Defense Authorization Bill Conferees Issue Report – Title VII (Health Care Provisions) (Reports and Other Matters)
TITLE VII--HEALTH CARE PROVISIONS
Subtitle C--Reports and Other Matters
Section 1704(e) of the National Defense Authorization Act for Fiscal Year 2010 (Public Law 111-84; 123 Stat. 2573), as most recently amended by section 719 of the National Defense Authorization Act for Fiscal Year 2018 (Public Law 115-91; 131 Stat. 1440), is further amended by striking "
(a) Process Required.--Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall, in coordination with the Secretaries of the military departments and the Chairman of the
(b) Process Elements.--The process developed under subsection (a) shall include the following:
(1) A joint medical estimate to determine the medical requirements for treating members of the Armed Forces who are wounded, ill, or injured during military operations, including with respect to environmental health and force health protection.
(2) A process to review and revise military health related mission essential tasks in order to ensure that such tasks are aligned with health professional knowledge, skills, and abilities.
(3) A process to standardize the interoperability of medical equipment and capabilities to support the joint force.
(c) Report.--Not later than
(a) Inclusion in Next Annual Periodic Health Assessments.-- The Secretary of Defense shall incorporate medical screening questions specific to gambling disorder into the Annual Periodic Health Assessments of members of the Armed Forces conducted by the
(b) Inclusion in Certain Surveys.--The Secretary shall incorporate into ongoing research efforts of the Department questions on gambling disorder, as appropriate, including by restoring such questions to the following:
(1) The first
(2) The first
(c) Reports.--Not later than one year after the date of the completion of the assessment referred to in subsection (a), and of each survey referred to in subsection (b), as modified pursuant to this section, the Secretary shall submit to the Committees on Armed Services of the
(a) In General.--Not later than one year after the date of the enactment of this Act, the Secretary of Defense, the Secretary of
(b) Matters Included.--The study under subsection (a) shall include the following:
(1) An analysis of whether the requirement described in such subsection affects covered individuals from returning to work.
(2) The number of individuals who--
(A) are retired from the Armed Forces under chapter 61 of title 10, United States Code;
(B) are entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act pursuant to receiving benefits for 24 months as described in subparagraph (A) or (C) of section 226(b)(2) of such Act (42 U.S.C. 426(b)(2)); and
(C) because of such entitlement, are no longer enrolled in TRICARE Standard, TRICARE Prime, TRICARE Extra, or TRICARE Select.
(3) The number of covered individuals who would potentially enroll in TRICARE for Life but not enroll in the supplementary medical insurance program under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.) if able.
(c) Definitions.--In this section:
(1) The term "covered individual" means an individual--
(A) who is under 65 years of age;
(B) who is entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act pursuant to subparagraph (A) or (C) of section 226(b)(2) of such Act (42 U.S.C. 426(b)(2));
(C) whose entitlement to a benefit described in subparagraph (A) of such section has terminated due to performance of substantial gainful activity; and
(D) who is retired under chapter 61 of title 10, United States Code.
(2) The terms "TRICARE for Life", "TRICARE Extra", "TRICARE Standard", "TRICARE Select", and "TRICARE Prime" have the meanings given those terms in section 1072 of title 10, United States Code.
(a) In General.--The Assistant Secretary of Defense for Health Affairs may conduct a pilot program to assess the feasibility and advisability of partnerships between special operations forces and institutions of higher education, and health care systems if determined appropriate by the Assistant Secretary for purposes of the pilot program, through which special operations forces medics earn credit toward the master's degree of physician assistant for military operational work and training performed by the medics.
(b) Duration.--The Assistant Secretary shall conduct the pilot program for a period not to exceed five years.
(c) Clinical Training.--Partnerships under subsection (a) shall permit medics participating in the pilot program to conduct clinical training at medical facilities of the
(d) Evaluation.--The evaluation of work and training performed by medics for which credits are earned under the pilot program shall comply with civilian clinical evaluation standards applicable to the awarding of the master's degree of physician assistant.
