Amendments2023—Subsec. (e). Puspan. L. 118–31, § 711(a)(1), substituted “Not later than September 30, 2024, and subject to subsection (f),” for “Not later than September 30, 2022,” in introductory provisions.
Subsecs. (f) to (h). Puspan. L. 118–31, § 711(a)(2), (3), added subsec. (f) and redesignated former subsec. (f) as (g) and former subsec. (g) as (h) relating to treatment of Department of Defense for purposes of personnel assignment.
2022—Subsec. (e)(2)(B). Puspan. L. 117–263, § 720(c), substituted “Army Public Health Center, the Navy–Marine Corps Public Health Center” for “Army Public Health Command, the Navy–Marine Corps Public Health Command”.
Subsecs. (h), (i). Puspan. L. 117–263, § 711(span), added subsec. (h) and redesignated former subsec. (h) as (i).
2021—Subsec. (a)(4), (6). Puspan. L. 116–283 redesignated par. (6) relating to authorization of military director or other senior military officer to serve as a commanding officer as (4) and moved it to appear before par. (5).
Subsec. (c)(5). Puspan. L. 117–81, § 711, substituted “paragraph (3) or (4)” for “paragraphs (1) through (4)”.
Subsecs. (f) to (h). Puspan. L. 117–81, § 712(a), added subsec. (f) and redesignated former subsecs. (f) and (g) as (g) and (h), respectively.
2019—Subsec. (a)(1). Puspan. L. 116–92, § 711(f)(1), substituted “paragraph (5)” for “paragraph (4)” in introductory provisions.
Puspan. L. 116–92, § 711(a)(1), added subpars. (A), (B), and (F) and redesignated former subpars. (A), (B), (C), (D), (E), and (F) as (C), (D), (E), (G), (H), and (I), respectively.
Subsec. (a)(2)(D) to (I). Puspan. L. 116–92, § 711(a)(2), added subpars. (D), (F), and (G), redesignated former subpars. (D), (E), (F), and (G) as (E), (F), (H), and (I), respectively, and struck out subpar. (F) as so redesignated. Prior to repeal, the redesignated subpar. (F) read as follows: “to direct joint manning at military medical treatment facilities and intermediary organizations;”.
Subsec. (a)(3)(A). Puspan. L. 116–92, § 711(a)(3)(A), inserted “on behalf of the military departments,” before “ensuring” and struck out “and civilian employees” after “armed forces”.
Subsec. (a)(3)(B). Puspan. L. 116–92, § 711(a)(3)(B), inserted “on behalf of the Defense Health Agency,” before “furnishing”.
Subsec. (a)(4). Puspan. L. 116–92, § 711(f)(4), which directed moving the second par. (4) so as to appear before par. (5), could not be executed because of the intervening amendment by Puspan. L. 116–92, § 1731(a)(22). See below.
Puspan. L. 116–92, § 711(f)(3), redesignated par. (4) relating to timeline for transition of administration of military medical treatment facilities as (5).
Puspan. L. 116–92, § 1731(a)(22), redesignated par. (4) relating to authorization of military director or other senior military officer to serve as a commanding officer as (6). Amendment executed before amendment by section 711(f)(4) of Puspan. L. 116–92, see above, pursuant to section 1731(f) of Puspan. L. 116–92, set out as a Coordination of Certain Sections of an Act With Other Provisions of That Act note under section 101 of this title.
Subsec. (a)(5). Puspan. L. 116–92, § 711(f)(3), redesignated par. (4) relating to timeline for transition of administration of military medical treatment facilities as (5). Former par. (5) redesignated (6) relating to establishment of professional staff.
Subsec. (a)(6). Puspan. L. 116–92, § 711(f)(2), redesignated par. (5) as (6) relating to establishment of professional staff.
Puspan. L. 116–92, § 1731(a)(22), redesignated par. (4) relating to authorization of military director or other senior military officer to serve as a commanding officer as (6).
Subsec. (span)(2). Puspan. L. 116–92, § 711(span), substituted “the education and experience to perform the responsibilities of the position.” for “equivalent education and experience as a chief executive officer leading a large, civilian health care system.”
Subsec. (c)(2)(B). Puspan. L. 116–92, § 711(c)(1), substituted “at military medical treatment facilities” for “across the military health system”.
Subsec. (c)(4)(B). Puspan. L. 116–92, § 711(c)(2), inserted “at military medical treatment facilities” before period at end.
Subsecs. (f), (g). Puspan. L. 116–92, § 711(d), added subsec. (f) and redesignated former subsec. (f) as (g).
