Historical and Revision Notes

Revised section

Source (U.S. Code)

Source (Statutes at Large)

1079(a)

1079(span)

37:402(a)(2) (as applicable to 37:411(a)).

37:411(a).

37:411(span).

37:414.

June 7, 1956, ch. 374, §§ 102(a)(2) (as applicable to § 201(a)), 201(a), (span), 204, 70 Stat. 250, 252, 253.

In subsection (a), the words “appointed, enlisted, inducted or called, ordered or conscripted in a uniformed service”, in 37:402(a)(2) are omitted as surplusage, since it does not matter how a member became a member. The words “active duty for a period of more than 30 days” are substituted for the words “active duty or active duty for training pursuant to a call or order that does not specify a period of thirty days or less”, in 37:402(a)(2), to reflect section 101(22) and (23) of this title. The words “, under the authority of this section,” are substituted for the words “pursuant to the provisions of this title” to make clear that the section provides independent procurement authority. The words “all”, “by the hospital”, and “a period of”, in 37:411(a), are omitted as surplusage.

In subsection (a)(1), the word “rooms”, in 37:411(a), is substituted for the word “accommodations”.

In subsection (a)(5), the word “services” is substituted for the word “procedures” and the word “performed” is substituted for the word “accomplished”, in 37: 411(a). The words “or surgeon” are inserted for clarity.

In subsection (span), the word “variances” is substituted for the words “limitations, additions, exclusions”. The words “or care other than that provided for in sections 1076–1078 of this title” are substituted for 37:414. The words “definitions, and related provisions”, in 37:411(span), are omitted as surplusage, since the Secretary of an executive department has inherent authority to interpret laws and issue regulations.

Editorial Notes
References in Text

The Social Security Act, referred to in subsecs. (h)(1), (4)(A), (B)(i), (i)(1), (2), (n)(2), and (r)(2)(A), is act Aug. 13, 1935, ch. 531, 49 Stat. 620. Part B of title XI of the Act is classified generally to part B (§ 1320c et seq.) of subchapter XI of chapter 7 of Title 42, The Public Health and Welfare. Titles XVIII and XIX of the Act are classified generally to subchapters XVIII (§ 1395 et seq.) and XIX (§ 1396 et seq.), respectively, of chapter 7 of Title 42. Parts A and B of title XVIII of the Act are classified generally to parts A (§ 1395c et seq.) and B (§ 1395j et seq.), respectively, of subchapter XVIII of chapter 7 of Title 42. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Prior Provisions

Provisions similar to those in subsec. (a)(7) to (14) of this section were contained in the following appropriation acts, with the exception of the provisions similar to par. (14) which first appeared in Puspan. L. 96–154:

Puspan. L. 98–473, title I, § 101(h) [title VIII, §§ 8031, 8032, 8045], Oct. 12, 1984, 98 Stat. 1904, 1929, 1931.

Puspan. L. 98–212, title VII, §§ 737, 738, 752, Dec. 8, 1983, 97 Stat. 1445, 1447.

Puspan. L. 97–377, title I, § 101(c) [title VII, §§ 740, 741, 756], Dec. 21, 1982, 96 Stat. 1833, 1857, 1860.

Puspan. L. 97–114, title VII, §§ 741, 742, 759, Dec. 29, 1981, 95 Stat. 1585, 1588.

Puspan. L. 96–527, title VII, §§ 742, 743, 763, Dec. 15, 1980, 94 Stat. 3088, 3092.

Puspan. L. 96–154, title VII, §§ 744, 745, 769, Dec. 21, 1979, 93 Stat. 1159, 1163.

Puspan. L. 95–457, title VIII, §§ 844, 845, Oct. 13, 1978, 92 Stat. 1251.

Puspan. L. 95–111, title VIII, §§ 843, 844, Sept. 21, 1977, 91 Stat. 907.

Puspan. L. 94–419, title VII, §§ 742, 743, Sept. 22, 1976, 90 Stat. 1298.

Puspan. L. 94–212, title VII, §§ 750, 751, Fespan. 9, 1976, 90 Stat. 176.

Provisions similar to those added to subsec. (h)(2) of this section by section 1401(e)(4)(B) of Puspan. L. 98–525 were contained in the following prior appropriation acts:

Puspan. L. 98–473, title I, § 101(h) [title VIII, § 8077], Oct. 12, 1984, 98 Stat. 1904, 1938.

Puspan. L. 98–212, title VII, § 785, Dec. 8, 1983, 97 Stat. 1453.

