10 U.S.C. § 1085 — Medical and dental care from another ex-

Page 1117 TITLE 10—ARMED FORCES § 1085 change a determination because of new evidence or for other good cause. The Secretary’s deter- mination may not be reviewed in any court or by the Comptroller General, unless there has been fraud or gross negligence. (Added Pub. L. 85–861, § 1(25)(B), Sept. 2, 1958, 72 Stat. 1450; amended Pub. L. 89–614, § 2(1), Sept. 30, 1966, 80 Stat. 862; Pub. L. 96–513, title V, § 511(34)(A), (36), Dec. 12, 1980, 94 Stat. 2922, 2923; Pub. L. 98–557, § 19(11), Oct. 30, 1984, 98 Stat. 2870; Pub. L. 108–375, div. A, title X, § 1084(c)(1), Oct. 28, 2004, 118 Stat. 2061.) HISTORICAL AND REVISION NOTES Revised section Source (U.S. Code) Source (Statutes at Large) 1084 ......... 37:404. June 7, 1956, ch. 374, § 304, 70 Stat. 254. The words ‘‘the General Accounting Office’’ are sub- stituted for the words ‘‘any accounting officer of the Government’’ for clarity. The words ‘‘All’’ and ‘‘for all purposes’’ are omitted as surplusage. Editorial Notes PRIOR PROVISIONS A prior section 1084, act Aug. 10, 1956, ch. 1041, 70A Stat. 87, related to administration of former sections 1071 to 1086 of this title, prior to repeal by Pub. L. 85–861, § 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by the Federal Voting Assistance Act of 1955 which is classified to subchapter I–D (§ 1973cc et seq.) of chapter 20 of Title 42, The Public Health and Welfare. AMENDMENTS 2004—Pub. L. 108–375 substituted ‘‘Comptroller Gen- eral’’ for ‘‘General Accounting Office’’. 1984—Pub. L. 98–557 substituted reference to admin- istering Secretary for reference to Secretary of Defense and Secretary of Health and Human Services and ref- erence to administering Secretary for reference to he. 1980—Pub. L. 96–513 substituted ‘‘Secretary of Health and Human Services’’ for ‘‘Secretary of Health, Edu- cation, and Welfare’’, and ‘‘this chapter’’ for ‘‘sections 1071–1087 of this title’’. 1966—Pub. L. 89–614 substituted ‘‘1087’’ for ‘‘1085’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1980 AMENDMENT Amendment by Pub. L. 96–513 effective Dec. 12, 1980, see section 701(b)(3) of Pub. L. 96–513, set out as a note under section 101 of this title. EFFECTIVE DATE OF 1966 AMENDMENT For effective date of amendment by Pub. L. 89–614, see section 3 of Pub. L. 89–614, set out as a note under section 1071 of this title. § 1085. Medical and dental care from another ex- ecutive department: reimbursement If a member or former member of a uniformed service under the jurisdiction of one executive department (or a dependent of such a member or former member) receives inpatient medical or dental care in a facility under the jurisdiction of another executive department, the appropria- tion for maintaining and operating the facility furnishing the care shall be reimbursed at rates established by the President to reflect the aver- age cost of providing the care. (Added Pub. L. 85–861, § 1(25)(B), Sept. 2, 1958, 72 Stat. 1450; amended Pub. L. 89–264, § 1, Oct. 19, 1965, 79 Stat. 989; Pub. L. 96–513, title V, § 511(36), (37), Dec. 12, 1980, 94 Stat. 2923; Pub. L. 98–94, title XII, § 1268(6), Sept. 24, 1983, 97 Stat. 706; Pub. L. 98–557, § 19(12), Oct. 30, 1984, 98 Stat. 2870; Pub. L. 99–145, title XIII, § 1303(a)(8), Nov. 8, 1985, 99 Stat. 739.) HISTORICAL AND REVISION NOTES Revised section Source (U.S. Code) Source (Statutes at Large) 1085 ......... 37:421(d). June 7, 1956, ch. 374, § 301(d), 70 Stat. 253. The words ‘‘other than that of the member or former member concerned’’ are substituted for the words ‘‘that is not the service of which he is a member or retired member, or that is not the service of the member or re- tired member upon whom he is dependent’’. The word ‘‘medical’’ before the word ‘‘facility’’ is omitted to make clear that the provision also relates to dental care. The words ‘‘pursuant to the provisions of this chapter’’ are omitted as surplusage. Editorial Notes PRIOR PROVISIONS A prior section 1085, act Aug. 10, 1956, ch. 1041, 70A Stat. 87, related to prevention of fraud, coercion, and undue influence, to free discussion, and to acts done in good faith, prior to