§1074. Medical and dental care for members and certain former members
(a)(1) Under joint regulations to be prescribed by the administering Secretaries, a member of a uniformed service described in paragraph (2) is entitled to medical and dental care in any facility of any uniformed service.
(2) Members of the uniformed services referred to in paragraph (1) are as follows:
(A) A member of a uniformed service on active duty.
(B) A member of a reserve component of a uniformed service who has been commissioned as an officer if-
(i) the member has requested orders to active duty for the member's initial period of active duty following the commissioning of the member as an officer;
(ii) the request for orders has been approved;
(iii) the orders are to be issued but have not been issued or the orders have been issued but the member has not entered active duty; and
(iv) the member does not have health care insurance and is not covered by any other health benefits plan.
(b)(1) Under joint regulations to be prescribed by the administering Secretaries, a member or former member of a uniformed service who is entitled to retired or retainer pay, or equivalent pay may, upon request, be given medical and dental care in any facility of any uniformed service, subject to the availability of space and facilities and the capabilities of the medical and dental staff. The administering Secretaries may, with the agreement of the Secretary of Veterans Affairs, provide care to persons covered by this subsection in facilities operated by the Secretary of Veterans Affairs and determined by him to be available for this purpose on a reimbursable basis at rates approved by the President.
(2) Paragraph (1) does not apply to a member or former member entitled to retired pay for non-regular service under chapter 1223 of this title who is under 60 years of age.
(c)(1) Funds appropriated to a military department, the Department of Homeland Security (with respect to the Coast Guard when it is not operating as a service in the Navy), or the Department of Health and Human Services (with respect to the National Oceanic and Atmospheric Administration and the Public Health Service) may be used to provide medical and dental care to persons entitled to such care by law or regulations, including the provision of such care (other than elective private treatment) in private facilities for members of the uniformed services. If a private facility or health care provider providing care under this subsection is a health care provider under the Civilian Health and Medical Program of the Uniformed Services, the Secretary of Defense, after consultation with the other administering Secretaries, may by regulation require the private facility or health care provider to provide such care in accordance with the same payment rules (subject to any modifications considered appropriate by the Secretary) as apply under that program.
(2)(A) Subject to such exceptions as the Secretary of Defense considers necessary, coverage for medical care for members of the uniformed services under this subsection, and standards with respect to timely access to such care, shall be comparable to coverage for medical care and standards for timely access to such care under the managed care option of the TRICARE program known as TRICARE Prime.
(B) The Secretary of Defense shall enter into arrangements with contractors under the TRICARE program or with other appropriate contractors for the timely and efficient processing of claims under this subsection.
(C) The Secretary of Defense shall consult with the other administering Secretaries in the administration of this paragraph.
(3)(A) A member of the uniformed services described in subparagraph (B) may not be required to receive routine primary medical care at a military medical treatment facility.
(B) A member referred to in subparagraph (A) is a member of the uniformed services on active duty who is entitled to medical care under this subsection and who-
(i) receives a duty assignment described in subparagraph (C); and
(ii) pursuant to the assignment of such duty, resides at a location that is more than 50 miles, or approximately one hour of driving time, from the nearest military medical treatment facility adequate to provide the needed care.
(C) A duty assignment referred to in subparagraph (B) means any of the following:
(i) Permanent duty as a recruiter.
(ii) Permanent duty at an educational institution to instruct, administer a program of instruction, or provide administrative services in support of a program of instruction for the Reserve Officers' Training Corps.
(iii) Permanent duty as a full-time adviser to a unit of a reserve component.
(iv) Any other permanent duty designated by the Secretary concerned for purposes of this paragraph.
(4)(A) Subject to such terms and conditions as the Secretary of Defense considers appropriate, coverage comparable to that provided by the Secretary under subsections (d) and (e) of section 1079 of this title shall be provided under this subsection to members of the uniformed services who incur a serious injury or illness on active duty as defined by regulations prescribed by the Secretary.
(B) The Secretary of Defense shall prescribe in regulations-
(i) the individuals who shall be treated as the primary caregivers of a member of the uniformed services for purposes of this paragraph; and
(ii) the definition of serious injury or illness for the purposes of this paragraph.
(d)(1) For the purposes of this chapter, a member of a reserve component of the armed forces who is issued a delayed-effective-date active-duty order, or is covered by such an order, shall be treated as being on active duty for a period of more than 30 days beginning on the later of the date that is-
(A) the date of the issuance of such order; or
(B) 180 days before the date on which the period of active duty is to commence under such order for that member.
(2) In this subsection, the term "delayed-effective-date active-duty order" means an order to active duty for a period of more than 30 days under section 12304b of this title or a provision of law referred to in section 101(a)(13)(B) of this title that provides for active-duty service to begin under such order on a date after the date of the issuance of the order.
(Added
| Revised section | Source (U.S. Code) | Source (Statutes at Large) |
|---|---|---|
| 1074(a) 1074(b) |
37:421(a). 37:402(a)(3) (as applicable to 37:421(b)). 37:421(b). |
June 7, 1956, ch. 374, §§102(a)(3) (as applicable to §301(b)), 301(a), (b), |
In subsection (a), words of entitlement are substituted for the correlative words of obligation.
In subsection (b), the words "active duty (other than for training)" are substituted for the words "active duty as defined in section 901(b) of Title 50" to reflect section 101(22) of this title. The words "and dental" are inserted before the word "staff" for clarity. The words "retirement" and "retirement pay" are omitted as surplusage.
Editorial Notes
Prior Provisions
Provisions similar to those in subsec. (c) of this section were contained in
A prior section 1074, act Aug. 10, 1956, ch. 1041,
Amendments
2017-Subsec. (d)(2).