A prior section 1079, act Aug. 10, 1956, ch. 1041, 70A Stat. 84, related to establishment of right to vote, prior to repeal by Puspan. L. 85–861, § 36B(5), Sept. 2, 1958, 72 Stat. 1570, as superseded by the Federal Voting Assistance Act of 1955 which is classified to subchapter I–D (§ 1973cc et seq.) of chapter 20 of Title 42, The Public Health and Welfare.

Amendments

2021—Subsec. (a)(12). Puspan. L. 116–283, § 703, substituted “certified clinical social worker, or other class of provider as designated by the Secretary of Defense,” for “or certified clinical social worker,”.

Subsec. (a)(18). Puspan. L. 117–81, § 701(a)(1), which directed adding par. (18) at the end of subsec. (a), effective after the addition of par. (19), was executed by adding it before par. (19) to reflect the probable intent of Congress.

Subsec. (a)(19). Puspan. L. 117–81, § 702, added par. (19).

Subsec. (e). Puspan. L. 116–283, § 704(a), amended subsec. (e) generally. Prior to amendment, subsec. (e) related to extended benefits for eligible dependents.

Subsec. (f)(2), (4). Puspan. L. 116–283, § 704(span), substituted “subparagraph (C), (E), (F), or (G) of subsection (e)(1)” for “paragraph (3) or (4) of subsection (e)”.

Subsec. (q). Puspan. L. 116–283, § 1081(a)(25), substituted “section 1074g(i)” for “section 1074g(h)”.

Subsec. (r). Puspan. L. 117–81, § 701(a)(2), added subsec. (r).

2018—Subsec. (q). Puspan. L. 115–232 substituted “section 1074g(h)” for “section 1074g(g)”.

2017—Subsec. (a)(15). Puspan. L. 115–91, § 704, inserted “, except that hospice care may be provided to an individual under the age of 21 concurrently with health care services or hospitalization for the same condition” before period at end.

Subsec. (span). Puspan. L. 115–91, § 739(d)(1), substituted “calendar year” for “fiscal year” wherever appearing.

Subsec. (q). Puspan. L. 115–91, § 702(span)(2), added subsec. (q).

2016—Subsec. (g)(1). Puspan. L. 114–328, § 618(span), inserted “or 351” after “section 310”.

Subsec. (h)(4)(C)(ii). Puspan. L. 114–328, § 748(span), struck out “in support of a contingency operation under a provision of law referred to in section 101(a)(13)(B) of this title” after “30 days”.

2014—Subsec. (a)(6) to (16). Puspan. L. 113–291, § 703(a)(1), redesignated pars. (7) to (17) as (6) to (16), respectively, and struck out former par. (6) which read as follows: “Inpatient mental health services may not (except as provided in subsection (i)) be provided to a patient in excess of—

“(A) 30 days in any year, in the case of a patient 19 years of age or older;

“(B) 45 days in any year, in the case of a patient under 19 years of age; or

“(C) 150 days in any year, in the case of inpatient mental health services provided as residential treatment care.”

Subsec. (a)(17). Puspan. L. 113–291, § 706, added par. (17). Former par. (17) redesignated (16).

Subsec. (e)(7). Puspan. L. 113–291, § 703(c)(1), substituted “subsection (a)(12)” for “subsection (a)(13)”.

Subsecs. (i) to (q). Puspan. L. 113–291, § 703(a)(2), (3), redesignated subsecs. (j) to (q) as (i) to (p), respectively, and struck out former subsec. (i) which related to limitation in former subsec. (a)(6) of this section as being inapplicable to inpatient mental health services in certain instances.

2009—Subsec. (f)(2)(B). Puspan. L. 111–84 struck out period after “year”.

2008—Subsec. (f)(2). Puspan. L. 110–417 substituted “year shall not exceed $36,000, prorated as determined by the Secretary of Defense,” for “month shall not exceed $2,500,” in subpar. (A) and “year.” for “month” in subpar. (B).

2006—Subsec. (a)(1). Puspan. L. 109–364, § 702, amended par. (1) generally. Prior to amendment, par. (1) read as follows: “With respect to dental care, only that care required as a necessary adjunct to medical or surgical treatment may be provided.”

Subsec. (a)(2). Puspan. L. 109–364, § 703(span)(1), substituted “the schedule and method of cervical cancer screenings and breast cancer screenings” for “the schedule of pap smears and mammograms” in introductory provisions.

Subsec. (a)(2)(B). Puspan. L. 109–364, § 703(span)(2), substituted “cervical and breast cancer screenings” for “pap smears and mammograms”.

Subsec. (a)(17). Puspan. L. 109–364, § 701, added par. (17).

