10 U.S.C. § 1095a — Medical care: members held as captives

Page 1144 TITLE 10—ARMED FORCES § 1095a by subsection (a) [amending this section] shall apply with respect to health care services provided in a med- ical facility of the uniformed services after the date of the enactment of this Act [Nov. 5, 1990], but not with respect to collection under any insurance, medical service, or health plan agreement entered into before the date of the enactment of this Act that the Sec- retary of Defense determines clearly excludes payment for such services. Such an exception shall apply until the amendment or renewal of such agreement after that date.’’ EFFECTIVE DATE OF 1989 AMENDMENT Pub. L. 101–189, div. A, title VII, § 727(b), Nov. 29, 1989, 103 Stat. 1480, provided that: ‘‘The amendment made by this section [amending this section] shall take effect on October 1, 1989, and shall apply to amounts collected under section 1095 of title 10, United States Code, on or after that date.’’ EFFECTIVE DATE Pub. L. 99–272, title II, § 2001(b), Apr. 7, 1986, 100 Stat. 101, provided that: ‘‘Section 1095 of title 10, United States Code, as added by subsection (a), shall apply with respect to inpatient hospital care provided after September 30, 1986, but only with respect to an insur- ance, medical service, or health plan agreement en- tered into, amended, or renewed on or after the date of the enactment of this Act [Apr. 7, 1986].’’ PILOT PROGRAM ON INCREASED THIRD-PARTY COLLEC- TION REIMBURSEMENTS IN MILITARY MEDICAL TREAT- MENT FACILITIES Pub. L. 113–66, div. A, title VII, § 712, Dec. 26, 2013, 127 Stat. 793, required the Secretary of Defense, in coordi- nation with the Secretaries of the military depart- ments, to conduct a three-year pilot program to dem- onstrate and assess the feasibility of implementing commercially available enhanced recovery practices to increase reimbursement from third-party payers in military medical treatment facilities and report the re- sults to Congress not later than 180 days after the pro- gram’s completion. § 1095a. Medical care: members held as captives and their dependents (a) Under regulations prescribed by the Presi- dent, the Secretary concerned shall pay (by ad- vancement or reimbursement) any person who is a former captive, and any dependent of that per- son or of a person who is in a captive status, for health care and other expenses related to such care, to the extent that such care— (1) is incident to the captive status; and (2) is not covered— (A) by any other Government medical or health program; or (B) by insurance. (b) In the case of any person who is eligible for medical care under section 1074 or 1076 of this title, such regulations shall require that, when- ever practicable, such care be provided in a fa- cility of the uniformed services. (c) In this section: (1) The terms ‘‘captive status’’ and ‘‘former captive’’ have the meanings given those terms in section 559 of title 37. (2) The term ‘‘dependent’’ has the meaning given that term in section 551 of that title. (Added Pub. L. 99–399, title VIII, § 806(c)(1), Aug. 27, 1986, 100 Stat. 886, § 1095; renumbered § 1095a, Pub. L. 100–26, § 7(e)(2), Apr. 21, 1987, 101 Stat. 281; amended Pub. L. 100–526, title I, § 106(b)(1), Oct. 24, 1988, 102 Stat. 2625.) Editorial Notes AMENDMENTS 1988—Subsec. (c). Pub. L. 100–526 substituted ‘‘The terms ‘captive status’ ’’ for ‘‘ ‘Captive status’ ’’ in par. (1), and ‘‘The term ‘dependent’ ’’ for ‘‘ ‘Dependent’ ’’ in par. (2). Statutory Notes and Related Subsidiaries EFFECTIVE DATE; REGULATIONS Pub. L. 99–399, title VIII, § 806(c)(3), Aug. 27, 1986, 100 Stat. 886, provided that: ‘‘(A) Section 1095 [now 1095a] of title 10, United States Code, as added by paragraph (1), shall apply with re- spect to any person whose captive status begins after January 21, 1981. ‘‘(B) The President shall prescribe specific regula- tions regarding the carrying out of such section with respect to persons whose captive status begins during the period beginning on January 21, 1981, and ending on the effective date of that section [Aug. 27, 1986].’’ Executive Documents DELEGATION OF FUNCTIONS Functions of President under this section delegated to Secretary of Defense, see section 3 of Ex. Ord. No. 12598, June 17, 1987, 52 F.R. 23421, set out as a note under section 5569 of Title 5, Government Organization and Employees. § 1095b. TRICARE program: contractor payment of certain claims (a) PAYMENT OF CLAIMS.—(1) The Secretary of Defense may authorize a contractor under the TRICARE program to pay a claim described in paragraph (2) before seeking to recover from a third-party payer the costs incurred by the con- tractor to provide health care services that are the basis of the claim to a beneficiary under such program. (2) A claim under this paragraph is a claim— (A) that is submitted to the contractor by a provider under the TRICARE program for pay- ment for services for health care provided to a covered beneficiary; and (B) that is identified by the contractor as a claim for which a third-party payer may be liable. (b) RECOVERY FROM THIRD-PARTY PAYERS.— The United States shall have the same right to collect charges related to claims described in subsection (a) as charges for claims under sec- tion 1095 of this title. (c) DEFINITION OF THIRD-PARTY PAYER.—In this section, the term ‘‘third-party payer’’ has the meaning given that term in section 1095(h) of this title, except that such term excludes pri- mary medical insurers. (Added Pub. L. 105–261, div. A, title VII, § 711(a)(1), Oct. 17, 1998, 112 Stat. 2058; amended Pub. L. 106–65, div. A, title VII, § 716(c)(2), Oct. 5, 1999, 113 Stat. 692.) Editorial Notes AMENDMENTS 1999—Subsec. (b). Pub. L. 106–65 substituted ‘‘The United States shall have the same right to collect charges related to claims described in subsection (a) as charges for claims under section 1095 of this title.’’ for ‘‘A contractor for the provision of health care services