2009-Subsec. (d)(1)(B).
2008-Subsec. (b).
Subsec. (c)(4).
2006-Subsec. (a)(2)(B)(iii).
2004-Subsec. (d)(3).
2003-Subsec. (a).
Subsec. (d).
"(1) For the purposes of this chapter, a member of a reserve component of the armed forces who is issued a delayed-effective-date active-duty order, or is covered by such an order, shall be treated as being on active duty for a period of more than 30 days beginning on the later of the date that is-
"(A) the date of the issuance of such order; or
"(B) 90 days before date on which the period of active duty is to commence under such order for that member.
"(2) In this subsection, the term 'delayed-effective-date active-duty order' means an order to active duty for a period of more than 30 days in support of a contingency operation under a provision of law referred to in section 101(a)(13)(B) of this title that provides for active-duty service to begin under such order on a date after the date of the issuance of the order.
"(3) This section shall cease to be effective on September 30, 2004."
2002-Subsec. (c)(1).
2000-Subsec. (c).
Subsec. (c)(1).
Subsec. (c)(2)(C).
Subsec. (c)(3)(A).
1997-Subsec. (c).
1996-Subsec. (d).
"(d)(1) The Secretary of Defense may require, by regulation, a private CHAMPUS provider to apply the CHAMPUS payment rules (subject to any modifications considered appropriate by the Secretary) in imposing charges for health care that the private CHAMPUS provider provides to a member of the uniformed services who is enrolled in a health care plan of a facility deemed to be a facility of the uniformed services under section 911(a) of the Military Construction Authorization Act, 1982 (42 U.S.C. 248c(a)) when the health care is provided outside the catchment area of the facility.
"(2) In this subsection:
"(A) The term 'private CHAMPUS provider' means a private facility or health care provider that is a health care provider under the Civilian Health and Medical Program of the Uniformed Services.
"(B) The term 'CHAMPUS payment rules' means the payment rules referred to in subsection (c).
"(3) The Secretary of Defense shall prescribe regulations under this subsection after consultation with the other administering Secretaries."
1990-Subsec. (b).
1989-Subsec. (b).
Subsec. (c).
1984-Subsecs. (a), (b).
Subsec. (c).
1980-Subsec. (a).
Subsec. (b).
1966-Subsec. (b).
Statutory Notes and Related Subsidiaries
Effective Date of 2008 Amendment
Effective Date of 2006 Amendment
Effective Date of 2002 Amendment
Amendment by
Effective Date of 2000 Amendment
Effective Date of 1997 Amendment
"(A) April 1, 1998.
"(B) The date on which the TRICARE program is in place in the service area of the member."
Effective Date of 1984 Amendment
Amendment by
Effective Date of 1980 Amendment
Amendment by
Effective Date of 1966 Amendment
For effective date of amendment by
Program of the Department of Defense To Study Treatment of Certain Conditions Using Certain Psychedelic Substances
"(a)
"(b)
"(1) A department or agency of the Federal Government or a State government.
"(2) An academic institution.
"(c)
"(1) whether the clinical trial involves a substance included in the schedule under section 202 of the Controlled Substances Act (21 U.S.C. 812); or
"(2) section 912a of title 10, United States Code (article 112a of the Uniform Code of Military Justice).
"(d)
"(1) Identification of clinics designated to host activities under the program.
"(2) A description of entities to whom the Secretary has awarded such funding.
"(3) The number of members of the Armed Forces serving on active duty who participated in a clinical trial described in subsection (c), the covered conditions of such members treated, and whether such members returned to full duty.
"(4) Information on the findings of such clinical trials.
"(e)
"(1) The term 'covered condition' means any of the following:
"(A) Post-traumatic stress.
"(B) Traumatic brain injury.
"(2) The term 'covered psychedelic substances' means any of the following:
"(A) 3,4-Methylenedioxy-methamphetamine (commonly known as 'MDMA').
"(B) Psilocybin.
"(C) Ibogaine.
"(D) 5-Methoxy-N,N-dimethyltryptamine (commonly known as '5-MeO-DMT').
"(E) Qualified plant-based alternative therapies.
"(3) The term 'Secretary' means the Secretary of Defense.
"(4) The term 'State' has the meaning given such term in section 901 of title 32, United States Code."
Guidance for Addressing Healthy Relationships and Intimate Partner Violence Through TRICARE Program
"(a)
"(1) education on healthy relationships and intimate partner violence; and
"(2) protocols for-
"(A) the routine assessment of intimate partner violence and sexual assault; and
"(B) the promotion of, and strategies for, trauma-informed care plans.
"(b)
Registry of Certain TRICARE Beneficiaries Diagnosed With COVID–19
"(a)
"(b)
"(c)
"(1) The demographic information of the beneficiary.
"(2) Information on the industrial or occupational history of the beneficiary, to the extent such information is available in the records regarding the COVID–19 diagnosis of the beneficiary.
"(3) Administrative information regarding the COVID–19 diagnosis of the beneficiary, including the date of the diagnosis and the location and source of the test used to make the diagnosis.
"(4) Any symptoms of COVID–19 manifested in the beneficiary.
"(5) Any treatments for COVID–19 taken by the beneficiary, or other medications taken by the beneficiary, when the beneficiary was diagnosed with COVID–19.
"(6) Any pathological data characterizing the incidence of COVID–19 and the type of treatment for COVID–19 provided to the beneficiary.
"(7) Information on any respiratory illness of the beneficiary recorded prior to the COVID–19 diagnosis of the beneficiary.
"(8) Any information regarding the beneficiary contained in the Airborne Hazards and Open Burn Pit Registry established under section 201 of the Dignified Burial and Other Veterans' Benefits Improvement Act of 2012 (
"(9) Any other information determined appropriate by the Secretary.
