Sec. 722. INCLUSION OF DESIGNATED PROVIDERS IN UNIFORMED SERVICES HEALTH CARE DELIVERY SYSTEM
637 words·~3 min read·
/statute-compilations/comps-10712/sec-722A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
## SEC. 722 INCLUSION OF DESIGNATED PROVIDERS IN UNIFORMED SERVICES HEALTH CARE DELIVERY SYSTEM **[**[10 U.S.C. 1073 note](/us/usc/t10/s1073)**]** ###
(a)Inclusion in System The health care delivery system of the uniformed services shall include the designated providers. ###
(b)Agreements to Provide Managed Health Care Services ####
(1)After consultation with the other administering Secretaries, the Secretary of Defense shall negotiate and enter into an agreement with each designated provider under which the designated provider will provide health care services in or through managed care plans to covered beneficiaries who enroll with the designated provider. ####
(2)The agreement shall be entered into on a sole source basis. The Federal Acquisition Regulation, except for those requirements regarding competition, issued pursuant to section 1303(a) of title 41, United States Code shall apply to the agreements as acquisitions of commercial items. ####
(3)The implementation of an agreement is subject to availability of funds for such purpose. ###
(c)Effective Date of Agreements ####
(1)Unless an earlier effective date is agreed upon by the Secretary and the designated provider, the agreement shall take effect upon the later of the following: #####
(A)The date on which a managed care support contract under the TRICARE program is implemented in the service area of the designated provider. #####
(B)October 1, 1997. ####
(2)The Secretary may modify the effective date established under paragraph
(1)for an agreement to permit a transition period of not more than six months between the date on which the agreement is executed by the parties and the date on which the designated provider commences the delivery of health care services under the agreement. ###
(d)Temporary Continuation of Existing Participation Agreements The Secretary shall extend the participation agreement of a designated provider in effect immediately before the date of the enactment of this Act under section 718(c) of the National Defense Authorization Act for Fiscal Year 1991 (Public Law 101–510; 42 U.S.C. 248c) until the agreement required by this section takes effect under subsection (c), including any transitional period provided by the Secretary under paragraph
(2)of such subsection. ###
(e)Service Area The Secretary may not reduce the size of the service area of a designated provider below the size of the service area in effect as of September 30, 1996. ###
(f)Compliance With Administrative Requirements ####
(1)Unless otherwise agreed upon by the Secretary and a designated provider, the designated provider shall comply with necessary and appropriate administrative requirements established by the Secretary for other providers of health care services and requirements established by the Secretary of Health and Human Services for risk-sharing contractors under section 1876 of the Social Security Act (42 U.S.C. 1395mm). The Secretary and the designated provider shall determine and apply only such administrative requirements as are minimally necessary and appropriate. A designated provider shall not be required to comply with a law or regulation of a State government requiring licensure as a health insurer or health maintenance organization. ####
(2)A designated provider may not contract out more than five percent of its primary care enrollment without the approval of the Secretary, except in the case of primary care contracts between a designated provider and a primary care contractor in force on the date of the enactment of this Act. ###
(g)Continued Acquisition of Reduced-Cost Drugs A designated provider shall be treated as part of the Department of Defense for purposes of section 8126 of title 38, United States Code, in connection with the provision by the designated provider of health care services to covered beneficiaries pursuant to the participation agreement of the designated provider under section 718(c) of the National Defense Authorization Act for Fiscal Year 1991 (Public Law 101–510; 42 U.S.C. 248c note) or pursuant to the agreement entered into under subsection (b).
Connectionstraces to 2
Traces to 2 documents
2 references not yet in our index
- Pub. L. 101-510
- 42 USC 248c
Citation graph
cites case law
Sec. 722
INCLUSION OF DESIGNATED PROVIDERS IN UNIFORMED SERVICES HEALTH CARE DELIVERY SYSTEM
Pub. L.Pub. L. 101-510
Cite42 USC 248c
Cites 4Cited by 0 across 0 sources