S.Amdt. 5705

1. Adds SEC. 728. IMPROVEMENTS TO PROCESSES TO REDUCE FINANCIAL HARM CAUSED TO CIVILIANS FOR CARE PROVIDED AT MILITARY MEDICAL TREATMENT FACILITIES at the end of subtitle B of title VII

   Adds a section

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

   Inserted: (a) Clarification of Fee Waiver Process.--Subsection (b) of section 1079b of title 10, United States Code, is amended to read as follows:

   Inserted: "(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.".

   Inserted: (b) Modified Payment Plan for Certain Civilians.--Such section is further amended--

   Inserted: (1) by redesignating subsection (c) as subsection (d);

   Inserted: (2) by inserting after subsection (b) the following new subsection (c):

   Inserted: "(c) Modified Payment Plan for Certain Civilians.--(1)(A) If a civilian specified in subsection (a) is covered by a covered payer at the time care under this section is provided, the civilian shall only be responsible to pay for any services that are not covered by the covered payer or any copays, coinsurance, deductibles, or nominal fees otherwise owed by the civilian.

   Inserted: "(B)(i) The Secretary of Defense may bill only the covered payer for care provided to a civilian described in subparagraph (A).

   Inserted: "(ii) Payment received by the Secretary from the covered payer of a civilian for care provided under this section to the civilian shall be considered payment in full for such care.

   Inserted: "(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.

   Inserted: "(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.

   Inserted: "(4) The modified payment plan under this subsection may not be administered by a Federal agency other than the Department of Defense."; and

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   Inserted: (3) by adding at the end the following new subsection:

   Inserted: "(e) Definitions.--In this section:

   Inserted: "(1) The term 'covered payer' means a third-party payer or other insurance, medical service, or health plan.

   Inserted: "(2) The terms 'third-party payer' and 'insurance, medical service, or health plan' have the meaning given those terms in section 1095(h) of this title.".

   Inserted: (c) Applicability.--The amendments made by subsections (a) and (b) shall apply with respect to care provided on or after the date that is 180 days after the date of the enactment of this Act.

   Original wording

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

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As printed