H.R.1456 - Uniformed Services Retiree and Dependents Health Care Availability Act105th Congress (1997-1998)
Summary: H.R.1456 — 105th Congress (1997-1998)
Introduced in House (04/24/1997)
TABLE OF CONTENTS:
Title I: Enrollment of Retirees in TRICARE Prime and
Title II: FEHBP Option for Retirees
Uniformed Services Retiree and Dependents Health Care Availability Act - Title I: Enrollment of Retirees in TRICARE Prime and Medicare Reimbursement - States that the Secretary of Defense (Secretary) may not prohibit the enrollment of Medicare-eligible military retirees in the managed care option of the TRICARE program (a Department of Defense (DOD) managed health care program) solely on account of age or entitlement to hospital insurance benefits under Medicare part A.
(Sec. 103) Requires the Secretary and the Secretary of Health and Human Services (HHS Secretary) to jointly establish a program (subvention program) that, beginning October 1, 1997, provides DOD with reimbursement from the Medicare program for health care services provided to Medicare-eligible retirees through the TRICARE program. Allows such reimbursement only if such retirees are also enrolled in the supplementary medical insurance program under Medicare part B. Requires program enrollment to be voluntary. Authorizes the Secretary to: (1) waive enrollment fees; (2) modify existing TRICARE program contracts to incorporate enrollment provisions; and (3) establish cost-sharing requirements for enrollees.
(Sec. 104) Provides for the determination of DOD reimbursement amounts, requiring the HHS Secretary to make such payments from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Insurance Trust Fund.
(Sec. 105) Requires the Secretary to maintain current DOD health-care efforts for Medicare-eligible retirees in order to avoid imposing added costs to the Medicare program. Requires specified estimates of prior efforts and future targets with respect to DOD health care provided under the subvention program.
Directs the Comptroller General to determine and report to the two Secretaries and the Congress annually on the extent, if any, to which costs of the Secretary under the TRICARE program and the HHS Secretary under the Medicare program have increased as a result of the subvention program. Requires the Secretaries to take necessary action to offset any added costs.
(Sec. 106) Requires the Secretary to reimburse subvention program participants for any late enrollment penalties imposed under the Medicare program.
(Sec. 107) Provides that, in the case of a Medicare-eligible retiree who seeks to enroll in a Medicare supplemental policy, the issuer of such policy may not: (1) deny the issuance or effectiveness of such policy; or (2) discriminate in the policy's price.
Makes eligible for both the subvention program and the Medicare supplemental program a Medicare-eligible retiree who: (1) is at least 65 years old and was eligible to enroll in Medicare part B; and (2) did not enroll in the Medicare program during his or her initial enrollment period.
Title II: FEHBP Option for Retirees - Directs the Secretary to enter into an agreement with the Office of Personnel Management under which a Medicare-eligible military retiree will be offered an opportunity to enroll in a health benefits plan offered through the Federal Employee Health Benefits Program (FEHBP) as an additional option for receiving health care services. Makes eligible under such agreement: (1) a Medicare-eligible retiree who is entitled to retired or retainer pay; and (2) a dependent of such individual who is entitled to hospital insurance benefits under Medicare part A. Allows a retiree who enrolls in the FEHBP to continue to receive health care services through a military medical treatment facility. Outlines provisions concerning: (1) contribution requirements; (2) management of participation; and (3) reporting requirements concerning plan enrollment, costs and effectiveness. Requires the Secretary to begin offering the FEHBP option no later than January 1, 1999.
(Sec. 202) Requires the health and dental care benefits provided under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) and TRICARE Standard to be the same as those provided for the highest level of benefits under the service benefit plan of the FEHBP.