Subsec. (g). Puspan. L. 109–163, § 715(a), designated existing provisions as par. (1), struck out last sentence which read “In addition, when a member dies while on active duty for a period of more than 30 days, the member’s dependents who are receiving benefits under a plan covered by subsection (a) shall continue to be eligible for such benefits during the three-year period beginning on the date of the death of the member.”, and added pars. (2) to (5).

Subsec. (p)(4), (5). Puspan. L. 109–163, § 714, added par. (4) and redesignated former par. (4) as (5).

2004—Subsec. (h)(4)(C). Puspan. L. 108–375 added subpar. (C).

2002—Subsec. (i)(3). Puspan. L. 107–314, § 701(a), designated existing provisions as subpar. (A), substituted “Except as provided in subparagraph (B),” for “Except in the case of an emergency,”, and added subpars. (B) and (C).

Subsec. (p)(1). Puspan. L. 107–314, § 702(1), substituted “dependents described in paragraph (3)” for “dependents referred to in subsection (a) of a member of the uniformed services referred to in section 1074(c)(3) of this title who are residing with the member”.

Subsec. (p)(3), (4). Puspan. L. 107–314, § 702(2), (3), added par. (3) and redesignated former par. (3) as (4).

Subsec. (q). Puspan. L. 107–314, § 705(a), added subsec. (q).

2001—Subsec. (a)(5). Puspan. L. 107–107, § 703(span), amended par. (5) generally. Prior to amendment, par. (5) read as follows: “Durable equipment, such as wheelchairs, iron lungs and hospital beds may be provided on a rental basis.”

Subsec. (a)(17). Puspan. L. 107–107, § 701(g)(2), struck out par. (17) which read as follows:

“(17)(A) The Secretary of Defense may establish a program for the individual case management of a person covered by this section or section 1086 of this title who has extraordinary medical or psychological disorders and, under such a program, may waive benefit limitations contained in paragraphs (5) and (13) of this subsection or section 1077(span)(1) of this title and authorize the payment for comprehensive home health care services, supplies, and equipment if the Secretary determines that such a waiver is cost-effective and appropriate.

“(B) The total amount expended under subparagraph (A) for a fiscal year may not exceed $100,000,000.”

Subsec. (d) to (f). Puspan. L. 107–107, § 701(span), added subsecs. (d) to (f) and struck out former subsecs. (d) to (f) which related to medical care provided for retarded or handicapped dependents, the requirement of members sharing in cost of benefits provided, and the requirement that members use public facilities to the extent available and adequate, respectively.

Subsec. (h)(2). Puspan. L. 107–107, § 1048(c)(5), substituted “February 10, 1996,” for “the date of the enactment of this paragraph”.

Subsec. (h)(4). Puspan. L. 107–107, § 707(span), designated existing provisions as subpar. (A) and added subpar. (B).

Subsec. (j)(2) to (4). Puspan. L. 107–107, § 707(a), designated existing provisions of subpar. (A) of par. (2) as par. (2) and substituted “shall be determined under joint regulations” for “may be determined under joint regulations”, redesignated subpar. (B) of par. (2) as par. (4) and substituted therein “this subsection,” for “subparagraph (A),”, and added par. (3).

2000—Subsec. (a)(17). Puspan. L. 106–398, § 1 [[div. A], title VII, § 701(c)(1)], designated existing provisions as subpar. (A) and added subpar. (B).

Subsec. (g). Puspan. L. 106–398, § 1 [[div. A], title VII, § 704(span)], substituted “three-year period” for “one-year period”.

Subsec. (h)(5). Puspan. L. 106–398, § 1 [[div. A], title VII, § 757(a)], added par. (5).

Subsec. (p). Puspan. L. 106–398, § 1 [[div. A], title VII, § 722(span)(1)], added subsec. (p).

1997—Subsec. (h)(1). Puspan. L. 105–85, § 735(a), added par. (1) and struck out former par. (1) which read as follows: “Payment for a charge for services by an individual health care professional (or other noninstitutional health care provider) for which a claim is submitted under a plan contracted for under subsection (a) may not exceed the lesser of—

“(A) the amount equivalent to the 80th percentile of billed charges made for similar services in the same locality during the base period; or

“(B) an amount determined to be appropriate, to the extent practicable, in accordance with the same reimbursement rules as apply to payments for similar services under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).”

Subsec. (h)(2). Puspan. L. 105–85, § 735(c)(2), redesignated par. (4) as (2).

