10 U.S.C. § 1073d — Military medical treatment facilities

Page 1028 TITLE 10—ARMED FORCES § 1073d that such personnel are capable of meeting the oper- ational medical force requirements of the combatant commands applicable to such personnel. Such train- ing and practice opportunities shall be provided pri- marily through programs and activities of the De- fense Health Agency, in coordination with the Secre- taries of the military departments, and by such other mechanisms as the Secretary of Defense shall des- ignate for purposes of this paragraph. ‘‘(4) CONSTRUCTION OF DUTIES.—The duties of a Sur- geon General of the Armed Forces under this sub- section are in addition to the duties of such Surgeon General under section 3036, 5137, or 8036 of title 10, United States Code, as applicable. ‘‘(5) MANPOWER.— ‘‘(A) ADMINISTRATIVE CONTROL OF MILITARY PER- SONNEL.—Each Secretary of a military department shall exercise administrative control of members of the Armed Forces assigned to military medical treatment facilities, including personnel assign- ment and issuance of military orders. ‘‘(B) OVERSIGHT OF CERTAIN PERSONNEL BY THE DI- RECTOR OF THE DEFENSE HEALTH AGENCY.—In situa- tions in which members of the Armed Forces pro- vide health care services at a military medical treatment facility, the Director of the Defense Health Agency shall maintain operational control over such members and oversight for the provision of care delivered by such members through policies, procedures, and privileging responsibilities of the military medical treatment facility. ‘‘(f) REPORT.—Not later than 270 days after the date of the enactment of this Act [Aug. 13, 2018], the Sec- retary of Defense shall submit to the Committees on Armed Services of the Senate and the House of Rep- resentatives a report that sets forth the following: ‘‘(1) A description of the organizational structure of the office of each Surgeon General of the Armed Forces, and of any subordinate organizations of the Armed Forces that will support the functions and re- sponsibilities of a Surgeon General of the Armed Forces. ‘‘(2) The manning documents for staffing in support of the organizational structures described pursuant to paragraph (1), including manning levels before and after such organizational structures are imple- mented. ‘‘(3) Such recommendations for legislative or ad- ministrative action as the Secretary considers appro- priate in connection with the implementation of such organizational structures and, in particular, to avoid duplication of functions and tasks between the orga- nizations in such organizational structures and the Defense Health Agency.’’ SELECTION OF MILITARY COMMANDERS AND DIRECTORS OF MILITARY MEDICAL TREATMENT FACILITIES Pub. L. 115–91, div. A, title VII, § 722, Dec. 12, 2017, 131 Stat. 1441, provided that: ‘‘(a) IN GENERAL.—Not later than January 1, 2019, the Secretary of Defense, in consultation with the Secre- taries of the military departments, shall establish the common qualifications and core competencies required for an individual to serve as a military commander or director of a military medical treatment facility. ‘‘(b) OBJECTIVE.—The objective of the Secretary under this section shall be to ensure that each indi- vidual selected to serve as a military commander or di- rector of a military medical treatment facility is high- ly qualified to serve as health system executive. ‘‘(c) STANDARDS.—In establishing common qualifica- tions and core competencies under subsection (a), the Secretary shall include standards with respect to the following: ‘‘(1) Professional competence. ‘‘(2) Moral and ethical integrity and character. ‘‘(3) Formal education in health care executive leadership and in health care management. ‘‘(4) Such other matters the Secretary determines to be appropriate.’’ APPOINTMENTS Pub. L. 114–328, div. A, title VII, § 702(c), Dec. 23, 2016, 130 Stat. 2196, provided that: ‘‘The Secretary of Defense shall make appointments of the positions under section 1073c of title 10, United States Code, as added by sub- section (a)— ‘‘(1) by not later than October 1, 2018; and ‘‘(2) by not increasing the number of full-time equivalent employees of the Defense Health Agency.’’ § 1073d. Military medical treatment facilities (a) IN GENERAL.—To support the medical read- iness of the armed forces and the readiness of medical personnel, the Secretary of Defense, in consultation with the Secretaries of the mili- tary departments, shall maintain the military medical treatment facilities described in sub- sections (b), (c), and (d). (b) MEDICAL CENTERS.