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10 U.S.C. § 1110b — TRICARE program: extension of depend-
Federal law — U.S. Code and appendices · legal_authorities
Page 1172
TITLE 10—ARMED FORCES
§ 1110b
surance program under part B of title XVIII of
the Social Security Act (42 U.S.C. 1395j et
seq.).
(2) In carrying out this subsection, the Sec-
retary of Defense shall—
(A) establish procedures for identifying indi-
viduals described in subsection (b); and
(B) consult with the Secretary of Health and
Human Services to accurately identify and no-
tify such individuals.
(b) INDIVIDUALS DESCRIBED.—An individual de-
scribed in this subsection is an individual who
is—
(1) a covered beneficiary;
(2) entitled to benefits under part A of title
XVIII of the Social Security Act (42 U.S.C.
1395c) under section 226(b) or section 226A of
such Act (42 U.S.C. 426(b) and 426–1); and
(3) eligible to enroll in the supplementary
medical insurance program under part B of
such title (42 U.S.C. 1395j et seq.).
(Added Pub. L. 111–84, div. A, title VII, § 707(a),
Oct. 28, 2009, 123 Stat. 2376.)
Editorial Notes
REFERENCES IN TEXT
The Social Security Act, referred to in subsecs.
(a)(1)(B) and (b)(2), (3), is act Aug. 14, 1935, ch. 531, 49
Stat. 620. Parts A and B of title XVIII of the Act are
classified generally to parts A (§ 1395c et seq.) and B
(§ 1395j et seq.), respectively, of subchapter XVIII of
chapter 7 of Title 42, The Public Health and Welfare.
For complete classification of this Act to the Code, see
section 1305 of Title 42 and Tables.
§ 1110b. TRICARE program: extension of depend-
ent coverage
(a) IN
GENERAL.—In accordance with sub-
section (c), an individual described in subsection
(b) shall be deemed to be a dependent (as de-
scribed in section 1072(2)(D) of this title) for pur-
poses of coverage under the TRICARE program.
(b) INDIVIDUAL DESCRIBED.—An individual de-
scribed in this subsection is an individual who—
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Page 1172
TITLE 10—ARMED FORCES
§ 1110b
surance program under part B of title XVIII of
the Social Security Act (42 U.S.C. 1395j et
seq.).
(2) In carrying out this subsection, the Sec-
retary of Defense shall—
(A) establish procedures for identifying indi-
viduals described in subsection (b); and
(B) consult with the Secretary of Health and
Human Services to accurately identify and no-
tify such individuals.
(b) INDIVIDUALS DESCRIBED.—An individual de-
scribed in this subsection is an individual who
is—
(1) a covered beneficiary;
(2) entitled to benefits under part A of title
XVIII of the Social Security Act (42 U.S.C.
1395c) under section 226(b) or section 226A of
such Act (42 U.S.C. 426(b) and 426–1); and
(3) eligible to enroll in the supplementary
medical insurance program under part B of
such title (42 U.S.C. 1395j et seq.).
(Added Pub. L. 111–84, div. A, title VII, § 707(a),
Oct. 28, 2009, 123 Stat. 2376.)
Editorial Notes
REFERENCES IN TEXT
The Social Security Act, referred to in subsecs.
(a)(1)(B) and (b)(2), (3), is act Aug. 14, 1935, ch. 531, 49
Stat. 620. Parts A and B of title XVIII of the Act are
classified generally to parts A (§ 1395c et seq.) and B
(§ 1395j et seq.), respectively, of subchapter XVIII of
chapter 7 of Title 42, The Public Health and Welfare.
For complete classification of this Act to the Code, see
section 1305 of Title 42 and Tables.
§ 1110b. TRICARE program: extension of depend-
ent coverage
(a) IN
GENERAL.—In accordance with sub-
section (c), an individual described in subsection
(b) shall be deemed to be a dependent (as de-
scribed in section 1072(2)(D) of this title) for pur-
poses of coverage under the TRICARE program.
(b) INDIVIDUAL DESCRIBED.—An individual de-
scribed in this subsection is an individual who—
(1) would be a dependent under section
1072(2) of this title but for exceeding an age
limit under such section;
(2) has not attained the age of 26;
(3) is not eligible to enroll in an eligible em-
ployer-sponsored plan (as defined in section
5000A(f)(2) of the Internal Revenue Code of
1986);
(4) is not otherwise a dependent of a member
or a former member under any subparagraph
of section 1072(2) of this title; and
(5) meets other criteria specified in regula-
tions prescribed by the Secretary, similar to
regulations prescribed by the Secretary of
Health and Human Services under section
2714(b) of the Public Health Service Act.