Puspan. L. 105–85, § 735(a), struck out par. (2) which read as follows: “For the purposes of paragraph (1)(A), the 80th percentile of charges shall be determined by the Secretary of Defense, in consultation with the other administering Secretaries, and the base period shall be a period of twelve calendar months. The Secretary of Defense shall adjust the base period as frequently as he considers appropriate.”

Subsec. (h)(3). Puspan. L. 105–85, § 735(c)(2), redesignated par. (5) as (3).

Puspan. L. 105–85, § 735(a), struck out par. (3) which read as follows: “For the purposes of paragraph (1)(B), the appropriate payment amount shall be determined by the Secretary of Defense, in consultation with the other administering Secretaries.”

Subsec. (h)(4). Puspan. L. 105–85, § 735(c)(2), redesignated par. (4) as (2).

Subsec. (h)(5). Puspan. L. 105–85, § 735(c)(2), redesignated par. (5) as (3).

Puspan. L. 105–85, § 735(span), (c)(1), substituted “paragraph (2), the Secretary of Defense” for “paragraph (4), the Secretary” and inserted at end “With the consent of the health care provider, the Secretary is also authorized to reduce the authorized payment for certain health care services below the amount otherwise required by the payment limitations under paragraph (1).”

Subsec. (h)(6). Puspan. L. 105–85, § 735(c)(2), redesignated par. (6) as (4).

1996—Subsec. (a). Puspan. L. 104–201, § 731(span)(1), substituted “except as follows:” for “except that—” in introductory provisions.

Subsec. (a)(1). Puspan. L. 104–201, § 731(span)(2), (3), capitalized first letter of first word and substituted a period for the semicolon at end.

Subsec. (a)(2). Puspan. L. 104–201, § 731(span)(2), (3), capitalized first letter of first word and substituted a period for the semicolon at end.

Puspan. L. 104–201, § 701(span)(2), inserted “the schedule and method of colon and prostate cancer screenings,” after “pap smears and mammograms,” in introductory provisions and “or colon and prostate cancer screenings” after “pap smears and mammograms” in subpar. (B).

Puspan. L. 104–106, § 701, added par. (2) and struck out former par. (2) which read as follows: “routine physical examinations and immunizations of dependents over two years of age may only be provided when required in the case of dependents who are traveling outside the United States as a result of a member’s duty assignment and such travel is being performed under orders issued by a uniformed service, except that pap smears and mammograms may be provided on a diagnostic or preventive basis;”.

Subsec. (a)(3) to (12). Puspan. L. 104–201, § 731(span)(2), (3), capitalized first letter of first word and substituted a period for the semicolon at end.

Subsec. (a)(13). Puspan. L. 104–201, § 731(a), (span)(2), substituted “Any service” for “any service” and “paragraph (4).” for “paragraph (4);” and inserted at end “Pursuant to an agreement with the Secretary of Health and Human Services and under such regulations as the Secretary of Defense may prescribe, the Secretary of Defense may waive the operation of this paragraph in connection with clinical trials sponsored or approved by the National Institutes of Health if the Secretary of Defense determines that such a waiver will promote access by covered beneficiaries to promising new treatments and contribute to the development of such treatments.”

Subsec. (a)(14), (15). Puspan. L. 104–201, § 731(span)(2), (3), capitalized first letter of first word and substituted a period for the semicolon at end.

Subsec. (a)(16). Puspan. L. 104–201, § 731(span)(2), (4), capitalized first letter of first word and substituted a period for “; and” at end.

Subsec. (a)(17). Puspan. L. 104–201, § 731(span)(2), capitalized first letter of first word.

Subsec. (h)(1). Puspan. L. 104–106, § 731(a), added par. (1) and struck out former par. (1) which read as follows: “Payment for a charge for services by an individual health-care professional (or other noninstitutional health-care provider) for which a claim is submitted under a plan contracted for under subsection (a) may be denied only to the extent that the charge exceeds the amount equivalent to the 80th percentile of billed charges made for similar services in the same locality during the base period.”

Subsec. (h)(2). Puspan. L. 104–106, § 731(d), substituted “paragraph (1)(A)” for “paragraph (1)”.

Subsec. (h)(3). Puspan. L. 104–106, § 731(span), added par. (3).

Subsec. (h)(4). Puspan. L. 104–201, § 711, struck out “emergency” before “services from nonparticipating providers.”

Puspan. L. 104–106, § 731(c), added par. (4).

Subsec. (h)(5). Puspan. L. 104–201, § 732(2), added par. (5). Former par. (5) redesignated (6).

Puspan. L. 104–106, § 731(c), added par. (5).

Subsec. (h)(6). Puspan. L. 104–201, § 732(1), redesignated par. (5) as (6).

