rCiTSLbrary ! n C2-07-13 ! 7500 SGCL'iity BJvd. _JI! I Bsltimore, Marytend 21244 106th congress 2013 S. 2d Session To restore health care equity for Medicare-eligible uniformed services retirees, and for other purposes. IN THE SENATE OF THE UNITED STATES January 27, 2000 Mr. LOTT (for Mr. McCain) introduced the following bill; which was read twice and referred to the Connnittee on Ai-nied Services A BILL To restore health care equity for Medicare-ehgible uniformed services retirees, and for other purposes. 1 Be it enacted hy the Senate and House ofRepresenta- 2 tives ofthe United States ofAmerica in Congress assembled, 3 SECTION 1. SHORT TITLE. 4 This Act may be cited as the "Honoring Health Care 5 Commitments to Servicemembers Past and Present Act of 6 2000". —— . 2 SEC. SENSE OF SENATE ON HEALTH CARE FOR MEM- 1 2. 2 BERS OF THE UNIFORMED SERVICES WHO 3 FIRST BECAME MEMBERS BEFORE JUNE . 7, 4 AND THEIR DEPENDENTS. 1956, 5 It is the sense of the Senate that 6 (1) urgent priority should be given to the enact- 7 ment of legislation that provides health care cov- 8 erage for Medicare-eligible members and former 9 members of the uniformed services who first became 10 members of the uniformed services before June 7, 11 1956, and for their dependents, at no cost to such 12 members, former members, and dependents; and 13 (2) the bill proposing to provide the health care 14 coverage described in paragraph (1), which has been 15 introduced in the Senate, should 16 (A) receive priority of consideration by the 17 committee of the Senate having jurisdiction 18 over the bill; and 19 (B) become the pending business of the 20 Senate immediately after its reporting to the 21 Senate by the committee of the Senate de- 22 scribed in paragraph (1). •S 2013 IS — 3 1 SEC. 3. PARTICIPATION OF MEDICARE-ELIGIBLE BENE- 2 FICIARIES IN CERTAIN DEPARTMENT OF DE- FENSE PHARMACY PROGRAMS. 3 — 4 (a) In General. Not later than October 1, 2000, 5 the Secretary of Defense shall 6 expand and make permanent the dem- (1) 7 onstration project for pharmaceuticals by mail estab- 8 lished under subsection (a) of section 702 of the Na- 9 tional Defense Authorization Act for Fiscal Year 10 1993 (10 U.S.C. 1079 note) in order to permit indi- 11 viduals described in subsection (b) worldwide to ob- 12 tain pharmaceuticals through the project; and 13 (2) modify each managed health care program 14 which includes a managed care network of commu- 15 nity retail pharmacies under subsection (b) of such 16 section 702 to supply prescription pharmaceuticals 17 to the individuals described in subsection (b) of this 18 section through such network in the area covered by 19 such program. — 20 (b) Eligible Individuals. (1) Except as provided 21 in paragraph (2), an individual ehgible to obtain pharma- 22 ceuticals under this section is a member or former member 23 of the uniformed services described in section 1074(b) of 24 title 10, United States Code, a dependent of a member 25 described in subsection (a)(2)(B) or (b) of section 1076 26 of that title, or a dependent of a member who died while •S 2013 IS 4 1 on active duty for a period of more than 30 days, who A 2 is entitled to hospital insurance benefits under part of 3 title XVIII of the Social Security Act (42 U.S.C. 1395 4 et seq.). 5 (2) An individual described in paragraph (1) is not 6 eligible to obtain pharmaceuticals under this section if the 7 individual is covered by a health benefits plan offered 8 through the Federal Employees Health Benefits program, 9 whether as an employee under chapter 89 of title 5, 10 United States Code, or pursuant to section 1108 of title 1 1 10, United States Code. — 12 (c) Fees and Chaeges. (1) Subject to paragraph 13 (2), the amount of the deductible, copayment, annual fee, 14 or other fee, if any, paid by an eligible individual described 15 in subsection (b) who obtains a pharmaceutical under this 16 section through the project referred to in subsection (a)(1) 17 or a retail pharmacy network referred to in subsection 18 (a)(2) shall not exceed the amount of the deductible copay- 19 ment, annual fee, or other fee paid by other persons for 20 such pharmaceutical through the project or the pharmacy 21 network, as the case may be. 22 (2) An eligible individual described in subsection (b) 23 shall not be charged an enrollment fee for participation 24 in the project or a retail pharmacy network under this sec- 25 tion. •S 2013 IS 5 1 (3) The Secretary of Defense may not establish or 2 collect any new fee or charge under the project referred 3 to in subsection (a)(1), or any retail pharmacy network 4 referred to in subsection (a)(2), by reason of the participa- 5 tion of eligible individuals described in subsection (b) in 6 the project or network under this section. 7 SEC. 4. NATIONWIDE EXPANSION OF MEDICARE SUB- 8 VENTION. — 9 (a) Paeticipants. Effective October 1, 2000, sub- 10 section (a)(4) of section 1896 of the Social Security Act 11 (42 U.S.C. 1395ggg) is amended by adding after subpara- 12 graph (D) the following new flush matter: 13 "Notwithstanding the first sentence of this subpara- 14 graph, the term does not include any individual who 15 is covered by a health benefits plan offered through 16 the Federal Employees Health Benefits program, 17 whether as an employee under chapter 89 of title 5, 18 United States Code, or pursuant to section 1108 of 19 title 10, United States Code.". 