"(d)
"(1) a plan to implement the registry;
"(2) the cost of implementing the registry;
"(3) the location of the registry; and
"(4) any recommended legislative changes with respect to establishing the registry.
"(e)
Coverage of Testing for COVID–19: Application With Respect to TRICARE
Provision of Blood Testing for Firefighters of Department of Defense to Determine Exposure to Perfluoroalkyl and Polyfluoroalkyl Substances
"(a)
"(b)
Comprehensive Policy for Provision of Mental Health Care to Members of the Armed Forces
"(a)
"(b)
"(1) The compliance of health professionals in the military health system engaged in the provision of health care services to members with clinical practice guidelines for-
"(A) suicide prevention;
"(B) medication-assisted therapy for alcohol use disorders; and
"(C) medication-assisted therapy for opioid use disorders.
"(2) The access and availability of mental health care services to members who are victims of sexual assault or domestic violence.
"(3) The availability of naloxone reversal capability on military installations.
"(4) The promotion of referrals of members by civilian health care providers to military medical treatment facilities when such members are-
"(A) at high risk for suicide and diagnosed with a psychiatric disorder; or
"(B) receiving treatment for opioid use disorders.
"(5) The provision of comprehensive behavioral health treatment to members of the reserve components that takes into account the unique challenges associated with the deployment pattern of such members and the difficulty such members encounter post-deployment with respect to accessing such treatment in civilian communities.
"(c)
"(d)
Declassification by Department of Defense of Certain Incidents of Exposure of Members of the Armed Forces to Toxic Substances
"(a)
"(b)
"(1) Whether that individual was exposed to that toxic substance.
"(2) The potential severity of the exposure of that individual to that toxic substance.
"(3) Any potential health conditions that may have resulted from exposure to that toxic substance.
"(c)
"(d)
"(1)
"(2)
"(3)
"(4)
Adjustment of Medical Services, Personnel Authorized Strengths, and Infrastructure in Military Health System To Maintain Readiness and Core Competencies of Health Care Providers
"(a)
"(b)
"(1) Medical services provided through the military health system at military medical treatment facilities-
"(A) maintain the critical wartime medical readiness skills and core competencies of health care providers within the Armed Forces; and
"(B) ensure the medical readiness of the Armed Forces.
"(2) The authorized strengths for military and civilian personnel throughout the military health system-
"(A) maintain the critical wartime medical readiness skills and core competencies of health care providers within the Armed Forces; and
"(B) ensure the medical readiness of the Armed Forces.
"(3) The infrastructure in the military health system, including infrastructure of military medical treatment facilities-
"(A) maintains the critical wartime medical readiness skills and core competencies of health care providers within the Armed Forces; and
"(B) ensures the medical readiness of the Armed Forces.
"(4) Any covered beneficiary who may be affected by the measures implemented under subsection (a) will be able to receive through the purchased care component of the TRICARE program any medical services that will not be available to such covered beneficiary at a military medical treatment facility by reason of such measures.
"(c)
"(d)
"(1) The term 'clinical and logistical capabilities' means those capabilities relating to the provision of health care that are necessary to accomplish operational requirements, including-
"(A) combat casualty care;
"(B) medical response to and treatment of injuries sustained from chemical, biological, radiological, nuclear, or explosive incidents;
"(C) diagnosis and treatment of infectious diseases;
"(D) aerospace medicine;
"(E) undersea medicine;
"(F) diagnosis, treatment, and rehabilitation of specialized medical conditions;
"(G) diagnosis and treatment of diseases and injuries that are not related to battle; and
"(H) humanitarian assistance.
"(2) The terms 'covered beneficiary' and 'TRICARE program' have the meanings given those terms in section 1072 of title 10, United States Code.
"(3) The term 'critical wartime medical readiness skills and core competencies' means those essential medical capabilities, including clinical and logistical capabilities, that are-
"(A) necessary to be maintained by health care providers within the Armed Forces for national security purposes; and
"(B) vital to the provision of effective and timely health care during contingency operations."
Requirement To Review and Monitor Prescribing Practices at Military Treatment Facilities of Pharmaceutical Agents for Treatment of Post-Traumatic Stress
"(a)
"(1) conduct a comprehensive review of the prescribing practices at military treatment facilities of pharmaceutical agents for the treatment of post-traumatic stress;
"(2) implement a process or processes to monitor the prescribing practices at military treatment facilities of pharmaceutical agents that are discouraged from use under the VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress; and
"(3) implement a plan to address any deviations from such guideline in prescribing practices of pharmaceutical agents for management of post-traumatic stress at such facilities.
"(b)
Pilot Program on Investigational Treatment of Members of the Armed Forces for Traumatic Brain Injury and Post-Traumatic Stress Disorder
"(a)
"(b)
"(1) Any drug or device used in the treatment must be approved, cleared, or made subject to an investigational use exemption by the Food and Drug Administration, and the use of the drug or device must comply with rules of the Food and Drug Administration applicable to investigational new drugs or investigational devices.
"(2) The treatment must be approved by the Secretary following approval by an institutional review board operating in accordance with regulations issued by the Secretary of Health and Human Services, in addition to regulations issued by the Secretary of Defense regarding institutional review boards.
"(3) The patient receiving the treatment may not be a retired member of the Armed Forces who is entitled to benefits under part A, or eligible to enroll under part B, of title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
"(c)
"(d)
"(e)
"(f)
Department of Defense Guidance on Environmental Exposures at Military Installations
"(1)
"(2)
"(A) The criteria for when and under what circumstances public health assessments by the Agency for Toxic Substances and Disease Registry must be requested in connection with environmental contamination at military installations, including past incidents of environmental contamination.