(c) PREMIUM.—(1) The Secretary shall pre-
scribe by regulation a premium (or premiums)
for coverage under the TRICARE program pro-
vided pursuant to this section to an individual
described in subsection (b). Such premium shall
apply instead of any enrollment fees required
under section 1075 or 1075a of this title, as appro-
priate.
(2) The monthly amount of the premium in ef-
fect for a month for coverage under the
TRICARE program pursuant to this section
shall be the amount equal to the cost of such
coverage that the Secretary determines on an
appropriate actuarial basis.
(3) The Secretary shall prescribe the require-
ments and procedures applicable to the payment
of premiums under this subsection.
(4) Amounts collected as premiums under this
subsection shall be credited to the appropriation
available for the Defense Health Program Ac-
count under section 1100 of this title, shall be
merged with sums in such Account that are
available for the fiscal year in which collected,
and shall be available under subsection (b) of
such section for such fiscal year.
(Added Pub. L. 111–383, div. A, title VII,
§ 702(a)(1), Jan. 7, 2011, 124 Stat. 4244; Pub. L.
114–328, div. A, title VII, § 701(j)(1)(F), Dec. 23,
2016, 130 Stat. 2192; Pub. L. 115–91, div. A, title
VII, § 739(f), Dec. 12, 2017, 131 Stat. 1447.)
Editorial Notes
REFERENCES IN TEXT
Section 5000A of the Internal Revenue Code of 1986,
referred to in subsec. (b)(3), is classified to section
5000A of Title 26, Internal Revenue Code.
Section 2714 of the Public Health Service Act, re-
ferred to in subsec. (b)(5), is classified to section
300gg–14 of Title 42, The Public Health and Welfare.
AMENDMENTS
2017—Subsec. (c)(1). Pub. L. 115–91 substituted ‘‘sec-
tion 1075 or 1075a of this title, as appropriate’’ for ‘‘sec-
tion 1075 of this section’’.
2016—Subsec. (c)(1). Pub. L. 114–328 inserted at end
‘‘Such premium shall apply instead of any enrollment
fees required under section 1075 of this section.’’
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE OF 2016 AMENDMENT
Amendment by Pub. L. 114–328 applicable with re-
spect to the provision of health care under the
TRICARE program beginning on Jan. 1, 2018, see sec-
tion 701(k) of Pub. L. 114–328, set out as a note under
section 1072 of this title.
EFFECTIVE DATE AND REGULATIONS
Pub. L. 111–383, div. A, title VII, § 702(b), Jan. 7, 2011,
124 Stat. 4245, provided that: ‘‘The amendments made
by this section [enacting this section] shall take effect
on January 1, 2011. The Secretary of Defense shall pre-
scribe an interim final rule with respect to such amend-
ments, effective not later than January 1, 2011.’’
CHAPTER
56—DEPARTMENT
OF
DEFENSE
MEDICARE-ELIGIBLE
RETIREE
HEALTH
CARE FUND
Sec.
1111.
Establishment and purpose of Fund; defini-
tions; authority to enter into agreements.
1112.
Assets of Fund.
1113.
Payments from the Fund.
1114.
Board of Actuaries.
1115.
Determination of contributions to the Fund.
1116.
Payments into the Fund.
1117.
Investment of assets of Fund.
Editorial Notes
AMENDMENTS
2001—Pub. L. 107–107, div. A, title VII, § 711(e)(3), Dec.
28, 2001, 115 Stat. 1167, inserted ‘‘; authority to enter
into agreements’’ after ‘‘definitions’’ in item 1111.
Cross-references
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In General.—** In accordance with subsection (c), an individual described in subsection (b) shall be deemed to be a dependent (as described in [section 1072(2)(D) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1072/2/D&num=0&edition=prelim)) for purposes of coverage under the TRICARE program.
**(b) Individual Described.—** An individual described in this subsection is an individual who—
(1) would be a dependent under [section 1072(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1072/2&num=0&edition=prelim) but for exceeding an age limit under such section;
(2) has not attained the age of 26;
(3) is not eligible to enroll in an eligible employer-sponsored plan (as defined in section 5000A(f)(2) of the Internal Revenue Code of 1986);
(4) is not otherwise a dependent of a member or a former member under any subparagraph of [section 1072(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1072/2&num=0&edition=prelim); and
(5) meets other criteria specified in regulations prescribed by the Secretary, similar to regulations prescribed by the Secretary of Health and Human Services under section 2714(b) of the Public Health Service Act.