20 Repeal op Limitation on Number of (b) — 21 Sites. Effective October 1, 2000, paragraph (2) of sec- 22 tion 1896(b) of such Act is amended to read as follows: — 23 "(2) Location of sites. S 2013 IS — 6 — 1 "(A) In general. The program shall be 2 conducted in any site desi^ated jointly by the 3 administering Secretaries. — 4 "(B) Fee-for-service. If feasible, at 5 least 1 of the sites designated under subpara- 6 graph (A) shall be conducted using the fee-for- 7 service reimbursement method described in sub- 8 section (1)(1). 9 "(C) Uniformed services treatment — 10 FACILITIES. If feasible, designated providers 11 covered by section 722 of the National Defense 12 Authorization Act for 1997 (Pubhc Law 104- 13 201; 10 U.S.C. 1073 note) shaU be included 14 among the sites designated by the admin- 15 istering Secretaries.". 16 (c) Making Project Perivianent; Changes in — 17 Project References. — 18 (1) Elimination of time limitation. Para- 19 graph (4) of section 1896(b) of such Act is repealed. 20 Conforming changes of references to (2) — 21 demonstration project. Section 1896 of such 22 Act is further amended 23 (A) in the heading, by striking "DEM- 24 ONSTEATION PROJECT" and inserting "PROGRAM"; 25 S 2013 IS 7 (B) by amending subsection (a)(2) to read 1 2 as follows: — 3 "(2) Program. The term 'program' means 4 the program carried out under this section."; 5 (C) in the heading to subsection (b), by 6 striking "Demonstration Project" and in- 7 serting "Prograjvi"; 8 (D) by striking "demonstration project" or 9 "project" each place either appears and insert- 10 ing "program"; and 11 (E) in subsection (k)(2)— 12 (i) in the heading, by striking "ex- 13 TENSION AND EXPANSION OF DEMONSTRA- 14 TION project" and inserting "program"; 15 and 16 (ii) by striking subparagraphs (A) 17 through (C) and inserting the following: 18 "(A) whether there is a cost to the health 19 care program under this title in conducting the 20 program under this section; and 21 "(B) whether the terms and conditions of 22 the program should be modified.". 23 (3) Repeal op obsolete reporting re- — 24 quirement. Paragraph (5) of section 1896(b) of 25 such Act is repealed. •S 2013 IS — — 8 Correction of Reference to Medicare-Eli- 1 (d) — 2 GIBLE Retirees. Section 1896 of such Act is farther 3 amended 4 (1) in the heading, by striking "MILITARY 5 RETIREES" and inserting "UNIFORMED SERV- 6 ICES RETIREES"; 7 (2) in paragraph (4) of subsection (a) 8 (A) in the caption, by striking "Military 9 Retiree" and inserting "Uniformed Serv- 10 ICES Retiree"; and 11 (B) by striking "miUtary retiree" and in- 12 serting "uniformed services retiree"; and 13 (3) by striking "mihtary retirees" each place it 14 appears and inserting "uniformed services retirees". 15 (e) Permitting Payment on a Fee-for-Service — 16 Basis. — 17 (1) In general. Section 1896 of the Social 18 Security Act is further amended by adding at the 19 end the following nev^^ subsection: 20 "(1) Reimbursement on Fee-for-Service — 21 Basis. 22 "(1) Reimbursement at designated — 23 sites. In the case of a Medicare health care serv- 24 ice provided at a site, if any, designated for oper- 25 ation under the fee-for-service model under sub- S 2013 IS — 9 1 section (b)(2)(B), the Secretary shall reimburse the 2 Secretary of Defense at a rate equal to 95 percent 3 of the amount that otherwise would be payable 4 under this title on a noncapitated basis for the serv- 5 ice if the site were not part of the pro-am under 6 this section. 7 "(2) RelmbI'KSEmext for unexrolled indi- — 8 \lDU2^ajS. Notwithstanding subsection (i), in the 9 case of Medicare-eligible uniformed services retirees 10 or dependents who are not enrolled in the program 11 under this section, the Secretary may reimburse the 12 Secretary of Defense for Medicare health care serv- 13 ices provided to such retirees or dependents at a 14 military treatment facility under the program at a 15 rate that does not exceed the rate of payment that 16 would otherwise be made under this title for such 17 services. 18 "(3) Inapplicability op limitations on — 19 FEDER.-VL PAYMENTS. Sections 1814(c) and 20 1835(d), and paragraphs (2) and (3) of section 21 1862(a), do not apply to the making of payments 22 under this subsection.". — 23 (2) C0NF()RMIN(J AMENDMENTS. Such section 24 is further amended S 2013 IS -- 2 10 1 (A) in subsections (b)(l)(B)(v) and 2 (b)(l)(B)(viii)(I), by inserting "or subsection 3 (1)" after "subsection (i)"; 4 (B) in subsection (d)(1)(A), by inserting 5 "(insofar as it provides for the enrollment of in- 6 dividuals and payment on the basis described in 7 subsection (i))" before "shall meet"; 8 (C) in subsection (d)(1)(A), by inserting 9 "and the program (insofar as it provides for 10 payment for Medicare health care services pro- 11 vided at a military treatment facility on the 12 basis described in subsection (1)) shall meet all 13 requirements that are applicable to facilities 14 that provide such services under this title" after 15 "Medicare payments"; 16 (D) in subsection (d)(2), by inserting ", in- 17 sofar as it provides for the enrollment of indi- 18 viduals and payment on the basis described in 19 subsection (i)," before "shall comply"; 20 (E) in subsection (g)(1), by inserting "in- 21 sofar as it provides for the enrollment of indi- 22 viduals and payment on the basis described in 23 subsection (i)," before "the Secretary of De- 24 fense"; S 2013 IS