred to in paragraph (1) means a facility that-

"(A) is owned, operated, or staffed by a facility described in section 911(c) of the Military Construction Authorization Act, 1982 (42 U.S.C. 248c(c)); and

"(B) pursuant to an agreement entered into with the Secretary of Defense, is authorized for a designated service area to provide medical and dental care for persons eligible to receive such care in facilities of the uniformed services under chapter 55 of title 10, United States Code.

"(3) The authority of the Secretary of Defense under paragraph (1) shall take effect on the date on which the Secretary certifies to Congress that the managed-care delivery and reimbursement model required under section 718(c) of the National Defense Authorization Act for Fiscal Year 1991 (Public Law 101–510; 104 Stat. 1587) has been fully implemented.

"(b) Termination of Designation.-The designation of a satellite facility under subsection (a) may be terminated in accordance with the procedure provided under section 1252(e) of the Department of Defense Authorization Act, 1984 (42 U.S.C. 248d(e)).

"(c) Reimbursement for Care.-A facility described in section 911(c) of the Military Construction Authorization Act, 1982 (42 U.S.C. 248c(c)), may be reimbursed for medical and dental care provided by that facility or a satellite facility of that facility designated under subsection (a) to persons eligible to receive such care in facilities of the uniformed services under chapter 55 of title 10, United States Code. The reimbursement shall be made pursuant to an agreement with the Secretary of Defense as part of the managed-care delivery and reimbursement model required under section 718(c) of the National Defense Authorization Act for Fiscal Year 1991 (Public Law 101–510; 104 Stat. 1587).

"(d) Preemption of State and Local Laws.-A law or regulation of a State or local government relating to health insurance or health maintenance organizations shall not apply to a Uniformed Services Treatment Facility that enters into an agreement with the Secretary of Defense under section 718(c) of the National Defense Authorization Act for Fiscal Year 1991 (Public Law 101–510; 104 Stat. 1587) to the extent that-

"(1) the law or regulation is inconsistent with a specific provision of the agreement or a regulation prescribed by the Secretary relating to the managed-care delivery and reimbursement model; or

"(2) the Secretary determines that preemption of the law or regulation is necessary to implement or operate the managed-care delivery and reimbursement model referred to in that section or to achieve some other Federal interest."

Managed-Care Delivery and Reimbursement Model for the Uniformed Services Treatment Facilities

Section 718(c) of Pub. L. 101–510, as amended by Pub. L. 102–484, div. A, title VII, §716, Oct. 23, 1992, 106 Stat. 2438 ; Pub. L. 103–160, div. A, title VII, §718, Nov. 30, 1993, 107 Stat. 1694 , provided that:

"(1) Time for operation.-Not later than the date of the enactment of this Act [Nov. 5, 1990], the Secretary of Defense shall begin operation of a managed-care delivery and reimbursement model that will continue to utilize the Uniformed Services Treatment Facilities in the military health services system. A participation agreement negotiated between a Uniformed Services Treatment Facility and the Secretary of Defense under this subsection shall not be subject to the Federal Acquisition Regulation issued pursuant to section 25(c) of the Office of Federal Procurement Policy Act (41 U.S.C. 421(c)).

"(2) Copayments.-A Uniformed Services Treatment Facility for which there exists a managed-care plan developed as part of the model required by this subsection may impose reasonable charges for inpatient and outpatient care provided to all categories of beneficiaries enrolled in the plan. The schedule and application of such charges shall be in accordance with the terms and conditions specified in the plan.

"(3) Evaluation of performance under the model.-(A) The Secretary of Defense shall utilize a federally funded research and development center to conduct an independent evaluation of the performance of each Uniformed Services Treatment Facility operating under a managed-care plan developed as part of the model required by this subsection. The evaluation shall include an assessment of the efficiency of the Uniformed Services Treatment Facility in providing health care under the plan. The assessment shall be made in the same manner as provided in section 712(a) of the National Defense Authorization Act for Fiscal Year 1993 [Pub. L. 102–484] (10 U.S.C. 1073 note) for expansion of the CHAMPUS reform initiative.

"(B) Not later than December 31, 1995, the center conducting the evaluation and assessment shall submit to the Secretary of Defense and to Congress a report on the results of the evaluation and assessment. The report shall include such recommendations regarding the managed-care delivery and reimbursement model under this subsection as the entity considers to be appropriate.

"(4) Definition.-For purposes of this subsection, the term 'Uniformed Services Treatment Facility' means a facility described in section 911(a) of the Military Construction Authorization Act, 1982 (42 U.S.C. 248c(a))."

Section Referred to in Other Sections

This section is referred to in section 248d of this title.