§1071. Purpose of this chapter
The purpose of this chapter is to create and maintain high morale in the uniformed services by providing an improved and uniform program of medical and dental care for members and certain former members of those services, and for their dependents.
(Added
Revised section | Source (U.S. Code) | Source (Statutes at Large) |
---|---|---|
1071 | 37:401. | June 7, 1956, ch. 374, §101, |
The words "and certain former members" are inserted to reflect the fact that many of the persons entitled to retired pay are former members only. The words "and dental" are inserted to reflect the fact that members and, in certain limited situations, dependents are entitled to dental care under sections 1071–1085 of this title.
Prior Provisions
A prior section 1071, act Aug. 10, 1956, ch. 1041,
Amendments
1980-
1966-
Effective Date of 1980 Amendment
Amendment by
Effective Date of 1966 Amendment
Section 3 of
Short Title of 1987 Amendment
Short Title of 1966 Amendment
Section 1 of
Health Care Management Demonstration Program
"(a)
"(b)
"(1) A health care simulation model for studying alternative delivery policies, processes, organizations, and technologies.
"(2) A health care simulation model for studying long term disease management.
"(c)
"(d)
"(e)
"(f)
Processes for Patient Safety in Military and Veterans Health Care Systems
"(a)
"(b)
"(1) shall share information regarding the designs of systems or protocols established to reduce errors in the provision of health care described in subsection (a); and
"(2) shall develop such protocols as the Secretaries consider necessary for the establishment and administration of effective processes for the reporting, compilation, and analysis of such errors."
Cooperation in Developing Pharmaceutical Identification Technology
Patient Care Reporting and Management System
"(a)
"(b)
"(1) To study the occurrences of errors in the patient care provided under chapter 55 of title 10, United States Code.
"(2) To identify the systemic factors that are associated with such occurrences.
"(3) To provide for action to be taken to correct the identified systemic factors.
"(c)
"(1) A hospital-level patient safety center, within the quality assurance department of each health care organization of the Department of Defense, to collect, assess, and report on the nature and frequency of errors related to patient care.
"(2) For each health care organization of the Department of Defense and for the entire Defense health program, patient safety standards that are necessary for the development of a full understanding of patient safety issues in each such organization and the entire program, including the nature and types of errors and the systemic causes of the errors.
"(3) Establishment of a Department of Defense Patient Safety Center within the Armed Forces Institute of Pathology, which shall have the following missions:
"(A) To analyze information on patient care errors that is submitted to the Center by each military health care organization.
"(B) To develop action plans for addressing patterns of patient care errors.
"(C) To execute those action plans to mitigate and control errors in patient care with a goal of ensuring that the health care organizations of the Department of Defense provide highly reliable patient care with virtually no error.
"(D) To provide, through the Assistant Secretary of Defense for Health Affairs, to the Agency for Healthcare Research and Quality of the Department of Health and Human Services any reports that the Assistant Secretary determines appropriate.
"(E) To review and integrate processes for reducing errors associated with patient care and for enhancing patient safety.
"(F) To contract with a qualified and objective external organization to manage the national patient safety database of the Department of Defense.
"(d)
"(1) Establish not less than two Centers of Excellence for the development, validation, proliferation, and sustainment of the health care team coordination program, one of which shall support all fixed military health care organizations, the other of which shall support all combat casualty care organizations.
"(2) Deploy the program to all fixed and combat casualty care organizations of each of the Armed Forces, at the rate of not less than 10 organizations in each fiscal year.
"(3) Expand the scope of the health care team coordination program from a focus on emergency department care to a coverage that includes care in all major medical specialties, at the rate of not less than one specialty in each fiscal year.
"(4) Continue research and development investments to improve communication, coordination, and team work in the provision of health care.
"(e)
Confidentiality of Communications With Professionals Providing Therapeutic or Related Services Regarding Sexual or Domestic Abuse
"(a)
"(A) a dependent (as defined in section 1072(2) of title 10, United States Code, with respect to a member of the Armed Forces) of a member of the Armed Forces who-
"(i) is a victim of sexual harassment, sexual assault, or intrafamily abuse; or
"(ii) has engaged in such misconduct; and
"(B) a therapist, counselor, advocate, or other professional from whom the dependent seeks professional services in connection with effects of such misconduct.