Subsec. (j)(1). Puspan. L. 104–201, § 735(c), inserted “, including any plan offered by a third-party payer (as defined in section 1095(h)(1) of this title),” after “or health plan”.

1994—Subsec. (a). Puspan. L. 103–337, § 702(a)(1), substituted “dependents, as described in subparagraphs (A), (D), and (I) of section 1072(2) of this title,” for “spouses and children”.

Subsec. (d). Puspan. L. 103–337, § 702(a)(2), substituted “as described in subparagraph (A), (D), or (I) of section 1072(2)” for “as defined in section 1072(2)(A) or (D)”.

Subsec. (g). Puspan. L. 103–337, § 707(a), inserted at end “In addition, when a member dies while on active duty for a period of more than 30 days, the member’s dependents who are receiving benefits under a plan covered by subsection (a) shall continue to be eligible for such benefits during the one-year period beginning on the date of the death of the member.”

1993—Subsec. (a)(7). Puspan. L. 103–160, § 716(c), substituted “except that those services may be provided in any case in which another insurance plan or program provides primary coverage for those services;” for “except that—

“(A) those services may be provided in any case in which another insurance plan or program provides primary coverage for those services; and

“(B) the Secretary of Defense may waive the 40-mile radius restriction with regard to the provision of a particular service before October 1, 1993, if the Secretary determines that the use of a different geographical area restriction will result in a more cost-effective provision of the service;”.

Subsec. (a)(15). Puspan. L. 103–35 made technical amendment to directory language of Puspan. L. 102–484, § 704(1). See 1992 Amendment note below.

Subsec. (o). Puspan. L. 103–160, § 711, added subsec. (o).

1992—Subsec. (a)(15). Puspan. L. 102–484, § 1053(3), made technical amendment to directory language of Puspan. L. 102–190, § 702(span)(1)(C). See 1991 Amendment note below.

Puspan. L. 102–484, § 704(1), as amended by Puspan. L. 103–35, struck out “and” at end of par. (15).

Subsec. (a)(16). Puspan. L. 102–484, § 704(2), substituted “; and” for period at end.

Subsec. (a)(17). Puspan. L. 102–484, § 704(3), added par. (17).

Subsec. (j)(2)(B). Puspan. L. 102–484, § 1052(13), inserted a close parenthesis after “1395x(dd)(2)”.

1991—Subsec. (a)(6). Puspan. L. 102–25, § 316(span), revived par. (6) as in effect on Fespan. 14, 1991, thus negating amendment to par. (6) by Puspan. L. 101–510, § 703(a), from its original effective date (Fespan. 15, 1991) to the effective date as amended (Oct. 1, 1991). See 1990 Amendment note and Effective Date of 1990 Amendment note below.

Subsec. (a)(7). Puspan. L. 102–190, § 711, substituted “except that—” and subpars. (A) and (B), for “except that such services may be provided in any case in which another insurance plan or program provides primary coverage for the services;”.

Subsec. (a)(13). Puspan. L. 102–190, § 702(span)(1)(A), substituted “paragraph (4)” for “clause (4)”.

Subsec. (a)(14). Puspan. L. 102–190, § 702(span)(1)(B), struck out “and” at end.

Subsec. (a)(15). Puspan. L. 102–190, § 702(span)(1)(C), as amended by Puspan. L. 102–484, § 1053(3), substituted “; and” for period at end.

Subsec. (a)(16). Puspan. L. 102–190, § 702(span)(1)(D), added par. (16).

Subsec. (i). Puspan. L. 102–25, § 316(span), revived subsec. (i) as in effect on Fespan. 14, 1991, thus negating amendment to subsec. (i) by Puspan. L. 101–510, § 703(span), from its original effective date (Fespan. 15, 1991) to the effective date as amended (Oct. 1, 1991). See 1990 Amendment note and Effective Date of 1990 Amendment note below.

Subsec. (j)(1). Puspan. L. 102–190, § 713, inserted “, or covered by,” after “person enrolled in”.

Subsec. (j)(2)(B). Puspan. L. 102–190, § 702(span)(2), inserted “hospice program (as defined in section 1861(dd)(2) of the Social Security Act (42 U.S.C. 1395x(dd)(2)),”.

Subsec. (n). Puspan. L. 102–190, § 712(a), added subsec. (n).

1990—Subsec. (a)(2). Puspan. L. 101–510, § 701(a), inserted before the semicolon “, except that pap smears and mammograms may be provided on a diagnostic or preventive basis”.

