Sec. 716. IMPROVEMENTS TO PROCESSES TO REDUCE FINANCIAL HARM CAUSED TO CIVILIANS FOR CARE PROVIDED AT MILITARY MEDICAL TREATMENT FACILITIES
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## SEC. 716 IMPROVEMENTS TO PROCESSES TO REDUCE FINANCIAL HARM CAUSED TO CIVILIANS FOR CARE PROVIDED AT MILITARY MEDICAL TREATMENT FACILITIES ###
(a)Clarification of Fee Waiver Process Section 1079b of title 10, United States Code, is amended— ####
(1)by amending subsection
(b)to read as follows: > > ### “(b) Waiver of Fees > > The Director of the Defense Health Agency may issue a waiver for a fee that would otherwise be charged under the procedures implemented under subsection
(a)to a civilian provided medical care 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 Director of the Defense Health Agency.” > ; and ####
(2)by redesignating subsection
(c)as subsection (d). ###
(b)Modified Payment Plan for Certain Civilians Such section is further amended— ####
(1)by inserting after subsection (b), as amended by subsection (a), the following: > > ### “(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 the standard copays, coinsurance, deductibles, or nominal fees that are otherwise applicable under the covered payer plan. > > > ##### “(B) > > Except with respect to the copays, coinsurance, deductibles, and nominal fees specified in subparagraph (A)— > > > ###### “(i) > > the Secretary of Defense may bill only the covered payer for care provided to a civilian described in subparagraph (A); and > > > ###### “(ii) > > payment received by the Secretary from the covered payer of a civilian for care provided under this section that is provided to the civilian shall be considered payment in full for such care. > > > #### “(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 Director of the Defense Health Agency shall reduce each fee that would otherwise be charged to the civilian under this section according to a sliding fee discount program, as prescribed by the Director of the Defense Health Agency. > > > #### “(3) > > If a civilian specified in subsection
(a)does not meet the criteria under paragraph
(1)or (2), the Director of the Defense Health Agency shall implement an additional catastrophic waiver to prevent severe financial harm. > > > #### “(4) > > The modified payment plan under this subsection may not be administered by a Federal agency other than the Department of Defense.” > ; and ####
(2)by adding at the end the following new subsection: > > ### “(e) Definitions > > In this section: > > > #### “(1) > > The term ‘covered payer’ means a third-party payer or other insurance, medical service, or health plan. > > > #### “(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.” > . ###
(c)Applicability **[**[10 U.S.C. 1079b note](/us/usc/t10/s1079b)**]** 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.
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Sec. 716
IMPROVEMENTS TO PROCESSES TO REDUCE FINANCIAL HARM CAUSED TO CIVILIANS FOR CARE PROVIDED AT MILITARY MEDICAL TREATMENT FACILITIES
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