"(2) Not later than 180 days after the date of the enactment of this Act [Oct. 5, 1999], the Comptroller General shall conclude the study and submit a report on the results of the study to Congress and the Secretary of Defense.
"(b)
"(1) the findings of the Comptroller General;
"(2) the standards of confidentiality and ethical standards issued by relevant professional organizations;
"(3) applicable requirements of Federal and State law;
"(4) the best interest of victims of sexual harassment, sexual assault, or intrafamily abuse;
"(5) military necessity; and
"(6) such other factors as the Secretary, in consultation with the Attorney General, may consider appropriate.
"(c)
Health Care Quality Information and Technology Enhancement
"(a)
"(b)
"(1) To develop parameters for assessing the quality of health care information.
"(2) To develop the defense digital patient record.
"(3) To develop a repository for data on quality of health care.
"(4) To develop capability for conducting research on quality of health care.
"(5) To conduct research on matters of quality of health care.
"(6) To develop decision support tools for health care providers.
"(7) To refine medical performance report cards.
"(8) To conduct educational programs on medical informatics to meet identified needs.
"(c)
"(2) The program shall serve as a primary resource for the Department of Defense for matters concerning the capture, processing, and dissemination of data on health care quality.
"(d)
"(A) The Assistant Secretary of Defense for Health Affairs.
"(B) The Director of the TRICARE Management Activity of the Department of Defense.
"(C) The Surgeon General of the Army.
"(D) The Surgeon General of the Navy.
"(E) The Surgeon General of the Air Force.
"(F) Representatives of the Department of Veterans Affairs, designated by the Secretary of Veterans Affairs.
"(G) Representatives of the Department of Health and Human Services, designated by the Secretary of Health and Human Services.
"(H) Any additional members appointed by the Secretary of Defense to represent health care insurers and managed care organizations, academic health institutions, health care providers (including representatives of physicians and representatives of hospitals), and accreditors of health care plans and organizations.
"(2) The primary mission of the Committee shall be to advise the Secretary on the development, deployment, and maintenance of health care informatics systems that allow for the collection, exchange, and processing of health care quality information for the Department of Defense in coordination with other Federal departments and agencies and with the private sector.
"(3) Specific areas of responsibility of the Committee shall include advising the Secretary on the following:
"(A) The ability of the medical informatics systems at the Department of Defense and Department of Veterans Affairs to monitor, evaluate, and improve the quality of care provided to beneficiaries.
"(B) The coordination of key components of medical informatics systems, including digital patient records, both within the Federal Government and between the Federal Government and the private sector.
"(C) The development of operational capabilities for executive information systems and clinical decision support systems within the Department of Defense and Department of Veterans Affairs.
"(D) Standardization of processes used to collect, evaluate, and disseminate health care quality information.
"(E) Refinement of methodologies by which the quality of health care provided within the Department of Defense and Department of Veterans Affairs is evaluated.
"(F) Protecting the confidentiality of personal health information.
"(4) The Assistant Secretary of Defense for Health Affairs shall consult with the Committee on the issues described in paragraph (3).
"(5) The Secretary of Defense shall submit to Congress an annual report on medical informatics. The report shall include a discussion of the following matters:
"(A) The activities of the Committee.
"(B) The coordination of development, deployment, and maintenance of health care informatics systems within the Federal Government, and between the Federal Government and the private sector.
"(C) The progress or growth occurring in medical informatics.
"(D) How the TRICARE program and the Department of Veterans Affairs health care system can use the advancement of knowledge in medical informatics to raise the standards of health care and treatment and the expectations for improving health care and treatment.
"(6) Members of the Committee shall not be paid by reason of their service on the Committee.
"(7) The Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Committee.
"(e)
"(1) Health outcomes.
"(2) The extent of use of health report cards.
"(3) The extent of use of standard clinical pathways.
"(4) The extent of use of innovative processes for surveillance."