**(c) Premium.—**
(1) The Secretary shall prescribe by regulation a premium (or premiums) for coverage under the TRICARE program provided pursuant to this section to an individual described in subsection (b). Such premium shall apply instead of any enrollment fees required under section 1075 or 1075a of this title, as appropriate.
(2) The monthly amount of the premium in effect for a month for coverage under the TRICARE program pursuant to this section shall be the amount equal to the cost of such cov
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1110b
Stored review status: release_metadata_unconfirmed. Same stored citation; legal effect and authority still require review.
Federal law — U.S. Code and appendices · legal_authorities
Nothing in this subchapter shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395c
Stored review status: release_metadata_unconfirmed. The source passage cites 42 U.S.C. § 1395c. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
Page 2928
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1395b–10
(A) are from entities that manufacture
pharmaceutical, biotechnology, medical de-
vice, or diagnostic products that are covered
or for which coverage is being sought under
this subchapter; and
(B) are with respect to coverage, coding, or
payment under this subchapter for such
products.
(2) Application
The second sentence of subsection (c)(2)
shall apply to the ombudsman under subpara-
graph (A) in the same manner as such sentence
applies to the Medicare Beneficiary Ombuds-
man under subsection (c).
(e) Funding for implementation of beneficiary
enrollment simplification
For purposes of carrying out the provisions of
and the amendments made by section 120 of divi-
sion CC of the Consolidated Appropriations Act,
2021, the Secretary shall provide for the transfer,
from the Federal Hospital Insurance Trust Fund
under section 1395i of this title and the Federal
Supplementary Medical Insurance Trust Fund
under section 1395t of this title (in such propor-
tion as the Secretary determines appropriate),
to the Centers for Medicare & Medicaid Services
Program Management Account, of $2,000,000 for
each of fiscal years 2021 through 2030, to remain
available until expended.
(Aug. 14, 1935, ch. 531, title XVIII, § 1808, as added
and amended Pub. L. 108–173, title IX, §§ 900(a),
(b), 923(a), Dec. 8, 2003, 117 Stat. 2369, 2393; Pub.
L. 114–255, div. A, title IV, § 4010, Dec. 13, 2016, 130
Stat. 1185; Pub. L. 116–260, div. CC, title I,
§ 120(b), Dec. 27, 2020, 134 Stat. 2955.)
Editorial Notes
REFERENCES IN TEXT
Section 120 of division CC of the Consolidated Appro-
priations Act, 2021, referred to in subsec. (e), is section
120 of div. CC of Pub. L. 116–260, which amended this
section and sections
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1395c
Stored review status: historical_2024_not_currentness_verified. The source passage cites 42 U.S.C. § 1395c. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
**(a) Requirement of requests and certifications** Except as provided in subsections (d) and (g) and in [section 1395mm of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395mm&num=0&edition=prelim), payment for services furnished an individual may be made only to providers of services which are eligible therefor under [section 1395cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395cc&num=0&edition=prelim) and only if—
(1) written request, signed by such individual, except in cases in which the Secretary finds it impracticable for the individual to do so, is filed for such payment in such form, in such manner, and by such person or persons as the Secretary may by regulation prescribe, no later than the close of the period ending 1 calendar year after the date of service;
(2) a physician, or, in the case of services described in subparagraph (B), a physician, or a nurse practitioner, a clinical nurse specialist, or a physician assistant (as those terms are defined in [section 1395x(aa)(5) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa/5&num=0&edition=prelim)) who does not have a direct or indirect employment relationship with the facility but is working in collaboration with a physician,,11 So in original. or, in the case of services described in subparagraph (C), a physician, a nurse practitioner or clinical nurse specialist (as such terms are defined in [section 1395x(aa)(5) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/aa/5&num=0&edition=prelim)) who is working in accordance with State law, or a physician assistant (as defined in [section 1395x(aa)(5) of this title](https://usc
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395j
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Federal law — U.S. Code and appendices · legal_authorities
Page 3018
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 1395j
(I) a range of remedies to apply to hos-
pice programs under the conditions de-
scribed in paragraphs (1) through (4); and
(II) appropriate procedures for appeal-
ing determinations relating to the impo-
sition of such remedies.
