10 U.S.C. § 1094a — Continuing medical education require-

Page 1140 TITLE 10—ARMED FORCES § 1094a (e) In this section: (1) The term ‘‘license’’— (A) means a grant of permission by an offi- cial agency of a State, the District of Co- lumbia, or a Commonwealth, territory, or possession of the United States to provide health care independently as a health-care professional; and (B) includes, in the case of such care fur- nished in a foreign country by any person who is not a national of the United States, a grant of permission by an official agency of that foreign country for that person to provide health care independently as a health-care professional. (2) The term ‘‘health-care professional’’ means a physician, dentist, clinical psycholo- gist, marriage and family therapist certified as such by a certification recognized by the Secretary of Defense, or nurse and any other person providing direct patient care as may be designated by the Secretary of Defense in reg- ulations. (Added Pub. L. 99–145, title VI, § 653(a)(1), Nov. 8, 1985, 99 Stat. 657; amended Pub. L. 99–661, div. A, title XIII, § 1343(a)(5), Nov. 14, 1986, 100 Stat. 3992; Pub. L. 101–189, div. A, title VI, § 653(e)(1), title XVI, § 1622(e)(3), Nov. 29, 1989, 103 Stat. 1463, 1605; Pub. L. 105–85, div. A, title VII, § 737, Nov. 18, 1997, 111 Stat. 1814; Pub. L. 105–261, div. A, title VII, § 734(a), Oct. 17, 1998, 112 Stat. 2072; Pub. L. 108–375, div. A, title VII, § 717(b), Oct. 28, 2004, 118 Stat. 1986; Pub. L. 111–383, div. A, title VII, § 713, Jan. 7, 2011, 124 Stat. 4247; Pub. L. 112–81, div. A, title VII, § 713(a), Dec. 31, 2011, 125 Stat. 1476; Pub. L. 117–263, div. A, title VII, § 718, Dec. 23, 2022, 136 Stat. 2662; Pub. L. 118–159, div. A, title VII, §§ 713, 714(a), Dec. 23, 2024, 138 Stat. 1947.) Editorial Notes AMENDMENTS 2024—Subsec. (d)(1). Pub. L. 118–159, § 714(a)(1), sub- stituted ‘‘paragraph (2), (3), or (4)’’ for ‘‘paragraph (2) or (3)’’. Subsec. (d)(2). Pub. L. 118–159, § 713, inserted ‘‘an ex- amination or assessment under section 10206 of this title or’’ after ‘‘section 1091 of this title who is pro- viding’’ in introductory provisions. Subsec. (d)(4). Pub. L. 118–159, § 714(a)(2), added par. (4). 2022—Subsec. (d)(2). Pub. L. 117–263 inserted ‘‘con- tractor not covered under section 1091 of this title who is providing medical treatment as part of a mission re- lating to emergency, humanitarian, or refugee assist- ance,’’ after ‘‘section 1091 of this title,’’ in introductory provisions. 2011—Subsec. (d)(1). Pub. L. 112–81, § 713(a)(1), inserted ‘‘at any location’’ before ‘‘in any State’’ and sub- stituted ‘‘regardless of where such health-care profes- sional or the patient are located, so long as the prac- tice is within the scope of the authorized Federal du- ties.’’ for ‘‘regardless of whether the practice occurs in a health care facility of the Department of Defense, a civilian facility affiliated with the Department of De- fense, or any other location authorized by the Sec- retary of Defense.’’ Pub. L. 111–383, § 713(1), inserted ‘‘or (3)’’ after ‘‘para- graph (2)’’. Subsec. (d)(2). Pub. L. 112–81, § 713(a)(2), substituted ‘‘member of the armed forces, civilian employee of the Department of Defense, personal services contractor under section 1091 of this title, or other health-care professional credentialed and privileged at a Federal health care institution or location specially designated by the Secretary for this purpose’’ for ‘‘member of the armed forces’’. Pub. L. 111–383, § 713(2), inserted ‘‘as being described in this paragraph’’ after ‘‘paragraph (1)’’ in introduc- tory provisions. Subsec. (d)(3). Pub. L. 111–383, § 713(3), added par. (3). 2004—Subsec. (e)(2). Pub. L. 108–375 inserted ‘‘mar- riage and family therapist certified as such by a certifi- cation recognized by the Secretary of Defense,’’ after ‘‘psychologist,’’. 1998—Subsec. (a)(1). Pub. L. 105–261 inserted at end ‘‘In the case of a physician, the physician may not pro- vide health care as a physician under this chapter un- less the current license is an unrestricted license that is not subject to limitation on the scope of practice or- dinarily granted to other physicians for a similar spe- cialty by the jurisdiction that granted the license.’’ 1997—Subsecs. (d), (e). Pub. L. 105–85 added subsec. (d) and redesignated former subsec. (d) as (e). 