Sec. 703. MILITARY MEDICAL TREATMENT FACILITIES
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## SEC. 703 MILITARY MEDICAL TREATMENT FACILITIES ###
(a)Administration ####
(1)In general Chapter 55 of title 10, United States Code, as amended by section 702, is further amended by inserting after section 1073c the following new section: > > ## “SEC. 1073d Military medical treatment facilities > > **[**[10 U.S.C. 1073d](/us/usc/t10/s1073d)**]** > > > ### “(a) In General > > To support the medical readiness of the armed forces and the readiness of medical personnel, the Secretary of Defense, in consultation with the Secretaries of the military departments, shall maintain the military medical treatment facilities described in subsections (b), (c), and (d). > > > ### “(b) Medical Centers > > > ####
(1)> > The Secretary of Defense shall maintain medical centers in areas with a large population of members of the armed forces and covered beneficiaries. > > > #### “(2) > > Medical centers shall serve as referral facilities for members and covered beneficiaries who require comprehensive health care services that support medical readiness. > > > #### “(3) > > Medical centers shall consist of the following: > > > ##### “(A) > > Inpatient and outpatient tertiary care facilities that incorporate specialty and subspecialty care. > > > ##### “(B) > > Graduate medical education programs. > > > ##### “(C) > > Residency training programs. > > > ##### “(D) > > Level one or level two trauma care capabilities. > > > #### “(4) > > The Secretary may designate a medical center as a regional center of excellence for unique and highly specialized health care services, including with respect to polytrauma, organ transplantation, and burn care. > > > ### “(c) Hospitals > > > ####
(1)> > The Secretary of Defense shall maintain hospitals in areas where civilian health care facilities are unable to support the health care needs of members of the armed forces and covered beneficiaries. > > > #### “(2) > > Hospitals shall provide— > > > ##### “(A) > > inpatient and outpatient health services to maintain medical readiness; and > > > ##### “(B) > > such other programs and functions as the Secretary determines appropriate. > > > #### “(3) > > Hospitals shall consist of inpatient and outpatient care facilities with limited specialty care that the Secretary determines— > > > ##### “(A) > > is cost effective; or > > > ##### “(B) > > is not available at civilian health care facilities in the area of the hospital. > > > ### “(d) Ambulatory Care Centers > > > ####
(1)> > The Secretary of Defense shall maintain ambulatory care centers in areas where civilian health care facilities are able to support the health care needs of members of the armed forces and covered beneficiaries. > > > #### “(2) > > Ambulatory care centers shall provide the outpatient health services required to maintain medical readiness, including with respect to partnerships established pursuant to section 706 of the National Defense Authorization Act for Fiscal Year 2017. > > > #### “(3) > > Ambulatory care centers shall consist of outpatient care facilities with limited specialty care that the Secretary determines— > > > ##### “(A) > > is cost effective; or > > > ##### “(B) > > is not available at civilian health care facilities in the area of the ambulatory care center.” > . ####
(2)Clerical amendment **[**[10 U.S.C. 1071](/us/usc/t10/s1071)**]** The table of sections at the beginning of such chapter, as amended by section 702, is further amended by inserting after the item relating to section 1073c the following new item:" “1073d. Military medical treatment facilities.” ". ####
(3)Satellite centers **[**[10 U.S.C. 1073d note](/us/usc/t10/s1073d)**]** In addition to the centers of excellence designated under section 1073d(b)(4) of title 10, United States Code, as added by paragraph (1), the Secretary of Defense may establish satellite centers of excellence to provide specialty care for certain conditions, including with respect to— #####
(A)post-traumatic stress; #####
(B)traumatic brain injury; and #####
(C)such other conditions as the Secretary considers appropriate. ###
(b)Exception **[**[10 U.S.C. 1073d note](/us/usc/t10/s1073d)**]** In carrying out section 1073d of title 10, United States Code, as added by subsection (a)(1), the Secretary of Defense may not restructure or realign the infrastructure of, or modify the health care services provided by, a military medical treatment facility unless the Secretary determines that, if such a restructure, realignment, or modification will eliminate the ability of a covered beneficiary to access health care services at a military medical treatment facility, the covered beneficiary will be able to access such health care services through the purchased care component of the TRICARE program. ###
(c)Update of Study ####
(1)In general The Secretary of Defense, in collaboration with the Secretaries of the military departments, shall update the report described in paragraph
(2)to address the restructuring or realignment of military medical treatment facilities pursuant to section 1073d of title 10, United States Code, as added by subsection (a), including with respect to any expansions or consolidations of such facilities. ####