—(1) The Secretary of Defense shall maintain medical centers in areas with a large population of members of the armed forces and covered beneficiaries. (2) Medical centers shall serve as referral fa- cilities for members and covered beneficiaries who require comprehensive health care services that support medical readiness. (3) Medical centers shall consist of the fol- lowing: (A) Inpatient and outpatient tertiary care facilities that incorporate specialty and sub- specialty care. (B) Graduate medical education programs. (C) Residency training programs. (D) Level one, level two, or level three trau- ma care capabilities. (4)(A) The Secretary shall designate certain major medical centers as regional centers of ex- cellence for the provision of specialty care serv- ices in the areas of specialty care described in subparagraph (D). A major medical center may be designated as a center of excellence under this subparagraph for more than one such area of specialty care. (B) The Secretary may designate certain med- ical centers as satellite centers of excellence for the provision of specialty care services for spe- cific conditions, such as the following: (i) Post-traumatic stress. (ii) Traumatic brain injury. (iii) Such other conditions as the Secretary determines appropriate. (C) Centers of excellence designated under this paragraph shall serve the purposes of— (i) ensuring the military medical force readi- ness of the Department of Defense and the medical readiness of the armed forces; (ii) improving the quality of health care fur- nished by the Secretary to eligible bene- ficiaries; and (iii) improving health outcomes for eligible beneficiaries. (D) The areas of specialty care described in this subparagraph are as follows: (i) Oncology. (ii) Burn injuries and wound care. (iii) Rehabilitation medicine. (iv) Psychological health and traumatic brain injury. (v) Amputations and prosthetics. (vi) Neurosurgery. Page 1029 TITLE 10—ARMED FORCES § 1073d (vii) Orthopedic care. (viii) Substance abuse. (ix) Infectious diseases and preventive medi- cine. (x) Cardiothoracic surgery. (xi) Such other areas of specialty care as the Secretary determines appropriate. (E)(i) Centers of excellence designated under this paragraph shall be the primary source with- in the military health system for the receipt by eligible beneficiaries of specialty care. (ii) Eligible beneficiaries seeking a specialty care service through the military health system shall be referred to a center of excellence des- ignated under subparagraph (A) for that area of specialty care or, if the specialty care service sought is unavailable at such center, to an ap- propriate specialty care provider in the private sector. (F) Not later than 90 days prior to the designa- tion of a center of excellence under this para- graph, the Secretary shall notify the Commit- tees on Armed Services of the House of Rep- resentatives and the Senate of such designation. (G) In this paragraph, the term ‘‘eligible bene- ficiary’’ means any beneficiary under this chap- ter. (5)(A) The Secretary of Defense shall designate and maintain certain military medical treat- ment facilities as core casualty receiving facili- ties, to ensure the medical capability and capac- ity required to diagnose, treat, and rehabilitate large volumes of combat casualties and, as may be directed by the President or the Secretary, provide a medical response to events the Presi- dent determines or declares as natural disasters, mass casualty events, or other national emer- gencies. (B) The Secretary shall ensure that the mili- tary medical treatment facilities selected for designation pursuant to subparagraph (A) are geographically located to facilitate the aeromedical evacuation of casualties from thea- ters of operations. (C) The Secretary— (i) shall ensure that the Secretaries of the military departments assign military per- sonnel to core casualty receiving facilities designated under subparagraph (A) at not less than 90 percent of the staffing level required to maintain the operating bed capacity nec- essary to support operation planning require- ments; (ii) may augment the staffing of military personnel at core casualty receiving facilities under subparagraph (A) with civilian employ- ees of the Department of Defense to fulfill the staffing requirement under clause (i); and (iii) shall ensure that each core casualty re- ceiving facility under subparagraph (A) is staffed with a civilian Chief Financial Officer and a civilian Chief Operating Officer with ex- perience in the management of civilian hos- pital systems, for the purpose of ensuring con- tinuity in the management of the facility. (D) In this paragraph: (i) The term ‘‘core casualty receiving facil- ity’’ means a Role 4 medical treatment facil- ity that serves as a medical hub for the receipt and treatment of casualties, including civilian casualties, that may result from combat or from an event the President determines or de- clares as a natural disaster, mass casualty event, or other national emergency. (ii) The term ‘‘Role 4 medical treatment fa- cility’’ means a medical treatment facility that provides the full range of preventative, curative, acute, convalescent, restorative, and rehabilitative care. (c) HOSPITALS.