1989—Subsec. (c)(2). Pub. L. 101–189, § 653(e)(1), sub- stituted ‘‘subsections (c) and (e) through (h)’’ for ‘‘sub- sections (b) and (d) through (g)’’. Subsec. (d)(1). Pub. L. 101–189, § 1622(e)(3)(A), sub- stituted ‘‘The term ‘license’’ for ‘‘ ‘License’’ in intro- ductory provisions. Subsec. (d)(2). Pub. L. 101–189, § 1622(e)(3)(B), sub- stituted ‘‘The term ‘health-care’’ for ‘‘ ‘Health-care’’. 1986—Subsec. (d)(2). Pub. L. 99–661 realigned margin of par. (2) to conform to margin of par. (1). Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1998 AMENDMENT Pub. L. 105–261, div. A, title VII, § 734(c)(1), Oct. 17, 1998, 112 Stat. 2073, provided that: ‘‘The amendment made by subsection (a) [amending this section] shall take effect on October 1, 1999.’’ EFFECTIVE DATE Pub. L. 99–145, title VI, § 653(b), Nov. 8, 1985, 99 Stat. 658, provided that: ‘‘Section 1094 of title 10, United States Code, as added by subsection (a), does not apply during the three-year period beginning on the date of the enactment of this Act [Nov. 8, 1985] with respect to the provision of health care by any person who on the date of the enactment of this Act is a member of the Armed Forces.’’ REGULATIONS Pub. L. 118–159, div. A, title VII, § 714(b), Dec. 23, 2024, 138 Stat. 1948, provided that: ‘‘Not later than 180 days after the date of the enactment of this Act [Dec. 23, 2024], the Secretary of Defense shall issue an interim final regulation to implement the amendments made by subsection (a) [amending this section].’’ Pub. L. 112–81, div. A, title VII, § 713(b), Dec. 31, 2011, 125 Stat. 1476, provided that: ‘‘The Secretary of Defense shall prescribe regulations to carry out the amend- ments made by this section [amending this section].’’ § 1094a. Continuing medical education require- ments: system for monitoring physician com- pliance The Secretary of Defense shall establish a mechanism for ensuring that each person under the jurisdiction of the Secretary of a military department who provides health care under this chapter as a physician satisfies the continuing medical education requirements applicable to the physician. (Added Pub. L. 105–261, div. A, title VII, § 734(b)(1), Oct. 17, 1998, 112 Stat. 2073.) Statutory Notes and Related Subsidiaries IMPLEMENTATION Pub. L. 105–261, div. A, title VII, § 734(c)(2), Oct. 17, 1998, 112 Stat. 2073, provided that: ‘‘The system required Page 1141 TITLE 10—ARMED FORCES § 1095 by section 1094a of title 10, United States Code (as added by subsection (b)), shall take effect on the date that is three years after the date of the enactment of this Act [Oct. 17, 1998].’’ OVERSIGHT OF GRADUATE MEDICAL EDUCATION PROGRAMS OF MILITARY DEPARTMENTS Pub. L. 114–328, div. A, title VII, § 749, Dec. 23, 2016, 130 Stat. 2242, provided that: ‘‘(a) PROCESS.—Not later than one year after the date of the enactment of this Act [Dec. 23, 2016], the Sec- retary of Defense shall establish and implement a proc- ess to provide oversight of the graduate medical edu- cation programs of the military departments to ensure that such programs fully support the operational med- ical force readiness requirements for health care pro- viders of the Armed Forces and the medical readiness of the Armed Forces. The process shall include the fol- lowing: ‘‘(1) A process to review such programs to ensure, to the extent practicable, that such programs are— ‘‘(A) conducted jointly among the military de- partments; and ‘‘(B) focused on, and related to, operational med- ical force readiness requirements. ‘‘(2) A process to minimize duplicative programs re- lating to such programs among the military depart- ments. ‘‘(3) A process to ensure that— ‘‘(A) assignments of faculty, support staff, and students within such programs are coordinated among the military departments; and ‘‘(B) the Secretary optimizes resources by using military medical treatment facilities as training platforms when and where most appropriate. ‘‘(4) A process to review and, if necessary, restruc- ture or realign, such programs to sustain and im- prove operational medical force readiness. ‘‘(b) REPORT.—Not later than 30 days after the date on which the Secretary establishes the process under subsection (a), the Secretary shall submit to the Com- mittees on Armed Services of the Senate and the House of Representatives a report that describes such process. The report shall include a description of each graduate medical education program of the military depart- ments, categorized by the following: ‘‘(1) Programs that provide direct support to oper- ational medical force readiness. ‘‘(2) Programs that provide indirect support to operational medical force readiness. ‘‘(3) Academic programs that provide other medical support. ‘‘(c) COMPTROLLER GENERAL REVIEW AND REPORT.