Subsec. (a)(6). Puspan. L. 101–510, § 703(a), substituted “in excess of—” for “in excess of 60 days in any year;” and added subpars. (A) to (C).

Subsec. (a)(8). Puspan. L. 101–510, § 702(a)(1), inserted “(other than certified marriage and family therapists)” after “marital counselors” and inserted before semicolon “and services of certified marriage and family therapists may be provided consistent with such rules as may be prescribed by the Secretary of Defense, including credentialing criteria and a requirement that the therapists accept payment under this section as full payment for all services provided”.

Subsec. (a)(13). Puspan. L. 101–510, § 702(a)(2), inserted “certified marriage and family therapist,” after “psychologist,”.

Subsec. (span)(2). Puspan. L. 101–510, § 712(a)(1), substituted “$150” for “$50” and inserted at end “Notwithstanding the preceding sentence, in the case of a dependent of an enlisted member in a pay grade below E–5, the initial deductible each fiscal year under this paragraph shall be limited to $50.”

Subsec. (span)(3). Puspan. L. 101–510, § 712(a)(2), substituted “$300 (or in the case of the family group of an enlisted member in a pay grade below E–5, the first $100)” for “$100”.

Subsec. (i). Puspan. L. 101–510, § 703(span), amended subsec. (i) generally. Prior to amendment, subsec. (i) read as follows: “The limitation in subsection (a)(6) does not apply in the case of inpatient mental health services—

“(1) provided under the program for the handicapped under subsection (d);

“(2) provided as residential treatment care;

“(3) provided as partial hospital care; or

“(4) provided pursuant to a waiver authorized by the Secretary of Defense because of extraordinary medical or psychological circumstances that are confirmed by review by a non-Federal health professional pursuant to regulations prescribed by the Secretary of Defense.”

Subsec. (j)(2)(B). Puspan. L. 101–510, § 1484(g)(1), inserted “the term” after “In subparagraph (A),”.

1989—Subsec. (h)(1), (2). Puspan. L. 101–189 substituted “80th percentile” for “90th percentile”.

1988—Subsec. (span)(1). Puspan. L. 100–456, § 646(a)(1), inserted provisions authorizing Secretary of Defense to exempt a patient from paying such amount if the hospital to which the patient is admitted does not impose a legal obligation on any of its patients to pay for inpatient care.

Subsec. (m). Puspan. L. 100–456, § 646(a)(2), added subsec. (m).

1987—Subsec. (a)(15). Puspan. L. 100–180, § 726(a), added par. (15).

Subsec. (span)(5). Puspan. L. 100–180, § 721(a), added par. (5).

1986—Subsec. (a)(7). Puspan. L. 99–661, § 703, substituted “provides primary coverage for the services” for “pays for at least 75 percent of the services”.

Subsec. (l). Puspan. L. 99–661, § 652(d), added subsec. (l).

1984—Subsec. (a). Puspan. L. 98–557, § 19(7)(B), substituted reference to other administering Secretaries for reference to Secretary of Health and Human Services in provisions preceding cl. (1).

Subsec. (a)(3). Puspan. L. 98–525, § 632(a)(1), substituted “not more than one eye examination may be provided to a patient in any calendar year” for “eye examinations may not be provided”.

Subsec. (a)(4). Puspan. L. 98–557, § 19(7)(A), substituted reference to the administering Secretaries for reference to the Secretary of Defense and the Secretary of Health and Human Services.

Subsec. (a)(7) to (14). Puspan. L. 98–525, § 1401(e)(4)(A), added cls. (7) to (14).

Subsecs. (span)(4), (c), (d). Puspan. L. 98–557, § 19(7)(A), substituted reference to the administering Secretaries for reference to the Secretary of Defense and the Secretary of Health and Human Services.

Subsec. (e). Puspan. L. 98–525, § 1405(23), substituted “under subsection (d) as follows:” for “under subsection (d).” in provisions preceding cl. (1).

Subsecs. (e)(1), (f). Puspan. L. 98–557, § 19(7)(A), substituted reference to the administering Secretaries for reference to the Secretary of Defense and the Secretary of Health and Human Services.

Subsec. (h)(2). Puspan. L. 98–557, § 19(7)(B), substituted reference to other administering Secretaries for reference to Secretary of Health and Human Services.

Puspan. L. 98–525, § 1401(e)(4)(B), substituted “The Secretary of Defense shall adjust the base period as frequently as he considers appropriate” for “The base period shall be adjusted at least once a year”.

Subsec. (j)(2)(A). Puspan. L. 98–557, § 19(7)(A), substituted reference to the administering Secretaries for reference to the Secretary of Defense and the Secretary of Health and Human Services.

