PRIA, Government Policy, Made Personal

Summary

The Secretary of Defense may run a specialized treatment facility program under rules the Secretary creates, after talking with the other military department leaders. The Secretary can name military and civilian health centers as specialized treatment facilities. The Secretary can also ignore the 40-mile rule in section 1079(a)(6) for a specific service if using a different distance saves money. Civilian facilities must serve an area about the same size as military facilities. A covered beneficiary who lives in a facility’s service area may have to get a nonavailability of health care statement before getting that specialized service outside the program. The Secretary may pay or reimburse travel costs, temporary lodging, and meals (meals limited to a per diem rate in the rules) for a covered beneficiary and a person who accompanies them, or provide those things in-kind. The Department may only do this if the total cost is less than other ways of providing the care. “Covered beneficiary” means a person covered under section 1079 or section 1086.

Title 10, §1105

Armed Forces, Source: USLM XML via OLRC

(a)Program Authorized.—

The Secretary of Defense may conduct a specialized treatment facility program pursuant to regulations prescribed by the Secretary of Defense. The Secretary shall consult with the other administering Secretaries in prescribing regulations for the program and in conducting the program.

(b)Facilities Authorized To Be Used.—

Under the specialized treatment facility program, the Secretary may designate health care facilities of the uniformed services and civilian health care facilities as specialized treatment facilities.

(c)Waiver of Nonemergency Health Care Restriction.—

Under the specialized treatment facility program, the Secretary may waive, with regard to the provision of a particular service, the 40-mile radius restriction set forth in section 1079(a)(6) of this title if the Secretary determines that the use of a different geographical area restriction will result in a more cost-effective provision of the service.

(d)Civilian Facility Service Area.—

For purposes of the specialized treatment facility program, the service area of a civilian health care facility designated pursuant to subsection (b) shall be comparable in size to the service areas of facilities of the uniformed services.

(e)Issuance of Nonavailability of Health Care Statements.—

A covered beneficiary who resides within the service area of a specialized treatment facility designated under the specialized treatment facility program may be required to obtain a nonavailability of health care statement in the case of a specialized service offered by the facility in order for the covered beneficiary to receive the service outside of the program.

(f)Payment of Costs Related to Care in Specialized Treatment Facilities.—

(1)Subject to paragraph (2), in connection with the treatment of a covered beneficiary under the specialized treatment facility program, the Secretary may provide the following benefits:

(A)Full or partial reimbursement of a member of the uniformed services for the reasonable expenses incurred by the member in transporting a covered beneficiary to or from a health care facility of the uniformed services or a civilian health care facility at which specialized health care services are provided pursuant to this chapter.

(B)Full or partial reimbursement of a person (including a member of the uniformed services) for the reasonable expenses of transportation, temporary lodging, and meals (not to exceed a per diem rate determined in accordance with implementing regulations) incurred by such person in accompanying a covered beneficiary as a nonmedical attendant to a health care facility referred to in subparagraph (A).

(C)In-kind transportation, lodging, or meals instead of reimbursements under subparagraph (A) or (B) for transportation, lodging, or meals, respectively.

(2)The Secretary may make reimbursements for or provide transportation, lodging, and meals under paragraph (1) in the case of a covered beneficiary only if the total cost to the Department of Defense of doing so and of providing the health care in such case is less than the cost to the Department of providing the health care to the covered beneficiary by other means authorized under this chapter.

(g)Covered Beneficiary Defined.—

In this section, the term “covered beneficiary” means a person covered under section 1079 or 1086 of this title.

Notes & Related Subsidiaries

Editorial Notes

Amendments

2014—Subsec. (c). Pub. L. 113–291 substituted “section 1079(a)(6)” for “section 1079(a)(7)”. 1996—Subsec. (h). Pub. L. 104–106 struck out subsec. (h) which read as follows: “Expiration of Program.—The Secretary may not carry out the specialized treatment facility program authorized by this section after September 30, 1995.” 1993—Pub. L. 103–160 substituted “Specialized treatment facility program” for “Issuance of nonavailability of health care statements” as section catchline and amended text generally. Prior to amendment, text read as follows: “In determining whether to issue a nonavailability of health care statement for any person entitled to health care in facilities of the uniformed services under this chapter, the commanding officer of such a facility may consider the availability of health care services for such person pursuant to any contract or agreement entered into under this chapter for the provision of health care services within the area served by that facility.”

§1105 Specialized Treatment Facility Program

Summary

Title 10, §1105

Notes & Related Subsidiaries

Editorial Notes

Amendments

Citations & Metadata