§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
Disease and Chronic Care Management
"(a)
"(b)
"(1) To facilitate the improvement of the health status of individuals under care in the military health care system.
"(2) To ensure the availability of effective health care services in that system for individuals with diseases and other chronic conditions.
"(3) To ensure the proper allocation of health care resources for individuals who need care for disease or other chronic conditions.
"(c)
"(1) Based on uniform policies prescribed by the Secretary, the program shall, at a minimum, address the following chronic diseases and conditions:
"(A) Diabetes.
"(B) Cancer.
"(C) Heart disease.
"(D) Asthma.
"(E) Chronic obstructive pulmonary disorder.
"(F) Depression and anxiety disorders.
"(2) The program shall meet nationally recognized accreditation standards for disease and chronic care management.
"(3) The program shall include specific outcome measures and objectives on disease and chronic care management.
"(4) The program shall include strategies for disease and chronic care management for all beneficiaries, including beneficiaries eligible for benefits under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), for whom the TRICARE program is not the primary payer for health care benefits.
"(5) Activities under the program shall conform to applicable laws and regulations relating to the confidentiality of health care information.
"(d)
"(1) require a comprehensive analysis of the disease and chronic care management opportunities within each region of the TRICARE program, including within military treatment facilities and through contractors under the TRICARE program;
"(2) ensure continuous, adequate funding of disease and chronic care management activities throughout the military health care system in order to achieve maximum health outcomes and cost avoidance;
"(3) eliminate, to the extent practicable, any financial disincentives to sustained investment by military hospitals and health care services contractors of the Department of Defense in the disease and chronic care management activities of the Department;
"(4) ensure that appropriate clinical and claims data, including pharmacy utilization data, is available for use in implementing the program;
"(5) ensure outreach to eligible beneficiaries who, on the basis of their clinical conditions, are candidates for the program utilizing print and electronic media, telephone, and personal interaction; and
"(6) provide a system for monitoring improvements in health status and clinical outcomes under the program and savings associated with the program.
"(e)
"(1)
"(2)
"(A) A description of the design and development of the program required by subsection (a).
"(B) A description of the implementation plan required by subsection (d).
"(C) A description and assessment of improvements in health status and clinical outcomes that are anticipated as a result of implementation of the program.
"(D) A description of the savings and return on investment associated with the program.
"(E) A description of an investment strategy to assure the sustainment of the disease and chronic care management programs of the Department of Defense."
Prevention, Mitigation, and Treatment of Blast Injuries
"(a)
"(b)
"(1) planning for the medical research and development projects, diagnostic and field treatment programs, and patient tracking and monitoring activities within the Department that relate to combat blast injuries;
"(2) efficient execution of such projects, programs, and activities;
"(3) enabling the sharing of blast injury health hazards and survivability data collected through such projects, programs, and activities with the programs of the Department of Defense;
"(4) working with the Director, Defense Research and Engineering and the Secretaries of the military departments to ensure resources are adequate to also meet non-medical requirements related to blast injury prevention, mitigation, and treatment; and
"(5) ensuring that a joint combat trauma registry is established and maintained for the purposes of collection and analysis of contemporary combat casualties, including casualties with traumatic brain injury.
"(c)
"(1)
"(A) The characterization of blast effects leading to injury, including the injury potential of blasts in various environments.
"(B) Medical technologies and protocols to more accurately detect and diagnose blast injuries, including improved discrimination between traumatic brain injuries and mental health disorders.
"(C) Enhanced treatment of blast injuries in the field.
"(D) Integrated treatment approaches for members of the Armed Forces who have a combination of traumatic brain injuries and mental health disorders or other injuries.
"(E) Such other blast injury matters as the executive agent considers appropriate.
"(2)
"(3)
"(d)
"(1) review and assess the adequacy of current research efforts of the Department on the prevention and mitigation of blast injuries;
"(2) based on subsection (c)(1), establish requirements for further research; and
"(3) address any deficiencies identified in paragraphs (1) and (2) by establishing, coordinating, and overseeing Department-wide research and development initiatives on the prevention and mitigation of blast injuries, including explosive detection and defeat and personnel and vehicle blast protection.
"(e)
"(1) studies to improve the clinical evaluation and treatment approach for blast injuries, with an emphasis on traumatic brain injuries and other consequences of blast injury, including acoustic and eye injuries and injuries resulting from over-pressure wave;
"(2) studies on the incidence of traumatic brain injuries attributable to blast injury in soldiers returning from combat;
"(3) studies to develop protocols for medical tracking of members of the Armed Forces for up to five years following blast injuries; and
"(4) studies to refine and improve educational interventions for blast injury survivors and their families.
