(a) Requirement To Implement Procedures.—The Secretary of Defense shall implement 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 Defense Health Agency may issue a waiver for a fee that would otherwise be charged under the procedures implemented under subsection (a) to a civilian provided medical care who is not a covered beneficiary if the provision of such care enhances the knowledge, skills, and abilities of health care providers, as determined by the Director of the Defense Health Agency.
(c) Modified Payment Plan for Certain Civilians.—(1)(A) If a civilian specified in subsection (a) is covered by a covered payer at the time care under this section is provided, the civilian shall only be responsible to pay the standard copays, coinsurance, deductibles, or nominal fees that are otherwise applicable under the covered payer plan.
(B) Except with respect to the copays, coinsurance, deductibles, and nominal fees specified in subparagraph (A)—(i) the Secretary of Defense may bill only the covered payer for care provided to a civilian described in subparagraph (A); and
(ii) payment received by the Secretary from the covered payer of a civilian for care provided 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 Defense 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 subsection may not be administered by a Federal agency other than the Department of Defense.
(d) Use of Fees Collected.—A military medical 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 service, or health plan.
(2) The terms “third-party payer” and “insurance, medical service, or health plan” have the meaning given those terms in section 1095(h) of this title.
Structure US Code
Subtitle A— General Military Law
CHAPTER 55— MEDICAL AND DENTAL CARE
§ 1071. Purpose of this chapter
§ 1073. Administration of this chapter
§ 1073a. Contracts for health care: best value contracting
§ 1073b. Recurring reports and publication of certain data
§ 1073c. Administration of Defense Health Agency and military medical treatment facilities
§ 1073d. Military medical treatment facilities
§ 1073e. Protection of armed forces from infectious diseases
§ 1073f. Health care fraud and abuse prevention program
§ 1074. Medical and dental care for members and certain former members
§ 1074c. Medical care: authority to provide a wig
§ 1074d. Certain primary and preventive health care services
§ 1074f. Medical tracking system for members deployed overseas
§ 1074g. Pharmacy benefits program
§ 1074h. Medical and dental care: medal of honor recipients; dependents
§ 1074i. Reimbursement for certain travel expenses
§ 1074j. Sub-acute care program
§ 1074k. Long-term care insurance
§ 1074l. Notification to Congress of hospitalization of combat wounded members
§ 1074n. Annual mental health assessments for members of the armed forces
§ 1074o. Provision of hyperbaric oxygen therapy for certain members
§ 1075a. TRICARE Prime: cost sharing
§ 1076. Medical and dental care for dependents: general rule
§ 1076a. TRICARE dental program
§ 1076c. Dental insurance plan: certain retirees and their surviving spouses and other dependents
§ 1076d. TRICARE program: TRICARE Reserve Select coverage for members of the Selected Reserve
§ 1077. Medical care for dependents: authorized care in facilities of uniformed services
§ 1077a. Access to military medical treatment facilities and other facilities
§ 1078. Medical and dental care for dependents: charges
§ 1078a. Continued health benefits coverage
§ 1079. Contracts for medical care for spouses and children: plans
§ 1079a. TRICARE program: treatment of refunds and other amounts collected
§ 1079c. Provisional coverage for emerging services and supplies
§ 1080. Contracts for medical care for spouses and children: election of facilities
§ 1081. Contracts for medical care for spouses and children: review and adjustment of payments
§ 1082. Contracts for health care: advisory committees
§ 1083. Contracts for medical care for spouses and children: additional hospitalization
§ 1084. Determinations of dependency
§ 1085. Medical and dental care from another executive department: reimbursement
§ 1086. Contracts for health benefits for certain members, former members, and their dependents
§ 1086a. Certain former spouses: extension of period of eligibility for health benefits
§ 1088. Air evacuation patients: furnished subsistence
§ 1089. Defense of certain suits arising out of medical malpractice
§ 1090. Identifying and treating drug and alcohol dependence
§ 1090a. Identifying and treating eating disorders.
§ 1090b. Commanding officer and supervisor referrals of members for mental health evaluations
§ 1091. Personal services contracts
§ 1092. Studies and demonstration projects relating to delivery of health and medical care
§ 1092a. Persons entering the armed forces: baseline health data
§ 1093. Performance of abortions: restrictions
§ 1094. Licensure requirement for health-care professionals
§ 1094a. Continuing medical education requirements: system for monitoring physician compliance
§ 1095a. Medical care: members held as captives and their dependents
§ 1095b. TRICARE program: contractor payment of certain claims
§ 1095c. TRICARE program: facilitation of processing of claims
§ 1095d. TRICARE program: waiver of certain deductibles
§ 1095e. TRICARE program: beneficiary counseling and assistance coordinators
§ 1095f. TRICARE program: referrals and preauthorizations under TRICARE Prime
§ 1095g. TRICARE program: waiver of recoupment of erroneous payments caused by administrative error
§ 1096. Military-civilian health services partnership program
§ 1097a. TRICARE Prime: automatic enrollments
§ 1097b. TRICARE program: financial management
§ 1097c. TRICARE program: relationship with employer-sponsored group health plans
§ 1097d. TRICARE program: notice of change to benefits
§ 1098. Incentives for participation in cost-effective health care plans
§ 1099. Health care enrollment system and payment options
§ 1100. Defense Health Program Account
§ 1101. Resource allocation methods: capitation or diagnosis-related groups
§ 1102. Confidentiality of medical quality assurance records: qualified immunity for participants
§ 1103. Contracts for medical and dental care: State and local preemption
§ 1104. Sharing of health-care resources with the Department of Veterans Affairs
§ 1104a. Shared medical facilities with Department of Veterans Affairs
§ 1105. Specialized treatment facility program
§ 1106. Submittal of claims: standard form; time limits
§ 1107. Notice of use of an investigational new drug or a drug unapproved for its applied use
§ 1107a. Emergency use products
§ 1109. Organ and tissue donor program
§ 1110. System for tracking and recording vaccine information; anthrax vaccine immunization program
§ 1110a. Notification of certain individuals regarding options for enrollment under Medicare part B