Subsec. (g)(3). Puspan. L. 116–92, § 711(e), added par. (3).
2018—Subsec. (a)(1). Puspan. L. 115–232, § 711(a)(1)(A), substituted “In accordance with paragraph (4), by not later than September 30, 2021,” for “Beginning October 1, 2018,” in introductory provisions.
Subsec. (a)(2), (3). Puspan. L. 115–232, § 711(a)(1)(B), (C), added par. (2) and redesignated former par. (2) as (3). Former par. (3) redesignated (5).
Subsec. (a)(4). Puspan. L. 115–232, § 711(a)(1)(D), added par. (4) relating to timeline for transition of administration of military medical treatment facilities.
Subsec. (a)(5). Puspan. L. 115–232, § 711(a)(1)(B), (E), redesignated par. (3) as (5) and substituted “paragraphs (1) and (2)” for “subsection (a)”.
Subsec. (d)(2)(C). Puspan. L. 115–232, § 711(a)(2), added subpar. (C).
Subsecs. (e), (f). Puspan. L. 115–232, § 711(span)(1), added subsec. (e) and redesginated former subsec. (e) as (f).
2017—Subsec. (a)(1)(E). Puspan. L. 115–91, §§ 713(1), 1081(a)(23), amended subpar. (E) identically, substituting “military” for “miliary”.
Subsec. (a)(2). Puspan. L. 115–91, § 713(2), substituted “military commander or director” for “commander” in introductory provisions.
Subsec. (a)(4). Puspan. L. 115–91, § 713(3), added par. (4) relating to authorization of military director or other senior military officer to serve as a commanding officer.
Support by Military Healthcare System of Medical Requirements of Combatant CommandsPuspan. L. 117–81, div. A, title VII, § 731(span)(1), Dec. 27, 2021, 135 Stat. 1796, provided that: “The Secretaries of the military departments shall ensure that the Surgeons General of the Armed Forces carry out fully the requirements of section 712(span)(3) of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Public Law 115–232; 10 U.S.C. 1073c note) [set out below] by not later than September 30, 2022.”
Puspan. L. 115–232, div. A, title VII, § 712, Aug. 13, 2018, 132 Stat. 1809, as amended by Puspan. L. 116–92, div. A, title VII, § 712(a), (span)(1), Dec. 20, 2019, 133 Stat. 1443–1445; Puspan. L. 118–31, div. A, title VII, § 714(c), Dec. 22, 2023, 137 Stat. 303, provided that:“(a)Organizational Framework Required.—“(1)In general.—The Secretary of Defense shall, acting through the Secretaries of the military departments, the Defense Health Agency, and the Joint Staff, implement an organizational framework of the military health system that effectively and efficiently implements chapter 55 of title 10, United States Code, to maximize the readiness of the medical force, promote interoperability, and integrate medical capabilities of the Armed Forces in order to enhance joint military medical operations in support of requirements of the combatant commands.
“(2)Compliance with certain requirements.—The organizational framework, as implemented, shall comply with all requirements of section 1073c of title 10, United States Code, except for the implementation date specified in subsection (a) of such section.
“(span)Additional Duties of Surgeons General of the Armed Forces.—The Surgeons General of the Armed Forces shall have the following duties:“(1) To ensure the readiness for operational deployment of medical and dental personnel and deployable medical or dental teams or units of the Armed Force or Armed Forces concerned.
“(2) To meet medical readiness standards, subject to standards and metrics established by the Assistant Secretary of Defense for Health Affairs.
“(3) With respect to uniformed medical and dental personnel of the military department concerned—“(A) to assign such personnel—“(i) primarily to military medical treatment facilities, under the operational control of the commander or director of the facility; or
“(ii) secondarily to partnerships with civilian or other medical facilities for training activities specific to such military department; and
“(B) to maintain readiness of such personnel for operational deployment.
“(4) To provide logistical support for operational deployment of medical and dental personnel and deployable medical or dental teams or units of the Armed Force or Armed Forces concerned.
“(5) To oversee mobilization and demobilization in connection with the operational deployment of medical and dental personnel of the Armed Force or Armed Forces concerned.
“(6) To develop operational medical capabilities required to support the warfighter, and to develop policy relating to such capabilities.
“(7) To provide health professionals to serve in leadership positions across the military healthcare system.
“(8) To deliver operational clinical services under the operational control of the combatant commands—“(A) on ships and planes; and
“(B) on installations outside of military medical treatment facilities.