repeal by Pub. L. 85–861, § 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by the Federal Voting Assistance Act of 1955 which is classified to sub- chapter I–D (§ 1973cc et seq.) of chapter 20 of Title 42, The Public Health and Welfare. AMENDMENTS 1985—Pub. L. 99–145 indented first line of text. 1984—Pub. L. 98–557 substituted ‘‘If a member or former member of a uniformed service under the juris- diction of one executive department (or a dependent of such a member or former member) receives inpatient medical or dental care in a facility under the jurisdic- tion of another executive department, the appropria- tion for maintaining and operating the facility fur- nishing the care shall be reimbursed at rates estab- lished by the President to reflect the average cost of providing the care’’ for ‘‘If a member or former member of an armed force under the jurisdiction of a military department, or his dependent, receives inpatient med- ical or dental care in a facility under the jurisdiction of the Secretary of Health and Human Services, or if a member or former member of a uniformed service not under the jurisdiction of a military department, or his dependent, receives inpatient medical or dental care in a facility of an armed force under the jurisdiction of a military department, the appropriation for maintain- ing and operating the facility furnishing that care shall be reimbursed at rates established by the President to reflect the average cost of providing such care’’. 1983—Pub. L. 98–94 inserted a comma after ‘‘If a mem- ber or former member of an armed force under the ju- risdiction of a military department, or his dependent’’. 1980—Pub. L. 96–513 substituted ‘‘Secretary of Health and Human Services’’ for ‘‘Secretary of Health, Edu- cation, and Welfare’’, and ‘‘President’’ for ‘‘Bureau of the Budget’’. 1965—Pub. L. 89–264 substituted ‘‘executive depart- ment’’ for ‘‘uniformed service’’ in section catchline, and provisions requiring reimbursement if a member or former member of an armed force under the jurisdic- tion of a military department, or his dependent re- ceives care in a facility under the jurisdiction of Sec- retary of Health, Education, and Welfare, or if a mem- ber or former member of a uniformed service not under the jurisdiction of a military department, or his de- pendent, receives care in a facility of an armed force under the jurisdiction of a military department, for provisions which required reimbursement if a person Page 1118 TITLE 10—ARMED FORCES § 1086 received care in a facility of a uniformed service other than that of the member or former member concerned. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1980 AMENDMENT Amendment by Pub. L. 96–513 effective Dec. 12, 1980, see section 701(b)(3) of Pub. L. 96–513, set out as a note under section 101 of this title. TRANSFER OF FUNDS NECESSARY TO PROVIDE MEDICAL CARE Pub. L. 114–120, title II, § 217, Feb. 8, 2016, 130 Stat. 46, related to transfer of funds from the Secretary of Homeland Security to the Secretary of Defense in lieu of reimbursement required under section 1085 of title 10, prior to repeal by Pub. L. 114–328, div. A, title VII, § 722(c), Dec. 23, 2016, 130 Stat. 2229. Executive Documents DELEGATION OF FUNCTIONS Authority of President under this section to establish uniform rates of reimbursement for inpatient medical or dental care delegated to Secretary of Health and Human Services in respect of such care in a facility under his jurisdiction and to Secretary of Defense in re- spect of such care in a facility of an armed force under jurisdiction of a military department, see section 6 of Ex. Ord. No. 11609, July 22, 1971, 36 F.R. 13747, set out as a note under section 301 of Title 3, The President. § 1086. Contracts for health benefits for certain members, former members, and their de- pendents (a) To assure that health benefits are available for the persons covered by subsection (c), the Secretary of Defense, after consulting with the other administering Secretaries, shall contract under the authority of this section for health benefits for those persons under the same insur- ance, medical service, or health