Sec. 715. POSITIVE INCENTIVES UNDER THE COORDINATED CARE PROGRAM

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## SEC. 715 POSITIVE INCENTIVES UNDER THE COORDINATED CARE PROGRAM ###

(a)Inclusion of Positive Incentives for Enrollment The Secretary of Defense shall modify the Policy Guidelines on the Department of Defense Coordinated Care Program to provide covered beneficiaries with additional positive incentives to enroll in the Coordinated Care Program of the Department of Defense. ###

(b)Types of Positive Incentives The positive incentives provided under subsection

(a)may include— ####

(1)a reduction of the copayment and deductibles prescribed under sections 1079 and 1086 of title 10, United States Code, for covered beneficiaries who enroll in the Coordinated Care Program; ####

(2)alternative cost-sharing requirements for certain types of care; and ####

(3)an expansion of the benefits provided under the Coordinated Care Program beyond the benefits authorized under CHAMPUS. ###

(c)Effect on Certain Existing Programs The modification required under subsection

(a)shall permit health care demonstration projects in existence on the date of the enactment of this Act (including the CHAMPUS reform initiative, the catchment area management projects, the CHAMPUS select fiscal intermediary program in the Southeast Region, and the managed health care program established in the Tidewater region of Virginia) and future managed health care initiatives undertaken by the Department of Defense to offer covered beneficiaries who do not enroll in the Coordinated Care Program the opportunity to use a preferred provider network of health care providers. ###

(d)Determination of Incentives In determining what level and types of positive incentives are likely to induce covered beneficiaries to enroll in the Coordinated Care Program, the Secretary of Defense shall take into consideration the extent to which covered beneficiaries not enrolled in the program are permitted to choose health care providers without prior referral or approval. ###

(e)Prohibition on Exclusions Subject to the availability of space and facilities and the capabilities of the medical or dental staff, the Secretary of Defense may not deny access to military treatment facilities to covered beneficiaries who do not enroll in the Coordinated Care Program. However, the Secretary may establish reasonable admission preferences for covered beneficiaries enrolled in the program as an incentive to encourage enrollment. ###

(f)Definitions For purposes of this section: ####

(1)The term “**CHAMPUS**” means the Civilian Health and Medical Program of the Uniformed Services, as defined in paragraph

(4)of section 1072 of title 10, United States Code. ####

(2)The term “**covered beneficiary**” has the meaning given that term in paragraph

(5)of such section. ####

(3)The term “**Policy Guidelines on the Department of Defense Coordinated Care Program**” means the Policy Guidelines on the Department of Defense Coordinated Care Program that were issued by the Assistant Secretary of Defense for Health Affairs on January 8, 1992. * * * * * * * ## subtitle C Other Matters * * * * * * *