S.Amdt. 4057

SA 4057. Mr. CRUZ submitted an amendment intended to be proposed to
amendment SA 3867 submitted by Mr. Reed and intended to be proposed to
the bill H.R. 4350, to authorize appropriations for fiscal year 2022
for military activities of the Department of Defense, for military
construction, and for defense activities of the Department of Energy,
to prescribe military personnel strengths for such fiscal year, and for
other purposes; which was ordered to lie on the table; as follows:

At the end of subtitle B of title VII, add the following:

SEC. 728. IMPROVEMENTS TO PROCESSES TO REDUCE FINANCIAL HARM
CAUSED TO CIVILIANS FOR CARE PROVIDED AT
MILITARY MEDICAL TREATMENT FACILITIES.

(a) Clarification of Fee Waiver Process.--Section 1079b of
title 10, United States Code, is amended--
(1) by amending subsection (b) to read as follows:
``(b) Waiver of Fees.--Each commander (or director, as
applicable) of a military medical treatment facility shall
issue a waiver for a fee that would otherwise be charged
under the procedures implemented under subsection (a) to a
civilian provided medical care at the facility who is not a
covered beneficiary if the provision of such care enhances
the knowledge, skills, and abilities of health care
providers, as determined by the respective commander or
director.''; and
(2) by redesignating subsection (c) as subsection (d).
(b) Modified Payment Plan for Certain Civilians.--
(1) In general.--Such section is further amended by
inserting after subsection (b), as amended by subsection (a),
the following:
``(c) Modified Payment Plan for Certain Civilians.--(1)(A)
If a civilian specified in subsection (a) is covered by a
third-party payer, insurance, medical service, or health plan
(as those terms are defined in section 1095(h) of this title
and in this subsection referred to as a `Payer') at the time
care covered by this section is provided, the civilian is
only responsible to pay for any services not covered by their
Payer, copays, coinsurance, deductibles, or nominal fees.
``(B)(i) The Secretary of Defense may bill only the Payer
for care provided to a civilian described in subparagraph
(A).
``(ii) Payment received by the Secretary from the Payer of
a civilian for care covered by this section that is provided
to the civilian shall be considered payment in full for such
care.
``(2) If a civilian specified in subsection (a) does not
meet the criteria under paragraph (1), is underinsured, or
has a remaining balance and is at risk of financial harm, the
Secretary of Defense shall reduce each fee that would
otherwise be charged to the civilian under this section
according to a sliding fee discount program.
``(3) If a civilian specified in subsection (a) does not
meet the criteria under paragraph (1) or (2), the Secretary
of Defense shall implement an additional catastrophic waiver
to prevent financial harm.
``(4) The modified payment plan under this subsection may
not be administered by a Federal agency other than the
Department of Defense.''.
(2) Effective date for payment plan.--The Secretary of
Defense shall implement the payment plan established under
subsection (c) of section 1079b of title 10, United States
Code, as added by paragraph (1), not later than 180 days
after the date of the enactment of this Act.
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