Subsec. (k)(1), (2). Puspan. L. 98–557, § 19(7)(B), substituted reference to other administering Secretaries for reference to Secretary of Health and Human Services.

1983—Subsec. (a). Puspan. L. 98–94, § 1268(4)(A), substituted “30” for “thirty” in provisions preceding par. (1).

Subsec. (a)(6). Puspan. L. 98–94, § 931(a)(1), added par. (6).

Subsec. (d). Puspan. L. 98–94, § 1268(4)(A), substituted “30” for “thirty”.

Subsec. (g). Puspan. L. 98–94, § 1268(4)(B), struck out “of this section” after “subsection (d)”.

Subsecs. (i) to (k). Puspan. L. 98–94, § 931(a)(2), added subsecs. (i) to (k).

1981—Subsec. (span)(4). Puspan. L. 97–22 substituted “Secretary of Health and Human Services” for “Secretary of Health, Education, and Welfare”.

Subsec. (h). Puspan. L. 97–86 substituted reference to services of individual health-care professionals for former reference to physician services, struck out provisions that had used the concept of a predetermined charge level based upon customary charges, and inserted provisions requiring a readjustment of the base period at least once a year.

1980—Subsec. (a). Puspan. L. 96–513, § 511(36), (38)(A), substituted “Secretary of Health and Human Services” for “Secretary of Health, Education, and Welfare” wherever appearing, and “that—” for “that:”.

Subsec. (a)(2). Puspan. L. 96–342, § 810(a)(1), inserted “of dependents over two years of age” after “immunizations”.

Subsec. (a)(3). Puspan. L. 96–342, § 810(a)(2), struck out “routine care of the newborn, well-baby care, and” after “(3)”.

Subsec. (span)(4). Puspan. L. 96–552 added par. (4).

Puspan. L. 96–513, § 511(38)(B), substituted “percent” for “per centum” wherever appearing.

Subsec. (c). Puspan. L. 96–513, § 511(36), substituted “Secretary of Health and Human Services” for “Secretary of Health, Education, and Welfare”.

Subsec. (d). Puspan. L. 96–513, §§ 501(13), 511(36), substituted “section 1072(2)(A) or (D) of this title” for “section 1072(2)(A), (C), or (E) of this title”, and “Secretary of Health and Human Services” for “Secretary of Health, Education, and Welfare”.

Subsec. (e). Puspan. L. 96–513, § 511(36), (38)(C), substituted “Secretary of Health and Human Services” for “Secretary of Health, Education, and Welfare”, and “(d) as follows:” for “(d).”.

Subsec. (e)(2). Puspan. L. 96–342, § 810(span), substituted “$1,000” for “$350”.

Subsec. (f). Puspan. L. 96–513, § 511(36), substituted “Secretary of Health and Human Services” for “Secretary of Health, Education, and Welfare”.

Subsec. (g). Puspan. L. 96–513, § 511(38)(D), struck out “, United States Code,” after “37”.

Subsec. (h). Puspan. L. 96–513, § 511(36), substituted “Secretary of Health and Human Services” for “Secretary of Health, Education, and Welfare”.

1978—Subsec. (h). Puspan. L. 95–485 added subsec. (h).

1971—Subsec. (g). Puspan. L. 92–58 added subsec. (g).

1966—Subsec. (a). Puspan. L. 89–614 struck out “dependent” before “spouses and children” and substituted sentence providing that “The types of health care authorized under this section, shall be the same as those provided under section 1076 of this title”, enumerating exceptions in pars. (1) to (5) for former provisions which required the insurance, medical service, or health plans to include (1) hospitalization in semiprivate rooms for not more than 365 days for each admission, (2) medical and surgical care incident to hospitalization, (3) obstetrical and maternity service, including prenatal and postnatal care, (4) services of physician or surgeon before or after hospitalization for bodily injury or surgical operation, (5) diagnostic tests and services incident to hospitalization, and (6) payments by patient of hospital expenses, now incorporated in subsec. (span)(1).

Subsec. (span). Puspan. L. 89–614 incorporated existing provisions of subsec. (a)(6) in par. (1) and added pars. (2) and (3). Former subsec. (span) authorized the Secretary of Defense to make variances from subsec. (a) requirements as appropriate other than outpatient care or care other than provided for in sections 1076 to 1078 of this title.

Subsecs. (c) to (f). Puspan. L. 89–614 added subsecs. (c) to (f).