—(1) The Secretary of Defense shall maintain hospitals in areas where civilian health care facilities are unable to support the health care needs of members of the armed forces and covered beneficiaries. (2) Hospitals shall provide— (A) inpatient and outpatient health services to maintain medical readiness; and (B) such other programs and functions as the Secretary determines appropriate. (3) Hospitals shall consist of inpatient and outpatient care facilities with limited specialty care that the Secretary determines— (A) is cost effective; or (B) is not available at civilian health care facilities in the area of the hospital. (d) AMBULATORY CARE CENTERS.—(1) The Sec- retary of Defense shall maintain ambulatory care centers in areas where civilian health care facilities are able to support the health care needs of members of the armed forces and cov- ered beneficiaries. (2) Ambulatory care centers shall provide the outpatient health services required to maintain medical readiness, including with respect to partnerships established pursuant to section 706 of the National Defense Authorization Act for Fiscal Year 2017. (3) Ambulatory care centers shall consist of outpatient care facilities with limited specialty care that the Secretary determines— (A) is cost effective; or (B) is not available at civilian health care facilities in the area of the ambulatory care center. (e) MAINTENANCE OF INPATIENT CAPABILITIES AT MILITARY MEDICAL TREATMENT FACILITIES LO- CATED OUTSIDE THE UNITED STATES.—(1) In car- rying out subsection (a), the Secretary of De- fense shall ensure that each covered facility maintains, at a minimum, inpatient capabilities that the Secretary determines are similar to the inpatient capabilities of such facility on Sep- tember 30, 2016. (2) The Secretary may not eliminate the inpa- tient capabilities of a covered facility until the day that is 180 days after the Secretary provides a briefing to the Committees on Armed Services of the Senate and the House of Representatives regarding the proposed elimination. During any such briefing, the Secretary shall certify the fol- lowing: (A) The Secretary has entered into agree- ments with hospitals or medical centers in the host nation of such covered facility that— (i) replace the inpatient capabilities the Secretary proposes to eliminate; and (ii) ensure members of the armed forces and covered beneficiaries who receive health care from such covered facility, have, within Page 1030 TITLE 10—ARMED FORCES § 1073d a distance the Secretary determines is rea- sonable, access to quality health care, in- cluding case management and translation services. (B) The Secretary has consulted with the commander of the geographic combatant com- mand in which such covered facility is located to ensure that the proposed elimination would have no impact on the operational plan for such geographic combatant command. (C) Before the Secretary eliminates the inpa- tient capabilities of such covered facility, the Secretary shall provide each member of the armed forces or covered beneficiary who re- ceives health care from the covered facility with— (i) a transition plan for continuity of health care for such member or covered ben- eficiary; and (ii) a public forum to discuss the concerns of the member or covered beneficiary regard- ing the proposed reduction. (3) In this subsection, the term ‘‘covered facil- ity’’ means a military medical treatment facil- ity located outside the United States. (f) NOTIFICATION REQUIRED TO MODIFY SCOPE OF SERVICES PROVIDED AT MILITARY MEDICAL TREATMENT FACILITIES.—(1) The Secretary of Defense may not modify the scope of medical care provided at a military medical treatment facility, or the beneficiary population served at the facility, unless— (A) the Secretary submits to the Commit- tees on Armed Services of the House of Rep- resentatives and the Senate a notification of the proposed modification in scope; (B) a period of 180 days has elapsed following the date on which the Secretary submits such notification; and (C) if the proposed modification in scope in- volves the termination or reduction of inpa- tient capabilities at a military medical treat- ment facility located outside the United States, the Secretary has provided to each member of the armed forces or covered bene- ficiary receiving services at such facility a transition plan for the continuity of health care for such member or covered beneficiary. (2) Each notification under paragraph (1) shall contain information demonstrating, with re- spect to the military medical treatment facility for which the modification in scope has been proposed, the extent to which the commander of the military installation at which the facility is located has been consulted regarding such modi- fication, to ensure that the proposed modifica- tion in scope would have no impact on the oper- ational plan for such installation. (Added Pub. L. 114–328, div. A, title VII, § 703(a)(1), Dec. 23, 2016, 130 Stat. 2197; amended Pub. L. 115–91, div. A, title VII, § 711, Dec. 12, 2017, 131 Stat. 1436; Pub. L. 117–263, div. A, title VII, §§ 712, 713(a), 714(a), 715, Dec. 23, 2022, 136 Stat. 2657, 2659, 2660; Pub. L. 118–159, div. A, title XVII, § 1701(a)(19), Dec. 23, 2024, 138 Stat. 2204.) Editorial Notes REFERENCES IN TEXT Section 706 of the National Defense Authorization Act for Fiscal Year 2017, referred to in subsec. (d)(2), is section 706 of Pub. L. 114–328, which is set out as a note under section 1096 of this title. AMENDMENTS 2024—Subsec. (b)(5)(C)(ii). Pub. L. 118–159 substituted ‘‘fulfill’’ for ‘‘fulfil’’. 