Joint Department of Defense and Department of Veterans Affairs Reports Relating to Interdepartmental Cooperation in Delivery of Medical Care
"(a)
"(1) The military health care system of the Department of Defense and the Veterans Health Administration of the Department of Veterans Affairs are national institutions that collectively manage more than 1,500 hospitals, clinics, and health care facilities worldwide to provide services to more than 11,000,000 beneficiaries.
"(2) In the post-Cold War era, these institutions are in a profound transition that involves challenging opportunities.
"(3) During the period from 1988 to 1998, the number of military medical personnel has declined by 15 percent and the number of military hospitals has been reduced by one-third.
"(4) During the 2 years since 1996, the Department of Veterans Affairs has revitalized its structure by decentralizing authority into 22 Veterans Integrated Service Networks.
"(5) In the face of increasing costs of medical care, increased demands for health care services, and increasing budgetary constraints, the Department of Defense and the Department of Veterans Affairs have embarked on a variety of dynamic and innovative cooperative programs ranging from shared services to joint venture operations of medical facilities.
"(6) In 1984, there was a combined total of 102 Department of Veterans Affairs and Department of Defense facilities with sharing agreements. By 1997, that number had grown to 420. During the six years from fiscal year 1992 through fiscal year 1997, shared services increased from slightly over 3,000 services to more than 6,000 services, ranging from major medical and surgical services, laundry, blood, and laboratory services to unusual speciality care services.
"(7) The Department of Defense and the Department of Veterans Affairs are conducting four health care joint ventures in New Mexico, Nevada, Texas, and Oklahoma, and are planning to conduct four more such ventures in Alaska, Florida, Hawaii, and California.
"(b)
"(1) the Department of Defense and the Department of Veterans Affairs should be commended for the cooperation between the two departments in the delivery of medical care, of which the cooperation involved in the establishment and operation of the Department of Defense and the Department of Veterans Affairs Executive Council is a praiseworthy example;
"(2) the Department of Defense and the Department of Veterans Affairs are encouraged to continue to explore new opportunities to enhance the availability and delivery of medical care to beneficiaries by further enhancing the cooperative efforts of the departments; and
"(3) enhanced cooperation between the Department of Defense and the Department of Veterans Affairs is encouraged regarding-
"(A) the general areas of access to quality medical care, identification and elimination of impediments to enhanced cooperation, and joint research and program development; and
"(B) the specific areas in which there is significant potential to achieve progress in cooperation in a short term, including computerization of patient records systems, participation of the Department of Veterans Affairs in the TRICARE program, pharmaceutical programs, and joint physical examinations.
"(c)
"(2) The survey shall include the following:
"(A) Demographic characteristics, economic characteristics, and geographic location of beneficiary populations with regard to catchment or service areas.
"(B) The types and frequency of care required by veterans, retirees, and dependents within catchment or service areas of Department of Defense and Department of Veterans Affairs medical facilities and outside those areas.
"(C) The numbers of, characteristics of, and types of medical care needed by the veterans, retirees, and dependents who, though eligible for medical care in Department of Defense or Department of Veterans Affairs treatment facilities or through other federally funded medical programs, choose not to seek medical care from those facilities or under those programs, and the reasons for that choice.
"(D) The obstacles or disincentives for seeking medical care from such facilities or under such programs that are perceived by veterans, retirees, and dependents.
"(E) Any other matters that the Secretary of Defense and the Secretary of Veterans Affairs consider appropriate for the survey.
"(3) The Secretary of Defense or the Secretary of Veterans Affairs may waive the survey requirements under this subsection with respect to information that can be better obtained from a source other than the survey.
"(4) The Secretary of Defense and the Secretary of Veterans Affairs shall submit a report on the results of the survey to the appropriate committees of Congress. The report shall contain the matters described in paragraph (2) and any proposals for legislation that the Secretaries recommend for enhancing Department of Defense and Department of Veterans Affairs cooperative efforts with respect to the delivery of medical care.