plans he con- tracts for under section 1079(a) of this title. However, eye examinations and (except as pro- vided in subsection (i)) treatments for eating disorders may not be provided under such plans for persons covered by subsection (c). (b) For persons covered by this section the plans contracted for under section 1079(a) of this title shall contain the following provisions for payment by the patient: (1) Except as provided in paragraph (2), the first $150 each calendar year of the charges for all types of care authorized by this section and received while in an outpatient status and 25 percent of all subsequent charges for such care during a calendar year. (2) A family group of two or more persons covered by this section shall not be required to pay collectively more than the first $300 each calendar year of the charges for all types of care authorized by this section and received while in an outpatient status and 25 percent of the additional charges for such care during a calendar year. (3) 25 percent of the charges for inpatient care, except that in no case may the charges for inpatient care for a patient exceed $535 per day during the period beginning on April 1, 2006, and ending on September 30, 2011. The Secretary of Defense may exempt a patient from paying such charges if the hospital to which the patient is admitted does not impose a legal obligation on any of its patients to pay for inpatient care. (4) A member or former member of a uni- formed service covered by this section by rea- son of section 1074(b) of this title, or an indi- vidual or family group of two or more persons covered by this section, may not be required to pay a total of more than $3,000 for health care received during any calendar year under a plan contracted for under section 1079(a) of this title. (c) Except as provided in subsection (d), the following persons are eligible for health benefits under this section: (1) Those covered by sections 1074(b) and 1076(b) of this title, except those covered by section 1072(2)(E) of this title. (2) A dependent (other than a dependent cov- ered by section 1072(2)(E) of this title) of a member of a uniformed service— (A) who died while on active duty for a pe- riod of more than 30 days; or (B) who died from an injury, illness, or dis- ease incurred or aggravated— (i) while on active duty under a call or order to active duty of 30 days or less, on active duty for training, or on inactive duty training; or (ii) while traveling to or from the place at which the member is to perform, or has performed, such active duty, active duty for training, or inactive duty training. (3) A dependent covered by clause (F), (G), or (H) of section 1072(2) of this title who is not el- igible under paragraph (1). (d)(1) A person who is entitled to hospital in- surance benefits under part A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.) is not eligible for health benefits under this sec- tion. (2) The prohibition contained in paragraph (1) shall not apply to a person referred to in sub- section (c) who— (A) is enrolled in the supplementary medical insurance program under part B of such title (42 U.S.C. 1395j et seq.); and (B) in the case of a person under 65 years of age, is entitled to hospital insurance benefits under part A of title XVIII of the Social Secu- rity Act pursuant to subparagraph (A) or (C) of section 226(b)(2) of such Act (42 U.S.C. 426(b)(2)) or section 226A(a) of such Act (42 U.S.C. 426–1(a)). (3)(A) Subject to subparagraph (B), if a person described in paragraph (2) receives medical or dental care for which payment may be made under medicare and a plan contracted for under subsection (a), the amount payable for that care under the plan shall be the amount of the actual out-of-pocket costs incurred by the person for that care over the sum of— (i) the amount paid for that care under medicare; and (ii) the total of all amounts paid or payable by third party payers other than medicare. (B) The amount payable for care under a plan pursuant to subparagraph (A) may not exceed the total amount that would be paid under the plan if payment for that care were made solely under the plan.