Sec. 731. USE OF HEALTH MAINTENANCE ORGANIZATION MODEL AS OPTION FOR MILITARY HEALTH CARE
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## SEC. 731 USE OF HEALTH MAINTENANCE ORGANIZATION MODEL AS OPTION FOR MILITARY HEALTH CARE **[**[10 U.S.C. 1073 note](/us/usc/t10/s1073)**]** ###
(a)Use of Model The Secretary of Defense shall prescribe and implement a health benefit option (and accompanying cost-sharing requirements) for covered beneficiaries eligible for health care under chapter 55 of title 10, United States Code, that is modelled on health maintenance organization plans offered in the private sector and other similar Government health insurance programs. The Secretary shall include, to the maximum extent practicable, the health benefit option required under this subsection as one of the options available to covered beneficiaries in all managed health care initiatives undertaken by the Secretary after December 31, 1994. ###
(b)Elements of Option The Secretary shall offer covered beneficiaries who enroll in the health benefit option required under subsection
(a)reduced out-of-pocket costs and a benefit structure that is as uniform as possible throughout the United States. The Secretary shall allow enrollees to seek health care outside of the option, except that the Secretary may prescribe higher out-of-pocket costs than are provided under section 1079 or 1086 of title 10, United States Code, for enrollees who obtain health care outside of the option. ###
(c)Government Costs The health benefit option required under subsection
(a)shall be administered so that the costs incurred by the Secretary under the TRICARE program are no greater than the costs that would otherwise be incurred to provide health care to the members of the uniformed services and covered beneficiaries who participate in the TRICARE program. ###
(d)Definitions For purposes of this section: ####
(1)The term “**covered beneficiary**” means a beneficiary under chapter 55 of title 10, United States Code, other than a beneficiary under section 1074(a) of such title. ####
(2)The term “**TRICARE program**” means the managed health care program that is established by the Secretary of Defense under the authority of chapter 55 of title 10, United States Code, principally section 1097 of such title, and includes the competitive selection of contractors to financially underwrite the delivery of health care services under the Civilian Health and Medical Program of the Uniformed Services. ###
(e)Regulations Not later than December 31, 1994, the Secretary shall prescribe final regulations to implement the health benefit option required by subsection (a). ###
(f)Modification of Existing Contracts In the case of managed health care contracts in effect or in final stages of acquisition as of December 31, 1994, the Secretary may modify such contracts to incorporate the health benefit option required under subsection (a).
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Sec. 731
USE OF HEALTH MAINTENANCE ORGANIZATION MODEL AS OPTION FOR MILITARY HEALTH CARE
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