"(d)
"(A) All laws, policies, and regulations, and any attitudes of beneficiaries of the health care systems of the two departments, that have the effect of preventing the establishment, or limiting the effectiveness, of cooperative health care programs of the departments.
"(B) The requirements and practices involved in the credentialling and licensure of health care providers.
"(C) The perceptions of beneficiaries in a variety of categories (defined as the Secretaries consider appropriate) regarding the various Federal health care systems available for their use.
"(D) The types and frequency of medical services furnished by the Department of Defense and the Department of Veterans Affairs through cooperative arrangements to each category of beneficiary (including active-duty members, retirees, dependents, veterans in the health-care eligibility categories referred to as Category A and Category C, and persons authorized to receive medical care under section 1713 of title 38, United States Code) of the other department.
"(E) The extent to which health care facilities of the Department of Defense and Department of Veterans Affairs have sufficient capacity, or could jointly or individually create sufficient capacity, to provide services to beneficiaries of the other department without diminution of access or services to their primary beneficiaries.
"(F) The extent to which the recruitment of scarce medical specialists and allied health personnel by the Department of Defense and the Department of Veterans Affairs could be enhanced through cooperative arrangements for providing health care services.
"(G) The obstacles and disincentives to providing health care services through cooperative arrangements between the Department of Defense and the Department of Veterans Affairs.
"(2) The Secretaries shall jointly submit a report on the results of the review to the appropriate committees of Congress. The report shall include any proposals for legislation that the Secretaries recommend for eliminating or reducing impediments to interdepartmental cooperation that are identified during the review.
"(e)
"(2) The Secretary of Defense and the Secretary of Veterans Affairs shall jointly submit to the appropriate committees of Congress a semiannual report on the status of the review under this subsection and on efforts to increase the participation of the Department of Veterans Affairs in the TRICARE program. No report is required under this paragraph after the submission of a semiannual report in which the Secretaries declare that the Department of Veterans Affairs is participating in the TRICARE program to the extent that can reasonably be expected to be attained.
"(f)
"(A) undertake a comprehensive examination of existing pharmaceutical benefits and programs for beneficiaries of Department of Defense medical care programs, including matters relating to the purchasing, distribution, and dispensing of pharmaceuticals and the management of mail order pharmaceuticals programs; and
"(B) review the existing methods for contracting for and distributing medical supplies and services.
"(2) The committee shall submit a report on the results of the examination to the appropriate committees of Congress.
"(g)
"(h)
"(1) The Committee on Armed Services and the Committee on Veterans' Affairs of the Senate.
"(2) The Committee on Armed Services and the Committee on Veterans' Affairs of the House of Representatives.
"(i)
"(2) The report required by subsection (d)(2) shall be submitted not later than March 1, 1999.
"(3) The semiannual report required by subsection (e)(2) shall be submitted not later than March 1 and September 1 of each year.
"(4) The report on the examination required under subsection (f) shall be submitted not later than 60 days after the completion of the examination.
"(5) The report required by subsection (g) shall be submitted not later than March 1, 1999."
External Peer Review for Defense Health Program Extramural Medical Research Involving Human Subjects
"(a)
"(b)
"(c)
"(1) involves the participation of human subjects;
"(2) is conducted solely by a non-Federal entity; and
"(3) is funded through the Defense Health Program account.
"(d)
"(e)
"(1) A medical research project that the Secretary determines has been substantially completed by October 1, 1996.
"(2) A medical research project funded pursuant to any provision of law enacted on or after that date if the provision of law specifically refers to this section and specifically states that the peer review requirements do not apply."
Annual Beneficiary Survey
"(a)
"(1) The availability of health care services to such persons through the health care system provided for under that chapter, the types of services received, and the facilities in which the services were provided.
"(2) The familiarity of such persons with the services available under that system and with the facilities in which such services are provided.
"(3) The health of such persons.
"(4) The level of satisfaction of such persons with that system and the quality of the health care provided through that system.
"(5) Such other matters as the administering Secretaries determine appropriate.
"(b)
"(c)
Comprehensive Study of Military Medical Care System
Identification and Treatment of Drug and Alcohol Dependent Persons in the Armed Forces