10 U.S.C. § 1079a — TRICARE program: treatment of refunds

Page 1113 TITLE 10—ARMED FORCES § 1079b would apply until Oct. 1, 1991, in the case of health care provided under that section to the dependents of a member of the uniformed services who had served on active duty in the Persian Gulf theater of operations in connection with Operation Desert Storm, and that pa- tient copayment requirements could be waived upon the provider’s certification to the Secretary of Defense that the amount charged the Federal Government for such health care had not been increased above the amount that the provider would have charged the Fed- eral Government for such health care had the payment not been waived. TRANSITIONAL HEALTH CARE FOR MEMBERS, OR DE- PENDENTS OF MEMBERS, UPON RELEASE OF MEMBER FROM ACTIVE DUTY IN CONNECTION WITH OPERATION DESERT STORM For provision authorizing transitional health care, including health benefits contracted for under subsec. (a) of this section, for members, or dependents of mem- bers, upon release of member from active duty in con- nection with Operation Desert Storm, see section 313 of Pub. L. 102–25, set out as a note under section 1076 of this title. § 1079a. TRICARE program: treatment of refunds and other amounts collected All refunds and other amounts collected in the administration of the TRICARE program shall be credited to the appropriation available for that program for the fiscal year in which the re- fund or amount is collected. (Added Pub. L. 104–201, div. A, title VII, § 733(a)(1), Sept. 23, 1996, 110 Stat. 2597; amended Pub. L. 114–328, div. A, title VII, § 701(j)(1)(D), Dec. 23, 2016, 130 Stat. 2192.) Editorial Notes PRIOR PROVISIONS Provisions similar to those in this section were con- tained in the following appropriations acts: Pub. L. 104–61, title VIII, § 8094, Dec. 1, 1995, 109 Stat. 671. Pub. L. 103–335, title VIII, § 8144, Sept. 30, 1994, 108 Stat. 2656. AMENDMENTS 2016—Pub. L. 114–328 substituted ‘‘TRICARE pro- gram’’ for ‘‘CHAMPUS’’ in section catchline and ‘‘the TRICARE program’’ for ‘‘the Civilian Health and Med- ical Program of the Uniformed Services’’ in text. 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. § 1079b. Procedures for charging fees for care provided to civilians; retention and use of fees collected (a) REQUIREMENT TO IMPLEMENT PROCE- DURES.—The Secretary of Defense shall imple- ment procedures under which a military medical treatment facility may charge civilians who are not covered beneficiaries (or their insurers) fees representing the costs, as determined by the Secretary, of trauma and other medical care provided to such civilians. (b) WAIVER OF FEES.—The Director of the De- fense Health Agency may issue a waiver for a fee that would otherwise be charged under the pro- cedures implemented under subsection (a) to a civilian provided medical care who is not a cov- ered beneficiary if the provision of such care en- hances the knowledge, skills, and abilities of health care providers, as determined by the Di- rector of the Defense Health Agency. (c) MODIFIED PAYMENT PLAN FOR CERTAIN CI- VILIANS.—(1)(A) If a civilian specified in sub- section (a) is covered by a covered payer at the time care under this section is provided, the ci- vilian shall only be responsible to pay the stand- ard copays, coinsurance, deductibles, or nominal fees that are otherwise applicable under the cov- ered payer plan. (B) Except with respect to the copays, coinsur- ance, deductibles, and nominal fees specified in subparagraph (A)— (i) the Secretary of Defense may bill only the covered payer for care provided to a civil- ian described in subparagraph (A); and (ii) payment received by the Secretary from the covered payer of a civilian for care pro- vided 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 De- fense 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 sub- section may not be administered by a Federal agency other than the Department of Defense. (d) USE OF FEES COLLECTED.—A military med- ical treatment facility may retain and use the amounts collected under subsection (a) for— (1) trauma consortium activities; (2) administrative, operating, and equipment costs; and (3) readiness training. (e) DEFINITIONS.—In this section: (1) The term ‘‘covered payer’’ means a third- party payer or other insurance, medical serv- ice, or health plan. (2) The terms ‘‘third-party payer’’ and ‘‘in- surance, medical service, or health plan’’ have the meaning given those terms in section 1095(h) of this title. (Added Pub. L. 107–107, div. A, title VII, § 732(a)(1), Dec. 28, 2001, 115 Stat. 1169; amended Pub. L. 116–283, div. A, title VII, § 702, Jan. 1, 2021, 134 Stat. 3686; Pub. L. 117–263, div. A, title VII, § 716(a), (b), Dec. 23, 2022, 136 Stat. 2661.) Editorial Notes AMENDMENTS 2022—Subsec. (b). Pub. L. 117–263, § 716(a)(1), amended subsec. (b) generally. Prior to amendment, text read as follows: ‘‘The Secretary may waive a fee that would