"(f)
"(g)
"(1) Department of Defense programs focused on-
"(A) promoting the exchange of blast health hazards data with blast characterization data and blast modeling and simulation tools; and
"(B) encouraging the incorporation of blast hazards data into design and operational features of blast detection, mitigation, and defeat capabilities, such as comprehensive armor systems which provide blast, ballistic, and fire protection for the head, neck, ears, eyes, torso, and extremities; and
"(2) traumatic brain injury treatment programs to enhance the evaluation and care of members of the Armed Forces with traumatic brain injuries in medical facilities in the United States and in deployed medical facilities, including those outside the Department of Defense.
"(h)
"(1)
"(2)
"(A) A description of the activities undertaken under this section during the two years preceding the report to improve the prevention, mitigation, and treatment of blast injuries.
"(B) A consolidated budget presentation for Department of Defense biomedical research efforts and studies related to blast injury for the two fiscal years following the year of the report.
"(C) A description of any gaps in the capabilities of the Department and any plans to address such gaps within biomedical research related to blast injury, blast injury diagnostic and treatment programs, and blast injury tracking and monitoring activities.
"(D) A description of collaboration, if any, with other departments and agencies of the Federal Government, and with other countries, during the two years preceding the report in efforts for the prevention, mitigation, and treatment of blast injuries.
"(E) A description of any efforts during the two years preceding the report to disseminate findings on the diagnosis and treatment of blast injuries through civilian and military research and medical communities.
"(F) A description of the status of efforts during the two years preceding the report to incorporate blast injury effects data into appropriate programs of the Department of Defense and into the development of comprehensive force protection systems that are effective in confronting blast, ballistic, and fire threats.
"(i)
"(j)
"(k)
Access to Health Care Services for Beneficiaries Eligible for TRICARE and Department of Veterans Affairs Health Care
"(a)
"(A) ensure that the process provides for coordination of, and access to, health care from the two sources in a manner that prevents diminution of access to health care from either source; and
"(B) in consultation with the Secretary of Veterans Affairs, prescribe a clear definition of an 'episode of care' for use in the resolution of patient safety and continuity of care issues under such process.
"(2) Not later than May 1, 2003, the Secretary shall submit to the Committees on Armed Services of the Senate and of the House of Representatives a report describing the process prescribed under paragraph (1).
"(3) While prescribing the process under paragraph (1) and upon completion of the report under paragraph (2), the Secretary shall provide to the Comptroller General information that would be relevant in carrying out the study required by subsection (b).
"(b)
"(A) An analysis of whether covered beneficiaries who seek services through the Department of Veterans Affairs are receiving needed health care services in a timely manner from the Department of Veterans Affairs, as compared to the timeliness of the care available to covered beneficiaries under TRICARE Prime (as set forth in access to care standards under TRICARE program policy that are applicable to the care being sought).
"(B) An evaluation of the quality of care for covered beneficiaries who do not receive needed services from the Department of Veterans Affairs within a time period that is comparable to the time period provided for under such access to care standards and who then must seek alternative care under the TRICARE program.
"(C) Recommendations to improve access to, and timeliness and quality of, care for covered beneficiaries described in subsection (a).
"(D) An evaluation of the feasibility and advisability of making access to care standards applicable jointly under the TRICARE program and the Department of Veterans Affairs health care system.
"(E) A review of the process prescribed by the Secretary of Defense under subsection (a) to determine whether the process ensures the adequacy and quality of the health care services provided to covered beneficiaries under the TRICARE program and through the Department of Veterans Affairs, together with timeliness of access to such services and patient safety.
"(2) Not later than 60 days after the congressional committees specified in subsection (a)(2) receive the report required under that subsection, the Comptroller General shall submit to those committees a report on the study conducted under this subsection.
"(c)
"(1) The term 'covered beneficiary' has the meaning provided by section 1072(5) of title 10, United States Code.
"(2) The term 'TRICARE program' has the meaning provided by section 1072(7) of such title.
"(3) The term 'TRICARE Prime' has the meaning provided by section 1097a(f) of such title."
Pilot Program Providing for Department of Veterans Affairs Support in the Performance of Separation Physical Examinations
Health Care Management Demonstration Program
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, 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) Members of the Committee shall not be paid by reason of their service on the Committee.
"(6) The Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Committee.
"(e)
"(1) Measures of the quality of health care furnished, including timeliness and accessibility of care.
"(2) Population health.
"(3) Patient safety.
"(4) Patient satisfaction.
"(5) The extent of use of evidence-based health care practices.
"(6) The effectiveness of biosurveillance in detecting an emerging epidemic."
Joint Department of Defense and Department of Veterans Affairs Reports Relating to Interdepartmental Cooperation in Delivery of Medical Care
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