Remedies developed pursuant to the pre-
ceding sentence shall include the remedies
specified in subparagraph (B).
(ii) Conditions of imposition of remedies
Not later than October 1, 2022, the Sec-
retary shall develop and implement spe-
cific procedures with respect to the condi-
tions under which each of the remedies de-
veloped under clause (i) is to be applied,
including the amount of any fines and the
severity of each of these remedies. Such
procedures shall be designed so as to mini-
mize the time between identification of de-
ficiencies and imposition of these remedies
and shall provide for the imposition of in-
crementally more severe fines for repeated
or uncorrected deficiencies.
(B) Specified remedies
The remedies specified in this subpara-
graph are the following:
(i) Civil money penalties in an amount
not to exceed $10,000 for each day of non-
compliance by a hospice program with the
requirements specified in section 1395x(dd)
of this title.
(ii) Suspension of all or part of the pay-
ments to which a hospice program would
otherwise be entitled under this sub-
chapter with respect to items and services
furnished by a hospice program on or after
the date on which the Secretary deter-
mines that remedies should be imposed
pursuant to paragraphs (1) and (2).
(iii) The appointment of temporary man-
agement to oversee the operation of the
hospice program and to protect and assure
the health and safety of the individuals
under the care of the program while im-
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 1395j
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Individuals over 65 years** Every individual who—
(1) has attained age 65, and
(2)
(A) is entitled to monthly insurance benefits under [section 402 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section402&num=0&edition=prelim), would be entitled to those benefits except that he has not filed an application therefor (or application has not been made for a benefit the entitlement to which for any individual is a condition of entitlement therefor), or would be entitled to such benefits but for the failure of another individual, who meets all the criteria of entitlement to monthly insurance benefits, to meet such criteria throughout a month, and, in conformity with regulations of the Secretary, files an application for hospital insurance benefits under part A of subchapter XVIII,
(B) is a qualified railroad retirement beneficiary, or
(C)
(i) would meet the requirements of subparagraph (A) upon filing application for the monthly insurance benefits involved if medicare qualified government employment (as defined in [section 410(p) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section410/p&num=0&edition=prelim)) were treated as employment (as defined in [section 410(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section410/a&num=0&edition=prelim)) for purposes of this subchapter, and (ii) files an application, in conformity with regulations of the Secretary, for hospital insurance benefits under part A of subchapter XVIII,
shall be entitled to hospital insurance benefits under part A of subchapter XVIII for each month for which he meets the condition specified in paragraph (2), beginning with the first month after June 1966 for which he meet
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 426
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Federal law — U.S. Code and appendices · legal_authorities
Page 2093
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 426
‘‘(ii) TERMINATION AFTER 36 MONTHS.—
‘‘(I) IN GENERAL.—For purposes of section 225(c)(7)
of the Social Security Act [42 U.S.C. 425(c)(7)]
(added by this subsection), the first month of enti-
tlement beginning after 180 days after the date of
the enactment of this Act [Aug. 15, 1994] shall be
treated as the individual’s first month of entitle-
ment to such benefits.
‘‘(II)
CONCURRENT
BENEFICIARIES
CURRENTLY
UNDER TREATMENT.—In any case in which the indi-
vidual is also entitled to benefits under title XVI
[42 U.S.C. 1381 et seq.] and, as of 180 days after the
date of the enactment of this Act, such individual
is undergoing treatment required under section
1611(e)(3) of the Social Security Act [42 U.S.C.
1382(e)(3)] (as in effect immediately before the date
of the enactment of this Act), the Secretary of
Health and Human Services shall notify such indi-
vidual of the provisions of section 225(c)(7) of the
Social Security Act (added by this subsection) not
later than 180 days after the date of the enactment
of this Act.
‘‘(III) CONCURRENT BENEFICIARIES NOT CURRENTLY
UNDER TREATMENT.—In any case in which the indi-
vidual is also entitled to benefits under title XVI
but, as of 180 days after the date of the enactment
of this Act, such individual is not undergoing treat-
ment described in subclause (II), section 225(c)(7)
(added by this subsection) shall apply only with re-
spect to benefits for months after the month in
which treatment required under section 1611(e)(3) of
the Social Security Act (as amended by subsection
(b)) is available, as determined under regulations of
the Secretary of Health and Human Services, and
the Secretary notifies such individual of the avail-
ability of such treat
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 426
Stored review status: historical_2024_not_currentness_verified. The source passage cites 42 U.S.C. § 426. This identifies an authority to review, not proof of applicability.