§248d. Public Health Service facilities providing medical care for dependents, members, and former members of uniformed services

(a) Demonstration projects; comparisons with care furnished by contract providers

The Secretary of Defense, in consultation with 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 conduct demonstration projects for the purpose of comparing and evaluating the cost-effectiveness, accessibility, patient acceptance, and the quality of medical care contracted for by the Secretary of Defense under sections 1079 and 1086 of title 10, with the medical care provided in those facilities deemed to be facilities of the uniformed services by virtue of section 248c of this title. The Secretary of Defense shall begin conducting such projects within one year after September 24, 1983, and continue conducting such projects for not less than three years.

(b) Alternative payment mechanisms

The projects carried out by the Secretary of Defense under this subsection shall utilize various alternative mechanisms for the payment of medical services provided eligible persons, including capitation, prospective payment, all-inclusive fee-for-service charges, and other concepts and programs consistent with the purpose of this section.

(c) Designation of additional civilian medical facilities

If 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 determine such action is necessary in order to permit a meaningful evaluation of alternative methods of providing medical care to persons eligible for such care under sections 1079 and 1086 of title 10, they may jointly designate additional civilian medical facilities to be facilities of the uniformed services for the purposes of section 1079 of such title. The Secretary may designate a facility under the authority of this subsection for such purposes only if such action is agreed to by the governing body of the facility.

(d) Reports to Congress on study and project results

The Secretary of Defense, in consultation with 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 submit annually to the Committees on Appropriations and on Armed Services of the Senate and the House of Representatives a written report on the results of the studies and projects carried out under this section. The first such report shall be submitted not later than one year after September 24, 1983. The last such report shall be submitted not later than one year after the completion of all such studies and projects.

(e) Termination of 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 status of any facility referred to in subsection (a) or (c) of this section to furnish medical or dental care to members and former members of the uniformed services or their dependents, and such termination may become effective at any time after December 31, 1996. The termination of such status in the case of any such facility may be effected only by an order jointly issued by 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 which (1) identifies the facility whose status is being terminated, (2) specifies the date on which such status is being terminated, and (3) certifies that more cost-effective medical and dental care for members and former members of the uniformed services or their dependents is available elsewhere in the same geographic area. A copy of each such order shall be furnished to the affected facility and the Committees on Appropriations and on Armed Services of the Senate and the House of Representatives and shall become effective in accordance with the terms of the notice, but not earlier than six months following the date on which a copy of the notice has been furnished to the facility and the committees. Each such copy of the order shall include a copy of the certification required in clause (3) of the second sentence of this subsection and shall contain cost data substantiating the termination decision and identifying how more cost-effective care could be provided to the affected individuals. Any facility described in subsection (a) of this section or designated under subsection (c) of this section may terminate its status or designation made under that subsection at any time after the expiration of six months following the date on which a copy of the order terminating the status or designation has been furnished the facility.

(f) Limitation on expenditures

The total amount of expenditures by the Secretary of Defense to carry out this section and section 248c of this title may not exceed $154,000,000 for fiscal year 1991.

( Pub. L. 98–94, title XII, §1252(a)–(e), Sept. 24, 1983, 97 Stat. 698 ; Pub. L. 98–557, §17(f)(2), Oct. 30, 1984, 98 Stat. 2868 ; Pub. L. 99–661, div. A, title VII, §706, Nov. 14, 1986, 100 Stat. 3905 ; Pub. L. 100–456, div. A, title VI, §645, Sept. 29, 1988, 102 Stat. 1988 ; Pub. L. 101–510, div. A, title VII, §718(a), (b)(2), Nov. 5, 1990, 104 Stat. 1586 , 1587; Pub. L. 102–25, title VII, §705(h), Apr. 6, 1991, 105 Stat. 121 ; Pub. L. 103–160, div. A, title VII, §717(a), Nov. 30, 1993, 107 Stat. 1693 .)

Codification

Section was enacted as part of the Department of Defense Authorization Act, 1984, and not as part of the Public Health Service Act which comprises this chapter.

Amendments

1993-Subsec. (e). Pub. L. 103–160 substituted "1996" for "1993".

1991-Subsec. (f). Pub. L. 102–25 inserted "by the Secretary of Defense" after "expenditures".

1990-Subsec. (e). Pub. L. 101–510, §718(a), substituted "1993" for "1990".

Subsec. (f). Pub. L. 101–510, §718(b)(2), added subsec. (f).

1988-Subsec. (e). Pub. L. 100–456 substituted "1990" for "1988" in first sentence, substituted "which (1) identifies the facility whose status is being terminated, (2) specifies the date on which such status is being terminated, and (3) certifies that more cost-effective medical and dental care for members and former members of the uniformed services or their dependents is available elsewhere in the same geographic area" for "which identifies the facility whose status is being terminated and specifies the date on which such status is being terminated" in second sentence, and inserted after third sentence "Each such copy of the order shall include a copy of the certification required in clause (3) of the second sentence of this subsection and shall contain cost data substantiating the termination decision and identifying how more cost-effective care could be provided to the affected individuals."

1986-Subsec. (e). Pub. L. 99–661 substituted "1988" for "1987".

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

Change of Name

Committee on Armed Services of House of Representatives changed to Committee on National Security of House of Representatives by House Resolution No. 6, One Hundred Fourth Congress, Jan. 4, 1995.

Section Referred to in Other Sections

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