"(B) The procedures to be used to track and document the status and nature of responses to the findings and recommendations of the public health assessments of the Agency of Toxic Substances and Disease Registry that involve contamination at military installations.
"(C) The appropriate actions to be undertaken to assess significant long-term health risks from past environmental exposures to military personnel and civilian individuals from living or working on military installations.
"(3)
Smoking Cessation Program Under TRICARE
"(a) TRICARE
"(b)
"(c)
"(1) The availability, at no cost to the beneficiary, of pharmaceuticals used for smoking cessation, with a limitation on the availability of such pharmaceuticals to the national mail-order pharmacy program under the TRICARE program if appropriate.
"(2) Counseling.
"(3) Access to a toll-free quit line that is available 24 hours a day, 7 days a week.
"(4) Access to printed and Internet web-based tobacco cessation material.
"(d)
"(e)
"(f)
"(1)
"(A) the amount the beneficiary pays for copayments for smoking cessation services described in subsection (c); and
"(B) the amount the beneficiary would have paid if the beneficiary had not been excluded under subsection (b) from the smoking cessation program under subsection (a).
"(2)
"(g)
"(1) The status of the program.
"(2) The number of participants in the program.
"(3) The cost of the program.
"(4) The costs avoided that are attributed to the program.
"(5) The success rates of the program compared to other nationally recognized smoking cessation programs.
"(6) Findings regarding the success rate of participants in the program.
"(7) Recommendations to modify the policies and procedures of the program.
"(8) Recommendations concerning the future utility of the program.
"(h)
"(1) TRICARE
"(2)
Longitudinal Study on Traumatic Brain Injury Incurred by Members of the Armed Forces in Operation Iraqi Freedom and Operation Enduring Freedom
"(a)
"(b)
"(c)
"(1) The long-term physical and mental health effects of traumatic brain injuries incurred by members of the Armed Forces during service in Operation Iraqi Freedom or Operation Enduring Freedom.
"(2) The health care, mental health care, and rehabilitation needs of such members for such injuries after the completion of inpatient treatment through the Department of Defense, the Department of Veterans Affairs, or both.
"(3) The type and availability of long-term care rehabilitation programs and services within and outside the Department of Defense and the Department of Veterans Affairs for such members for such injuries, including community-based programs and services and in-home programs and services.
"(4) The effect on family members of a member incurring such an injury.
"(d)
"(e)
"(1) Current information on the cumulative outcomes of the study.
"(2) Such recommendations as the Secretary of Defense and the Secretary of Veterans Affairs jointly consider appropriate based on the outcomes of the study, including recommendations for legislative, programmatic, or administrative action to improve long-term care and rehabilitation programs and services for members of the Armed Forces with traumatic brain injuries."
Standards and Tracking of Access to Health Care Services for Wounded, Injured, or Ill Servicemembers Returning to the United States From a Combat Zone
"(a)
"(b)
"(1) The access of wounded, injured, or ill members of the Armed Forces to emergency care.
"(2) The access of such members to surgical services.
"(3) Waiting times for referrals and consultations of such members by medical personnel, dental personnel, mental health specialists, and rehabilitative service specialists, including personnel and specialists with expertise in prosthetics and in the treatment of head, vision, and spinal cord injuries.
"(4) Waiting times of such members for acute care and for routine follow-up care.
"(c)
"(d)
"(e)
"(1)
"(2)
Training Curricula for Family Caregivers on Care and Assistance for Members and Former Members of the Armed Forces With Traumatic Brain Injury
"(a)
"(1)
"(2)
"(A) Physicians, nurses, rehabilitation therapists, and other individuals with an expertise in caring for and assisting individuals with traumatic brain injury, including persons who specialize in caring for and assisting individuals with traumatic brain injury incurred in combat.
"(B) Representatives of family caregivers or family caregiver associations.
"(C) Health and medical personnel of the Department of Defense and the Department of Veterans Affairs with expertise in traumatic brain injury and personnel and readiness representatives of the Department of Defense with expertise in traumatic brain injury.
"(D) Psychologists or other individuals with expertise in the mental health treatment and care of individuals with traumatic brain injury.
"(E) Experts in the development of training curricula.
"(F) Family members of members of the Armed Forces with traumatic brain injury.
"(G) Such other individuals the Secretary considers appropriate.
"(3)
"(b)
"(1)
"(2)
"(A) be based on empirical research and validated techniques; and
"(B) shall provide for training that permits recipients to tailor caregiving to the unique circumstances of the member or former member of the Armed Forces receiving care.
"(3)
"(A) specify appropriate training commensurate with the severity of traumatic brain injury; and
"(B) identify appropriate care and assistance to be provided for the degree of severity of traumatic brain injury for caregivers of various levels of skill and capability.
"(4)
"(5)
"(c)
"(1)
"(A) to health care professionals who treat or otherwise work with members and former members of the Armed Forces with traumatic brain injury;
"(B) to family members affected by the traumatic brain injury of such members and former members; and
"(C) to other care or support personnel who may provide service to members or former members affected by traumatic brain injury.
"(2)
"(d)
"(1) The actions undertaken under this section.
"(2) Recommendations for the improvement or updating of training curriculum developed and provided under this section."
Pilot Projects on Early Diagnosis and Treatment of Post Traumatic Stress Disorder and Other Mental Health Conditions
Cooperative Outreach to Members and Former Members of the Naval Service Exposed to Environmental Factors Related to Sarcoidosis
Medical Readiness Plan and Joint Medical Readiness Oversight Committee
"(a)
"(b)
"(1)
"(2)
"(A) The Under Secretary of Defense for Personnel and Readiness, who shall chair the Committee.