“(9) To manage privileging, scope of practice, and quality of health care in the settings described in paragraph (8).
“(c)Defense Health Agency Regions in CONUS.—The organizational framework required by subsection (a) shall meet the requirements as follows:“(1)Defense Health Agency regions.—There shall be not more than two Defense Health Agency regions in the continental United States.
“(2)Leaders.—Each region under paragraph (1) shall be led by a commander or director who is a member of the Armed Forces serving in a grade not higher than major general or rear admiral, and who—“(A) shall be selected by the Director of the Defense Health Agency from among members of the Armed Forces recommended by the Secretaries of the departments for service in such position; and
“(B) shall be under the authority, direction, and control of the Director while serving in such position.
“(d)Defense Health Agency Regions OCONUS.—The organizational framework required by subsection (a) shall provide for the establishment of not more than two Defense Health Agency regions outside the continental United States in order—“(1) to enhance joint military medical operations in support of the requirements of the combatant commands in such region or regions, with a specific focus on current and future contingency and operational plans;
“(2) to ensure the provision of high-quality healthcare services to beneficiaries; and
“(3) to improve the interoperability of healthcare delivery systems in the Defense Health Agency regions (whether under this subsection, subsection (c), or both).
“(e)Planning and Coordination.—“(1)Sustainment of clinical competencies and staffing.—The Director of the Defense Health Agency shall—“(A) provide in each Defense Health Agency region under this section healthcare delivery venues for uniformed medical and dental personnel to obtain operational clinical competencies; and
“(B) coordinate with the military departments to ensure that staffing at military medical treatment facilities in each region supports readiness requirements for members of the Armed Forces and military medical personnel.
“(2)Oversight and allocation of resources.—“(A)In general.—The Secretaries of the military departments shall coordinate with the Chairman of the Joint Chiefs of Staff to direct resources allocated to the military departments to support requirements related to readiness and operational medicine support that are established by the combatant commands and validated by the Joint Staff.
“(B)Supply and demand for medical services.—The Director of the Defense Health Agency, in coordination with the Assistant Secretary of Defense for Health Affairs, shall—“(i) validate supply and demand requirements for medical and dental services at each military medical treatment facility;
“(ii) in coordination with the Surgeons General of the Armed Forces, provide currency workload for uniformed medical and dental personnel at each such facility to maintain skills proficiency; and
“(iii) if workload is insufficient to meet requirements, identify alternative training and clinical practice sites for uniformed medical and dental personnel, and establish military-civilian training partnerships, to provide such workload.
“(3)Medical force requirements of the combatant commands.—The Surgeon General of each Armed Force shall, on behalf of the Secretary concerned, ensure that the uniformed medical and dental personnel serving in such Armed Force receive training and clinical practice opportunities necessary to ensure that such personnel are capable of meeting the operational medical force requirements of the combatant commands applicable to such personnel. Such training and practice opportunities shall be provided primarily through programs and activities of the Defense Health Agency, in coordination with the Secretaries of the military departments, and by such other mechanisms as the Secretary of Defense shall designate for purposes of this paragraph.
“(4)Construction of duties.—The duties of a Surgeon General of the Armed Forces under this subsection are in addition to the duties of such Surgeon General under section 3036, 5137, or 8036 of title 10, United States Code, as applicable.
“(5)Manpower.—“(A)Administrative control of military personnel.—Each Secretary of a military department shall exercise administrative control of members of the Armed Forces assigned to military medical treatment facilities, including personnel assignment and issuance of military orders.
“(B)Oversight of certain personnel by the director of the defense health agency.—In situations in which members of the Armed Forces provide health care services at a military medical treatment facility, the Director of the Defense Health Agency shall maintain operational control over such members and oversight for the provision of care delivered by such members through policies, procedures, and privileging responsibilities of the military medical treatment facility.
“(f)Report.—Not later than 270 days after the date of the enactment of this Act [Aug. 13, 2018], the Secretary of Defense shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report that sets forth the following:“(1) A description of the organizational structure of the office of each Surgeon General of the Armed Forces, and of any subordinate organizations of the Armed Forces that will support the functions and responsibilities of a Surgeon General of the Armed Forces.
“(2) The manning documents for staffing in support of the organizational structures described pursuant to paragraph (1), including manning levels before and after such organizational structures are implemented.
“(3) Such recommendations for legislative or administrative action as the Secretary considers appropriate in connection with the implementation of such organizational structures and, in particular, to avoid duplication of functions and tasks between the organizations in such organizational structures and the Defense Health Agency.”