(e) Reports.--
(1) Initial report.--Not later than 180 days after the date of the enactment of this Act, the Secretary of Defense shall submit to the Committees on Armed Services of the
(A) A comprehensive framework for the military education to be provided to special operations forces medics under the pilot program, including courses of instruction at institutions of higher education and any health care systems participating in the pilot program.
(B) Metrics to be used to assess the effectiveness of the pilot program.
(C) A description of the mechanisms to be used by the Department, medics, or both to cover the costs of education received by medics under the pilot program through institutions of higher education or health care systems, including payment by the Department in return for a military service commitment, tuition or other educational assistance by the Department, use by medics of post-9/11 educational assistance available through the
(2) Final report.--Not later than 180 days after completion of the pilot program, the Secretary shall submit to the committees of
(A) An evaluation of the pilot program using the metrics of assessment set forth pursuant to paragraph (1)(B).
(B) An assessment of the utility of the funding mechanisms set forth pursuant to paragraph (1)(C).
(C) An assessment of the effects of the pilot program on recruitment and retention of medics for special operations forces.
(D) An assessment of the feasibility and advisability of extending one or more authorities for joint professional military education under chapter 107 of title 10, United States Code, to warrant officers or enlisted personnel, and if the Secretary considers the extension of any such authorities feasible and advisable, recommendations for legislative or administrative action to so extend such authorities.
(f) Construction of Authorities.--Nothing in this section may be construed to--
(1) authorize an officer or employee of the Federal Government to create, endorse, or otherwise incentivize a particular curriculum or degree track; or (2) require, direct, review, or control a State or educational institution, or the instructional content, curriculum, and related activities of a State or educational institution.
(a) Plan.--Not later than 30 days after the date on which the budget of the President for fiscal year 2020 is submitted to
(b) Matters Included.--The plan under subsection (a) shall include the following:
(1) A description of all medical research focus areas of the
(2) A description of the medical research projects funded under the Defense Health Program account and the projects under the Congressional Directed Medical Research Program.
(3) A description of the process to ensure synergy across the military medical research community in order to address gaps in military medical research, minimize duplication of research, and promote collaboration within research focus areas.
(4) A description of the efforts of the Secretary to coordinate with other departments and agencies of the Federal Government to increase awareness of complementary medical research efforts that are being carried out through the Federal Government.
(a) Briefing and Report on Current Transition.--
(1) In general.--The Comptroller General of
(2) Elements.--The briefing and report under paragraph (1) shall each include the following:
(A) A description and assessment of the extent to which the
(B) A description and assessment of any issues with health care delivery under the TRICARE program as a result of or in connection with the transition, and, with respect to such issues--
(i) the effect, if any, of the guidance and oversight provided by the
(ii) the solutions developed by the
(C) A description and assessment of the extent to which the
(D) A review of the
(b) Report on Future Transitions.--Not later than 270 days after the completion of any future transition between managed care support contractors for the TRICARE program, the Comptroller General shall submit to the committees of
(c) TRICARE Program Defined.--In this section, the term "TRICARE program" has the meaning given that term in section 1072 of title 10, United States Code.
(a) In General.--The Comptroller General of
(b) Elements.--The study required by subsection (a) shall--
(1) determine the potential demand for long-term care by veterans eligible for health care from the Department;
(2) determine the capacity of the Department for providing all four levels of long-term care, which are independent living, assisted living, nursing home care, and memory care;
(3) identify the number of veterans with combat- related disabilities who require a personal care assistant and which facilities of the Department provide this service; and
(4) examine the value of long-term care benefits provided by the Department, including personal care assistant services, to identify the potential elements of a pilot program that affords aging veterans the choice of receiving long-term care benefits at nonprofit continuing care retirement communities.
(c) Report.--Not later than
Section 178(c)(1)(C) of title 10, United States Code, is amended by striking "four members" and inserting "six members".
The full text of the report is found at: https://www.congress.gov/congressional-report/115th-congress/house-report/874/1?r=1
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