"(B) The Vice Chief of Staff of the Army, the Vice Chief of Naval Operations, the Vice Chief of Staff of the Air Force, and the Assistant Commandant of the Marine Corp [sic].
"(C) The Assistant Secretary of Defense for Health Affairs.
"(D) The Assistant Secretary of Defense for Reserve Affairs [now Assistant Secretary of Defense for Manpower and Reserve Affairs].
"(E) The Surgeon General of each of the Army, the Navy, and the Air Force.
"(F) The Assistant Secretary of the Army for Manpower and Reserve Affairs.
"(G) The Assistant Secretary of the Navy for Manpower and Reserve Affairs.
"(H) The Assistant Secretary of the Air Force for Manpower, Reserve Affairs, Installations, and Environment.
"(I) The Chief of the National Guard Bureau.
"(J) The Chief of Army Reserve.
"(K) The Chief of Navy Reserve.
"(L) The Chief of Air Force Reserve.
"(M) The Commander, Marine Corps Reserve.
"(N) The Director of the Defense Manpower Data Center.
"(O) A representative of the Department of Veterans Affairs designated by the Secretary of Veterans Affairs.
"(3)
"(A) To advise the Secretary of Defense on the medical readiness and health status of the members of the active and reserve components of the Armed Forces.
"(B) To advise the Secretary of Defense on the compliance of the Armed Forces with the medical readiness tracking and health surveillance policies of the Department of Defense.
"(C) To oversee the development and implementation of the comprehensive plan required by subsection (a) and the actions required by this subtitle and the amendments made by this subtitle, including with respect to matters relating to-
"(i) the health status of the members of the reserve components of the Armed Forces;
"(ii) accountability for medical readiness;
"(iii) medical tracking and health surveillance;
"(iv) declassification of information on environmental hazards;
"(v) postdeployment health care for members of the Armed Forces; and
"(vi) compliance with Department of Defense and other applicable policies on blood serum repositories.
"(D) To ensure unity and integration of efforts across functional and organizational lines within the Department of Defense with regard to medical readiness tracking and health surveillance of members of the Armed Forces.
"(E) To establish and monitor compliance with the medical readiness standards that are applicable to members and those that are applicable to units.
"(F) To improve continuity of care in coordination with the Secretary of Veterans Affairs, for members of the Armed Forces separating from active service with service-connected medical conditions.
"(4)
Accountability for Medical Readiness of Individuals and Units of the Reserve Components
"(1)
"(A) requiring more frequent health assessments of members than is required by section 1074f(b) of title 10, United States Code, with an objective of having every member of the Selected Reserve receive a health assessment as specified in section 1074f of such title not less frequently than once every two years; and
"(B) providing additional support and information to commanders to assist them in improving the health status of members of their units.
"(2)
"(3)
"(A) to the extent practicable, modify the predeployment health assessment survey to bring such survey into conformity with the detailed postdeployment health assessment survey in use as of October 1, 2004; and
"(B) ensure the use of the predeployment health assessment survey, as so modified, for predeployment health assessments after that date."
Uniform Policy on Deferral of Medical Treatment Pending Deployment to Theaters of Operations
"(1)
"(2)
"(A) The circumstances under which treatment for medical conditions may be deferred to be provided within a theater of operations in order to prevent delay or other disruption of a deployment to that theater.
"(B) The circumstances under which medical conditions are to be treated before deployment to that theater."
Medical Care and Tracking and Health Surveillance in the Theater of Operations
"(a)
"(b)
"(1)
"(2)
"(A) An analysis of the strengths and weaknesses of the medical tracking system administered under section 1074f of title 10, United States Code.
"(B) An analysis of the efficacy of health surveillance systems as a means of detecting-
"(i) any health problems (including mental health conditions) of members of the Armed Forces contemporaneous with the performance of the assessment under the system; and
"(ii) exposures of the assessed members to environmental hazards that potentially lead to future health problems.
"(C) An analysis of the strengths and weaknesses of such medical tracking and surveillance systems as a means for supporting future research on health issues.
"(D) Recommended changes to such medical tracking and health surveillance systems.
"(E) A summary of scientific literature on blood sampling procedures used for detecting and identifying exposures to environmental hazards.
"(F) An assessment of whether there is a need for changes to regulations and standards for drawing blood samples for effective tracking and health surveillance of the medical conditions of personnel before deployment, upon the end of a deployment, and for a followup period of appropriate length.
"(c)
"(d)
Declassification of Information on Exposures to Environmental Hazards
"(a)
"(1) In-theater injury rates.
"(2) Data derived from environmental surveillance.
"(3) Health tracking and surveillance data.
"(b)
Uniform Policy for Meeting Mobilization-Related Medical Care Needs at Military Installations
"(a)
"(1) Arrangements for health care to be provided by the Secretary of Veterans Affairs.
"(2) Procurement of services from local health care providers.
"(3) Temporary employment of health care personnel to provide services at such installation.
"(b)
"(1) are mobilized;
"(2) are deployed; or
"(3) are redeployed from a deployment location.
"(c)
"(1)
"(2)
"(3)
"(4)
"(d)
"(1) that the policy prescribed under subsection (c) is carried out with respect to any mobilization installation with the involvement of all agencies of the Department of Defense that have responsibility for management of the installation and all organizations of the Department that have command authority over any activity at the installation; and
"(2) that such policy is implemented on a uniform basis throughout the Department of Defense."
Full Implementation of Medical Readiness Tracking and Health Surveillance Program and Force Health Protection and Readiness Program
"(a)
"(1) the Medical Readiness Tracking and Health Surveillance Program under this title [see Tables for classification] and the amendments made by this title; and
"(2) the Force Health Protection and Readiness Program of the Department of Defense (relating to the prevention of injury and illness and the reduction of disease and noncombat injury threats).