— ‘‘(1) REVIEW.—The Comptroller General of the United States shall conduct a review of the process established under subsection (a), including with re- spect to each process described in paragraphs (1) through (4) of such subsection. ‘‘(2) REPORT.—Not later than 180 days after the date on which the Secretary submits the report under sub- section (b), the Comptroller General shall submit to the Committees on Armed Services of the Senate and the House of Representatives the review conducted under paragraph (1), including an assessment of the elements of the process established under subsection (a).’’ JOINT PILOT PROGRAM FOR PROVIDING GRADUATE MEDICAL EDUCATION AND TRAINING FOR PHYSICIANS Pub. L. 107–314, div. A, title VII, § 725(a)–(d), Dec. 2, 2002, 116 Stat. 2599, provided that: ‘‘(a) IN GENERAL.—The Secretary of Defense and the Secretary of Veterans Affairs shall jointly carry out a pilot program under which graduate medical education and training is provided to military physicians and physician employees of the Department of Defense and the Department of Veterans Affairs through one or more programs carried out in military medical treat- ment facilities of the Department of Defense and med- ical centers of the Department of Veterans Affairs. The pilot program shall begin not later than January 1, 2003. ‘‘(b) COST-SHARING AGREEMENT.—The Secretaries shall enter into an agreement for carrying out the pilot program. The agreement shall establish means for each Secretary to assist in paying the costs, with respect to individuals under the jurisdiction of that Secretary, in- curred by the other Secretary in providing medical education and training under the pilot program. ‘‘(c) USE OF EXISTING AUTHORITIES.—To carry out the pilot program, the Secretary of Defense and the Sec- retary of Veterans Affairs may use authorities provided to them under this subtitle [subtitle C (§§ 721–726) of title VII of div. A of Pub. L. 107–314, amending section 1104 of this title and sections 8110 and 8111 of Title 38, Veterans’ Benefits, enacting provisions set out as notes under section 1074g of this title and sections 8110 and 8111 of Title 38, and repealing provisions set out as a note under this section], section 8111 of title 38, United States Code (as amended by section 721(a)), and other laws relating to the furnishing or support of medical education and the cooperative use of facilities. ‘‘(d) TERMINATION OF PROGRAM.—The pilot program under this section shall terminate on July 31, 2008.’’ JOINT DOD–VA PILOT PROGRAM FOR PROVIDING GRAD- UATE MEDICAL EDUCATION AND TRAINING FOR PHYSI- CIANS Pub. L. 107–107, div. A, title VII, § 738, Dec. 28, 2001, 115 Stat. 1173, authorized a pilot program providing grad- uate medical education and training for physicians to be carried out jointly by the Secretary of Defense and the Secretary of Veterans Affairs, prior to repeal by Pub. L. 107–314, div. A, title VII, § 725(e), Dec. 2, 2002, 116 Stat. 2599. § 1095. Health care services incurred on behalf of covered beneficiaries: collection from third- party payers (a)(1) In the case of a person who is a covered beneficiary, the United States shall have the right to collect from a third-party payer reason- able charges for health care services incurred by the United States on behalf of such person through a facility of the uniformed services to the extent that the person would be eligible to receive reimbursement or indemnification from the third-party payer if the person were to incur such charges on the person’s own behalf. If the insurance, medical service, or health plan of that payer includes a requirement for a deduct- ible or copayment by the beneficiary of the plan, then the amount that the United States may collect from the third-party payer is a reason- able charge for the care provided less the appro- priate deductible or copayment amount. (2) A covered beneficiary may not be required to pay an additional amount to the United States for health care services by reason of this section. (b) No provision of any insurance, medical service, or health plan contract or agreement having the effect of excluding from coverage or limiting payment of charges for certain care shall operate to prevent collection by the United States under subsection (a) if that care is pro- vided— (1) through a facility of the uniformed serv- ices; (2) directly or indirectly by a governmental entity; (3) to an individual who has no obligation to pay for that care or for whom no other person has a legal obligation to pay; or