(2)Report described The report described in this paragraph is the Military Health System Modernization Study dated May 29th, 2015, required by section 713(a)(2) of the Carl Levin and Howard P. “Buck” McKeon National Defense Authorization Act for Fiscal Year 2015 (Public Law 113-291; 128 Stat. 3414). ####
(3)Submission Not later than 270 days after the date of the enactment of this Act, the Secretary of Defense shall submit to the congressional defense committees the updated report under paragraph (1). ###
(d)Implementation Plan ####
(1)In general Not later than two years after the date of the enactment of this Act, the Secretary of Defense shall submit to the congressional defense committees an implementation plan to restructure or realign the military medical treatment facilities pursuant to section 1073d of title 10, United States Code, as added by subsection (a). ####
(2)Elements The implementation plan under paragraph
(1)shall include the following: #####
(A)With respect to each military medical treatment facility— ######
(i)whether the facility will be realigned or restructured under the plan; ######
(ii)whether the functions of such facility will be expanded or consolidated; ######
(iii)the costs of such realignment or restructuring; ######
(iv)a description of any changes to the military and civilian personnel assigned to such facility as of the date of the plan; ######
(v)a timeline for such realignment or restructuring; ######
(vi)the justifications for such realignment or restructuring, including an assessment of the capacity of the civilian health care facilities located near such facility; ######
(vii)a comprehensive assessment of the health care services provided at the facility; ######
(viii)a description of the current accessibility of covered beneficiaries to health care services provided at the facility and proposed modifications to that accessibility, including with respect to types of services provided; ######
(ix)a description of the current availability of urgent care, emergent care, and specialty care at the facility and in the TRICARE provider network in the area in which the facility is located, and proposed modifications to the availability of such care; ######
(x)a description of the current level of coordination between the facility and local health care providers in the area in which the facility is located and proposed modifications to such level of coordination; and ######
(xi)a description of any unique challenges to providing health care at the facility, with a focus on challenges relating to rural, remote, and insular areas, as appropriate. #####
(B)A description of the relocation of the graduate medical education programs and the residency programs. #####
(C)A description of the plans to assist members of the Armed Forces and covered beneficiaries with travel and lodging, if necessary, in connection with the receipt of specialty care services at regional centers of excellence designated under subsection (b)(4) of such section 1073d. #####
(D)A description of how the Secretary will carry out subsection (b), including, with respect to each affected military medical treatment facility, a description of— ######
(i)the elements required for health care providers to accept and transition covered beneficiaries to the purchased care component of the TRICARE program; ######
(ii)a method to monitor and report on quality benchmarks for the beneficiary population that will be required to transition to such component of the TRICARE program; and ######
(iii)a process by which the Director of the Defense Health Agency will ensure that such component of the TRICARE program has the required capacity. ####
(3)GAO report Not later than 60 days after the date on which the Secretary of Defense submits the report under paragraph (1), the Comptroller General of the United States shall submit to the Committees on Armed Services of the Senate and the House of Representatives a review of such report. ####
(4)Notice and wait The Secretary may not implement the plan under paragraph
(1)unless— #####
(A)the Secretary has submitted the plan to the congressional defense committees; #####
(B)the Secretary has certified to the congressional defense committees that, pursuant to subsection (b), if a proposed restructure, realignment, or modification will eliminate the ability of a covered beneficiary to access health care services at a military medical treatment facility, the covered beneficiary will be able to access such health care services through the purchased care component of the TRICARE program; and #####
(C)a 180-day period has elapsed following the later of— ######
(i)the date on which the congressional defense committees have received both the implementation plan under subparagraph
(A)and the notice of certification under subparagraph (B); or ######
(ii)the date of the enactment of the William M.
(Mac)Thornberry National Defense Authorization Act for Fiscal Year 2021. ###
(e)Definitions **[**[10 U.S.C. 1073d note](/us/usc/t10/s1073d)**]** In this section, the terms “covered beneficiary” and “TRICARE program” have the meaning given those terms in section 1072 of title 10, United States Code.
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- 128 Stat. 3414
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Sec. 703
MILITARY MEDICAL TREATMENT FACILITIES
Stat.128 Stat. 3414
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