"(b)
Internet Accessibility of Health Assessment Information for Members of the Armed Forces
"(1) Information on the policies of the Department of Defense and the military department concerned regarding predeployment and postdeployment health assessments, including policies on the following matters:
"(A) Health surveys.
"(B) Physical examinations.
"(C) Collection of blood samples and other tissue samples.
"(2) Procedural information on compliance with such policies, including the following information:
"(A) Information for determining whether a member is in compliance.
"(B) Information on how to comply.
"(3) Health assessment surveys that are either-
"(A) web-based; or
"(B) accessible (with instructions) in printer-ready form by download."
Inclusion of Dental Care
Limitation on Fiscal Year 2004 Outlays for Temporary Reserve Health Care Programs
Disclosure of Information on Project 112 to Department of Veterans Affairs
Health Care at Former Uniformed Services Treatment Facilities for Active Duty Members Stationed at Certain Remote Locations
"(a)
"(b)
"(c)
"(d)
Temporary Authority for Managed Care Expansion to Members on Active Duty at Certain Remote Locations; "TRICARE Program" and "TRICARE Prime Plan" Defined
"(b)
"(2) A member or dependent of the member, as the case may be, who is entitled under paragraph (1) to receive health care services under CHAMPUS shall receive such care from a network provider under the TRICARE program if such a provider is available in the service area of the member.
"(3) Paragraph (1) shall take effect on the date of the enactment of this Act [Nov. 18, 1997] and shall expire with respect to a member upon the later of the following:
"(A) The date that is one year after the date of the enactment of this Act.
"(B) The date on which the amendments made by subsection (a) [amending this section] apply with respect to the coverage of medical care for, and provision of such care to, the member.
"(4) The Secretary of Defense shall consult with the other administering Secretaries in the administration of this subsection.
"(c)
"(1) receives a duty assignment described in subsection (d); and
"(2) pursuant to the assignment of such duty, resides at a location that is more than 50 miles, or approximately one hour of driving time, from-
"(A) the nearest health care facility of the uniformed services adequate to provide the needed care under chapter 55 of title 10, United States Code; and
"(B) the nearest source of the needed care that is available to the member under the TRICARE Prime plan.
"(d)
"(1) Permanent duty as a recruiter.
"(2) Permanent duty at an educational institution to instruct, administer a program of instruction, or provide administrative services in support of a program of instruction for the Reserve Officers' Training Corps.
"(3) Permanent duty as a full-time adviser to a unit of a reserve component of the uniformed services.
"(4) Any other permanent duty designated by the Secretary concerned for purposes of this subsection.
"(e)
"(f)
"(1) The term 'TRICARE program' has the meaning given that term in section 1072(7) of title 10, United States Code.
"(2) The term 'TRICARE Prime plan' means a plan under the TRICARE program that provides for the voluntary enrollment of persons for the receipt of health care services to be furnished in a manner similar to the manner in which health care services are furnished by health maintenance organizations.
"(3) The terms 'uniformed services' and 'administering Secretaries' have the meanings given those terms in section 1072 of title 10, United States Code."
[
["(2) The amendments made by subsection (a)(2) [amending section 731(b)–(f) of
["(A) The date that is one year after the date of the enactment of this Act.
["(B) The date on which the policies required by the amendments made by subsection (a)(1) or (b)(1) [amending this section and section 1079 of this title] are implemented with respect to the coverage of medical care for and provision of such care to the member or dependents, respectively.
["(3) Section 731(b)(3) of
Independent Research Regarding Gulf War Syndrome
Persian Gulf Illness
"SEC. 761. DEFINITIONS.
"For purposes of this subtitle [subtitle F (§§761–771) of title VII of
"(1) The term 'Gulf War illness' means any one of the complex of illnesses and symptoms that might have been contracted by members of the Armed Forces as a result of service in the Southwest Asia theater of operations during the Persian Gulf War.
"(2) The term 'Persian Gulf War' has the meaning given that term in section 101 of title 38, United States Code.
"(3) The term 'Persian Gulf veteran' means an individual who served on active duty in the Armed Forces in the Southwest Asia theater of operations during the Persian Gulf War.
"(4) The term 'contingency operation' has the meaning given that term in section 101(a) of title 10, United States Code, and includes a humanitarian operation, peacekeeping operation, or similar operation.
"SEC. 762. PLAN FOR HEALTH CARE SERVICES FOR PERSIAN GULF VETERANS.
"(a)
"(b)
"(1) use the presumptions of service connection and illness specified in paragraphs (1) and (2) of section 721(d) of the National Defense Authorization Act for Fiscal Year 1995 (
"(2) consider the need and methods available to provide health care services to Persian Gulf veterans who are no longer on active duty in the Armed Forces, such as Persian Gulf veterans who are members of the reserve components and Persian Gulf veterans who have been separated from the Armed Forces; and
"(3) estimate the costs to the Government of providing full or partial health care services under the plan to covered Persian Gulf veterans (and covered dependents eligible by law).
"(c)
"(d)
"SEC. 770. PERSIAN GULF ILLNESS CLINICAL TRIALS PROGRAM.
"(a)
"(1) There are many ongoing studies that investigate risk factors which may be associated with the health problems experienced by Persian Gulf veterans; however, there have been no studies that examine health outcomes and the effectiveness of the treatment received by such veterans.
"(2) The medical literature and testimony presented in hearings on Gulf War illnesses indicate that there are therapies, such as cognitive behavioral therapy, that have been effective in treating patients with symptoms similar to those seen in many Persian Gulf veterans.