2022—Subsec. (b)(3)(D). Pub. L. 117–263, § 712, sub- stituted ‘‘, level two, or level three’’ for ‘‘or level two’’. Subsec. (b)(4). Pub. L. 117–263, § 713(a), amended par. (4) generally. Prior to amendment, par. (4) read as fol- lows: ‘‘The Secretary may designate a medical center as a regional center of excellence for unique and highly specialized health care services, including with respect to polytrauma, organ transplantation, and burn care.’’ Subsec. (b)(5). Pub. L. 117–263, § 714(a), added par. (5). Subsec. (f). Pub. L. 117–263, § 715, added subsec. (f). 2017—Subsec. (e). Pub. L. 115–91 added subsec. (e). Statutory Notes and Related Subsidiaries DEADLINE Pub. L. 117–263, div. A, title VII, § 713(b), Dec. 23, 2022, 136 Stat. 2658, provided that: ‘‘The Secretary of Defense shall designate certain major medical centers as re- gional centers of excellence in accordance with section 1073d(b)(4)(A) of title 10, United States Code, as added by subsection (a), by not later than one year after the date of the enactment of this Act [Dec. 23, 2022].’’ TIMELINE FOR ESTABLISHMENT Pub. L. 117–263, div. A, title VII, § 714(b), Dec. 23, 2022, 136 Stat. 2660, provided that: ‘‘(1) DESIGNATION.—Not later than October 1, 2024, the Secretary of Defense shall designate four military med- ical treatment facilities as core casualty receiving fa- cilities under section 1073d(b)(5) of title 10, United States Code (as added by subsection (a)). ‘‘(2) OPERATIONAL.—Not later than October 1, 2025, the Secretary shall ensure that each such designated mili- tary medical treatment facility is fully staffed and operational as a core casualty receiving facility, in ac- cordance with the requirements of such section 1073d(b)(5).’’ ESTABLISHMENT OF CENTERS OF EXCELLENCE FOR ENHANCED TREATMENT OF OCULAR INJURIES Pub. L. 117–81, div. A, title VII, § 721, Dec. 27, 2021, 135 Stat. 1791, provided that: ‘‘(a) IN GENERAL.—Not later than October 1, 2023, the Secretary of Defense, acting through the Director of the Defense Health Agency, shall establish within the Defense Health Agency not fewer than four regional centers of excellence for the enhanced treatment of— ‘‘(1) ocular wounds or injuries; and ‘‘(2) vision dysfunction related to traumatic brain injury. ‘‘(b) LOCATION OF CENTERS.—Each center of excellence established under subsection (a) shall be located at a military medical center that provides graduate medical education in ophthalmology and related subspecialties and shall be the primary center for providing special- ized medical services for vision for members of the Armed Forces in the region in which the center of ex- cellence is located. ‘‘(c) POLICIES FOR REFERRAL OF BENEFICIARIES.—Not later than October 1, 2023, the Director of the Defense Health Agency shall publish on a publicly available internet website of the Department of Defense policies for the referral of eligible beneficiaries of the Depart- ment to centers of excellence established under sub- section (a) for evaluation and treatment. ‘‘(d) IDENTIFICATION OF MEDICAL PERSONNEL BILLETS AND STAFFING.—The Secretary of each military depart- ment, in conjunction with the Joint Staff Surgeon and the Director of the Defense Health Agency, shall iden- tify specific medical personnel billets essential for the evaluation and treatment of ocular sensory injuries and ensure that centers of excellence established under subsection (a) are staffed with such personnel at the Page 1031 TITLE 10—ARMED FORCES § 1073f 1 See References in Text note below. level required for the enduring medical support of each such center. ‘‘(e) BRIEFING.—Not later than December 31, 2023, the Secretary of Defense shall provide to the Committees on Armed Services of the Senate and the House of Rep- resentatives a briefing that— ‘‘(1) describes the establishment of each center of excellence established under subsection (a), to in- clude the location, capability, and capacity of each such center; ‘‘(2) describes the referral policy published by the Defense Health Agency under subsection (c); ‘‘(3) identifies the medical personnel billets identi- fied under subsection (d); and ‘‘(4) provides a plan for the staffing of personnel at such centers to ensure the enduring medical support of each such center. ‘‘(f) MILITARY MEDICAL CENTER DEFINED.—In this sec- tion, the term ‘military medical center’ means a med- ical center described in section 1073d(b) of title 10, United States Code.’’ SATELLITE CENTERS Pub. L. 114–328, div. A, title VII, § 703(a)(3), Dec. 23, 2016, 130 Stat. 2198, provided that: ‘‘In addition to the centers of excellence designated under section 1073d(b)(4) of title 10, United States Code, as added by paragraph (1), the Secretary of Defense may establish satellite centers of excellence to provide specialty care for certain conditions, including with respect to— ‘‘(A) post-traumatic stress; ‘‘(B) traumatic brain injury; and ‘‘(C) such other conditions as the Secretary con- siders appropriate.’’ LIMITATION ON RESTRUCTURE AND REALIGNMENT OF MILITARY MEDICAL TREATMENT FACILITIES Pub. L. 114–328, div. A, title VII, § 703(b), (e), Dec. 23, 2016, 130 Stat. 2198, 2200, provided that: ‘‘(b) EXCEPTION.—In carrying out section 1073d of title 10, United States Code, as added by subsection (a)(1), the Secretary of Defense may not restructure or re- align the infrastructure of, or modify the health care services provided by, a military medical treatment fa- cility unless the Secretary determines that, if such a restructure, realignment, or modification will elimi- nate the ability of a covered beneficiary to access health care services at a military medical treatment facility, the covered beneficiary will be able to access such health care services through the purchased care component of the TRICARE program.’’ ‘‘(e) DEFINITIONS.—In this section [enacting this sec- tion and provisions set out as notes under this section], the terms ‘covered beneficiary’ and ‘TRICARE pro- gram’ have the meaning given those terms in section 1072 of title 10, United States Code.’’ § 1073e. Protection of armed forces from infec- tious diseases (a) PROTECTION.—The Secretary of Defense shall develop and implement a plan to ensure that the armed forces have the diagnostic equip- ment, testing capabilities, and personal protec- tive equipment necessary to protect members of the armed forces from the threat of infectious diseases and to treat members who contract in- fectious diseases. (b) REQUIREMENTS.—In carrying out subsection (a), the Secretary shall ensure the following: (1) Each military medical treatment facility has the testing capabilities described in such subsection, as appropriate for the mission of the facility. (2) Each deployed naval vessel has access to the testing capabilities described in such sub- section. (3) Members of the armed forces deployed in support of a contingency operation outside of the United States have access to the testing capabilities described in such subsection, in- cluding at field hospitals, combat support hos- pitals, field medical stations, and expedi- tionary medical facilities. (4) The Department of Defense maintains— (A) a 30-day supply of personal protective equipment in a quantity sufficient for each member of the armed forces, including the reserve components thereof; and (B) the capability to rapidly resupply such equipment. (c) RESEARCH AND DEVELOPMENT.—(1) The Sec- retary shall include with the defense budget ma- terials (as defined by section 231(f) 1 of this title) for a fiscal year a plan to research and develop vaccines, diagnostics, and therapeutics for infec- tious diseases. (2) The Secretary shall ensure that the med- ical laboratories of the Department of Defense are equipped with the technology needed to fa- cilitate rapid research and development of vac- cines, diagnostics, and therapeutics in the case of a pandemic. (Added Pub. L. 116–283, div. A, title VII, § 712(a), Jan. 1, 2021, 134 Stat. 3691.) Editorial Notes REFERENCES IN TEXT Section 231(f) of this title, referred to in subsec. (c)(1), was redesignated as section 231(g) of this title by Pub. L. 117–263, div. A, title III, § 352(a)(2), Dec. 23, 2022, 136 Stat. 2533, and subsequently was redesignated as sec- tion 231(h) of this title by Pub. L. 118–159, div. A, title X, § 1021(1), Dec. 23, 2024, 138 Stat. 2052. § 1073f. Health care fraud and abuse prevention program (a) PROGRAM AUTHORIZED.—(1) The Secretary of Defense may carry out a program under this section to prevent and remedy fraud and abuse in the health care programs of the Department of Defense. (2) At the discretion of the Secretary, such program may be administered jointly by the In- spector General of the Department of Defense and the Director of the Defense Health Agency. (3) In carrying out such program, the authori- ties granted to the Secretary of Defense and the Inspector General of the Department of Defense under section 1128A(m) of the Social Security Act (42 U.S.C. 1320a–7a(m)) shall be available to the Secretary and the Inspector General. (b) CIVIL MONETARY PENALTIES.—(1) Except as provided in paragraph (2), the provisions of sec- tion 1128A of the Social Security Act (42 U.S.C. 1320a–7a) shall apply with respect to any civil monetary penalty imposed in carrying out the program authorized under subsection (a). (2) Consistent with section 1079a of this title, amounts recovered in connection with any such civil monetary penalty imposed— (A) shall be credited to appropriations avail- able as of the time of the collection for ex- penses of the health care program of the De-