§1073d Military Medical Treatment Facilities

Summary

The Secretary of Defense must keep and run military medical facilities so the armed forces stay medically ready and medical staff stay trained. There are three kinds of facilities. Medical centers go where many service members and their families live. They handle complex care and must have inpatient and outpatient specialty care, doctor training and residency programs, and level 1–3 trauma care. Some major centers will be named regional “centers of excellence” for specialty areas like cancer, burns, rehab, brain and psychological care, prosthetics, neurosurgery, orthopedics, substance abuse, infectious disease, heart and lung surgery, and other specialties the Secretary picks. Smaller satellite centers may focus on conditions such as post‑traumatic stress or traumatic brain injury. Centers of excellence must be the main place in the military health system for those specialty services, and if a needed specialty is not available there, patients can be sent to a private provider. The Secretary must tell the House and Senate Armed Services Committees at least 90 days before naming a center. The Secretary must also pick and keep “core casualty receiving facilities” that can treat large numbers of combat or disaster casualties, place them so they can get patients by air from theaters of operation, staff them with at least 90 percent of needed military personnel (with civilian DoD staff added if needed), and give each such facility a civilian CFO and COO with civilian hospital experience. Hospitals must be kept where local civilian care cannot meet military needs and must offer inpatient and outpatient services to keep troops ready, with limited specialty care when it is cost effective or not available nearby. Ambulatory care centers must be kept where civilian care can support needs and must offer outpatient services needed for readiness, including partnerships under section 706 of the National Defense Authorization Act for Fiscal Year 2017, with limited specialty care when cost effective or unavailable locally. For facilities outside the United States, the Secretary must keep at least the same inpatient capabilities they had on September 30, 2016. The Secretary may not remove inpatient services at an overseas facility until 180 days after briefing the House and Senate Armed Services Committees and must certify that host‑nation hospitals will replace those services, that geographic combatant commanders were consulted, and that every affected patient gets a transition plan and a public forum to raise concerns. The Secretary may not change what care a facility offers or who it serves unless the Secretary notifies the Armed Services Committees, waits 180 days, and (for cuts to inpatient care at overseas facilities) gives each affected patient a transition plan. Each notification must include endorsements from the Chairman of the Joint Chiefs of Staff and the relevant military department Surgeon General saying the change won’t hurt operations or medical training, and an assessment from the Director of the Defense Health Agency explaining how care will continue. Eligible beneficiary means any beneficiary under this chapter. Core casualty receiving facility means a Role 4 hub for receiving and treating casualties. Role 4 medical treatment facility means a place that provides the full range of preventive, acute, and rehabilitative care. Covered facility means a military medical treatment facility located outside the United States.