"(b)
"(c)
"SEC. 721. PROGRAMS RELATED TO DESERT STORM MYSTERY ILLNESS.
"(a)
"(1) inform such individuals regarding-
"(A) common disease symptoms reported by Persian Gulf veterans that may be due to service in the Southwest Asia theater of operations;
"(B) blood donation policy;
"(C) available counseling and medical care for such members; and
"(D) possible health risks to children of Persian Gulf veterans;
"(2) inform such individuals of the procedures for registering in either the Persian Gulf Veterans Health Surveillance System of the Department of Defense or the Persian Gulf War Health Registry of the Department of Veterans Affairs; and
"(3) encourage such members to report any symptoms they may have and to register in the appropriate health surveillance registry.
"(b)
"(1) For any Persian Gulf veteran who is on active duty and who registers with the Department of Defense's Persian Gulf War Veterans Health Surveillance System, a full medical evaluation and any required medical care.
"(2) For any Persian Gulf War veteran who is, as of the date of the enactment of this Act [Oct. 5, 1994], a member of a reserve component, opportunity to register at a military medical facility in the Persian Gulf Veterans Health Care Surveillance System and, in the case of a Reserve who registers in that registry, a full medical evaluation by the Department of Defense. Depending on the results of the evaluation and on eligibility status, reserve personnel may be provided medical care by the Department of Defense.
"(3) For a Persian Gulf veteran who is not, as of the date of the enactment of this Act [Oct. 5, 1994], on active duty or a member of a reserve component, assistance and information at a military medical facility on registering with the Persian Gulf War Registry of the Department of Veterans Affairs and information related to support services provided by the Department of Veterans Affairs.
"(c)
"(1) that the data collected by and the testing protocols of the Persian Gulf War Health Surveillance System maintained by the Department of Defense are compatible with the data collected by and the testing protocols of the Persian Gulf War Veterans Health Registry maintained by the Department of Veterans Affairs; and
"(2) that all information on individuals who register with the Department of Defense for purposes of the Persian Gulf War Health Surveillance System is provided to the Secretary of Veterans Affairs for incorporation into the Persian Gulf War Veterans Health Registry.
"(d)
"(2) A member of the Armed Forces who is a Persian Gulf veteran and who reports being ill as a result of serving on active duty in the Southwest Asia theater of operations during the Persian Gulf War shall be considered for Department of Defense purposes to have become ill as a result of serving in that theater of operations until such time as the weight of medical evidence establishes other cause or causes of the member's illness.
"(3) The Secretary concerned shall ensure that, for the purposes of health care treatment by the Department of Defense, health care and personnel administration, and disability evaluation by the Department of Defense, the symptoms of any member of the Armed Forces covered by paragraph (1) or (2) are examined in light of the member's service in the Persian Gulf War and in light of the reported symptoms of other Persian Gulf veterans. The Secretary shall ensure that, in providing health care diagnosis and treatment of the member, a broad range of potential causes of the member's symptoms are considered and that the member's symptoms are considered collectively, as well as by type of symptom or medical specialty, and that treatment across medical specialties is coordinated appropriately.
"(4) The Secretary of Defense shall ensure that the presumptions of service connection and illness specified in paragraphs (1) and (2) are incorporated in appropriate service medical and personnel regulations and are widely disseminated throughout the Department of Defense.
"(e)
"(2) Until revised disability criteria can be implemented and members of the Armed Forces can be rated against those criteria, the Secretary of Defense shall ensure-
"(A) that any member of the Armed Forces on active duty who may be suffering from a Persian Gulf-related illness is afforded continued military medical care; and
"(B) that any member of the Armed Forces on active duty who is found by a Physical Evaluation Board to be unfit for continuation on active duty as a result of a Persian Gulf-related illness for which the board has no rating criteria (or inadequate rating criteria) for the illness or condition from which the member suffers is placed on the temporary disability retired list.
"(f)
"(2) The review under paragraph (1) shall be carried out to ensure that former Persian Gulf veterans who may have been suffering from a Persian Gulf-related illness at the time of discharge or retirement from active duty as a result of the Physical Evaluation Board process are reevaluated in accordance with the criteria established under subsection (e)(1) and, if appropriate, are rerated.
"(g)
"[(h) Repealed.
"(i)
"SEC. 722. STUDIES OF HEALTH CONSEQUENCES OF MILITARY SERVICE OR EMPLOYMENT IN SOUTHWEST ASIA DURING THE PERSIAN GULF WAR.
"(a)
"(1) the nature and causes of illnesses suffered by individuals as a consequence of service or employment by the United States in the Southwest Asia theater of operations during the Persian Gulf War; and
"(2) the appropriate treatment for those illnesses.
"(b)
"(A) shall include consideration of the range of potential exposure of individuals to environmental, battlefield, and other conditions incident to service in the theater;
"(B) shall be conducted so as to provide assessments of both short-term and long-term effects to the health of individuals as a result of those exposures; and
"(C) shall include, at a minimum, the following types of studies:
"(i) An epidemiological study or studies on the incidence, prevalence, and nature of the illness and symptoms and the risk factors associated with symptoms or illnesses.
"(ii) Studies to determine the health consequences of the use of pyridostigmine bromide as a pretreatment antidote enhancer during the Persian Gulf War, alone or in combination with exposure to pesticides, environmental toxins, and other hazardous substances.
"(iii) Clinical research and other studies on the causes, possible transmission, and treatment of Persian Gulf-related illnesses.
"(2)(A) The first project carried out under paragraph (1)(C)(ii) shall be a retrospective study of members of the Armed Forces who served in the Southwest Asia theater of operations during the Persian Gulf War.
"(B) The second project carried out under paragraph (1)(C)(ii) shall consist of animal research and nonanimal research, including in vitro systems, as required, designed to determine whether the use of pyridostigmine bromide in combination with exposure to pesticides or other organophosphates, carbamates, or relevant chemicals will result in increased toxicity in animals and is likely to have a similar effect on humans.
"(c)
"(1) Individuals who served as members of the Armed Forces in the Southwest Asia theater of operations during the Persian Gulf War.
"(2) Individuals who were civilian employees of the Department of Defense in that theater during that period.
"(3) To the extent appropriate, individuals who were employees of contractors of the Department of Defense in that theater during that period.
"(4) To the extent appropriate, the spouses and children of individuals described in paragraph (1).
"(d)
"(2) The plan for studies pursuant to subsection (a) shall be updated annually. The Secretary of Defense shall request an annual review by the National Academy of Sciences of the updated plan and study progress and results achieved during the preceding year.
"(3) The plan, and annual updates to the plan, shall be prepared in coordination with the Secretary of Veterans Affairs and the Secretary of Health and Human Services.
"(e)
"(2) For each year in which activities continue in support of the studies conducted pursuant to subsection (a), the Secretary of Defense shall include in the budget request for the Department of Defense a request for such funds as the Secretary determines necessary to continue the activities during that fiscal year.
"(f)
"(2) Not later than October 1 of each year through 1998, the Secretary shall submit to Congress a report on the results of the studies conducted pursuant to subsection (a), plans for continuation of the studies, and the results of the annual review of the studies by the National Academy of Sciences.
"(3) Each report under this section shall be prepared in coordination with the Secretary of Veterans Affairs and the Secretary of Health and Human Services.
"(g)
[For provisions establishing the Persian Gulf War Veterans Health Registry, provisions requiring a study by the Office of Technology Assessment of the Persian Gulf Registry and the Persian Gulf War Veterans Health Registry, provisions relating to an agreement with the National Academy of Sciences for review of health consequences of service during the Persian Gulf War, and coordination of government activities on health-related research on the Persian Gulf War, see title VII of
Funding of Fisher Houses Associated With Army Medical Treatment Facilities
Mental Health Evaluations of Members of Armed Forces
Study on Risk-Sharing Contracts for Health Care
Registry of Members of Armed Forces Serving in Operation Desert Storm
"(a)
"(1) Members who, as determined by the Secretary, were exposed to the fumes of burning oil in the Operation Desert Storm theater of operations during the Persian Gulf conflict.
"(2) Any other members who served in the Operation Desert Storm theater of operations during the Persian Gulf conflict.
"(b)
"(A) with respect to each class of members referred to in each of paragraphs (1) and (2) of subsection (a)-
"(i) a list containing each such member's name and other relevant identifying information with respect to the member; and
"(ii) to the extent that data are available and inclusion of the data is feasible, a description of the circumstances of the member's service during the Persian Gulf conflict, including the locations in the Operation Desert Storm theater of operations in which such service occurred and the atmospheric and other environmental circumstances in such locations at the time of such service; and
"(B) with respect to the members referred to in subsection (a)(1), a description of the circumstances of each exposure of each such member to the fumes of burning oil as described in such subsection (a)(1), including the length of time of the exposure.
"(2) The Secretary shall establish the Registry with the advice of an independent scientific organization.
"[(c) Repealed.
"(d)
"(e)
"(f)
"(1) The term 'Operation Desert Storm' has the meaning given such term in section 3(1) of the Persian Gulf Conflict Supplemental Authorization and Personnel Benefits Act of 1991 (
"(2) The term 'Persian Gulf conflict' has the meaning given such term in section 3(3) of such Act."
[For provisions relating to the Persian Gulf War Veterans Health Registry, see title VII of
Advisory Committee on Mental Health Evaluation Protections
Prohibition on Fee for Outpatient Care at Military Medical Treatment Facilities
Restriction on Use of Information Obtained During Certain Epidemiologic-Assessment Interviews
"(1) Information obtained by the Department of Defense during or as a result of an epidemiologic-assessment interview with a serum-positive member of the Armed Forces may not be used to support any adverse personnel action against the member.
"(2) For purposes of paragraph (1):
"(A) The term 'epidemiologic-assessment interview' means questioning of a serum-positive member of the Armed Forces for purposes of medical treatment or counseling or for epidemiologic or statistical purposes.
"(B) The term 'serum-positive member of the Armed Forces' means a member of the Armed Forces who has been identified as having been exposed to a virus associated with the acquired immune deficiency syndrome.
"(C) The term 'adverse personnel action' includes-
"(i) a court-martial;
"(ii) non-judicial punishment;
"(iii) involuntary separation (other than for medical reasons);
"(iv) administrative or punitive reduction in grade;
"(v) denial of promotion;
"(vi) an unfavorable entry in a personnel record;
"(vii) a bar to reenlistment; and
"(viii) any other action considered by the Secretary concerned to be an adverse personnel action."
Study of Medical Needs of Armed Forces; Report to President and Congress
Executive Documents
Delegation of Functions
Authority of President under subsec. (b) to approve uniform rates of reimbursement for care provided in facilities operated by Secretary of Veterans Affairs delegated to Secretary of Veterans Affairs, see section 7(a) of Ex. Ord. No. 11609, July 22, 1971, 36 F.R. 13747, set out as a note under section 301 of Title 3, The President.
Executive Order No. 13075
Ex. Ord. No. 13075, Feb. 19, 1997, 63 F.R. 9085, which established the Special Oversight Board for Department of Defense Investigations of Gulf War Chemical and Biological Incidents, was revoked by Ex. Ord. No. 13225, §3(e), Sept. 28, 2001, 66 F.R. 50292.