Statutory Notes and Related Subsidiaries
Effective Date of 2021 Amendment

Puspan. L. 117–81, div. A, title VII, § 701(d), Dec. 27, 2021, 135 Stat. 1779, provided that: “The amendments made by this section [enacting section 1090a of this title, transferring former section 1090a of this title to section 1090span of this title, and amending this section and section 1086 of this title] shall take effect on October 1, 2022.”

Effective Date of 2006 Amendment

Puspan. L. 109–163, div. A, title VII, § 715(span), Jan. 6, 2006, 119 Stat. 3345, provided that: “The amendments made by subsection (a) [amending this section] shall take effect on October 7, 2001, and shall apply with respect to deaths occurring on or after that date.”

Effective Date of 2002 Amendment

Puspan. L. 107–314, div. A, title VII, § 701(span), Dec. 2, 2002, 116 Stat. 2583, provided that: “The amendments made by subsection (a) [amending this section] shall take effect October 1, 2003.”

Puspan. L. 107–314, div. A, title VII, § 705(span), Dec. 2, 2002, 116 Stat. 2585, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to any contract under the TRICARE program entered into on or after the date of the enactment of this Act [Dec. 2, 2002].”

Effective Date of 2001 Amendment

Puspan. L. 107–107, div. A, title VII, § 707(c), Dec. 28, 2001, 115 Stat. 1164, provided that: “The amendments made by this section [amending this section] shall take effect on the date that is 90 days after the date of the enactment of this Act [Dec. 28, 2001].”

Effective Date of 2000 Amendment

Puspan. L. 106–398, § 1 [[div. A], title VII, § 701(c)(3)], Oct. 30, 2000, 114 Stat. 1654, 1654A–172, provided that: “The amendments made by paragraphs (1) and (2) [amending this section and provisions set out as a note under section 1077 of this title] shall apply to fiscal years after fiscal year 1999.”

Amendment by section 1 [[div. A], title VII, § 722(span)(1)] of Puspan. L. 106–398 effective Oct. 1, 2001, see section 1 [[div. A], title VII, § 722(c)(1)] of Puspan. L. 106–398, set out as a note under section 1074 of this title.

Effective Date of 1994 Amendment

Puspan. L. 103–337, div. A, title VII, § 707(c), Oct. 5, 1994, 108 Stat. 2801, provided that: “The amendments made by subsections (a) and (span) [amending this section and section 1076a of this title] shall apply with respect to the dependents described in such amendments of a member of a uniformed service who dies on or after October 1, 1993, while on active duty for a period of more than 30 days.”

Effective Date of 1993 Amendment

Amendment by Puspan. L. 103–35 applicable as if included in the enactment of Puspan. L. 102–484, see section 202(span) of Puspan. L. 103–35, set out as a note under section 155 of this title.

Effective Date of 1992 Amendment

Puspan. L. 102–484, div. A, title X, § 1053, Oct. 23, 1992, 106 Stat. 2501, provided that the amendment made by that section is effective Dec. 5, 1991.

Effective Date of 1991 Amendment

Puspan. L. 102–25, title III, § 316(span), Apr. 6, 1991, 105 Stat. 87, provided that the amendment made by that section is effective Fespan. 15, 1991.

Effective Date of 1990 Amendment

Puspan. L. 101–510, div. A, title VII, § 701(span), Nov. 5, 1990, 104 Stat. 1580, provided that: “The amendment made by subsection (a) [amending this section] shall apply to the provision of pap smears and mammograms under section 1079 or 1086 of title 10, United States Code, on or after the date of the enactment of this Act [Nov. 5, 1990].”

Puspan. L. 101–510, div. A, title VII, § 702(span), Nov. 5, 1990, 104 Stat. 1581, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to the services of certified marriage and family therapists provided under section 1079 or 1086 of title 10, United States Code, on or after the date of the enactment of this Act [Nov. 5, 1990].”

Puspan. L. 101–510, div. A, title VII, § 703(d), Nov. 5, 1990, 104 Stat. 1582, as amended by Puspan. L. 102–25, title III, § 316(a)(1), Apr. 6, 1991, 105 Stat. 87, provided that: “This section and the amendments made by this section [amending this section] shall take effect on October 1, 1991, and shall apply with respect to mental health services provided under section 1079 or 1086 of title 10, United States Code, on or after that date.”

Puspan. L. 101–510, div. A, title VII, § 712(c), Nov. 5, 1990, 104 Stat. 1583, provided that: “The amendments made by this section [amending this section and section 1086 of this title] shall apply with respect to health care provided under sections 1079 and 1086 of title 10, United States Code, on or after April 1, 1991.”

Effective Date of 1989 Amendment

Puspan. L. 101–189, div. A, title VII, § 730(span), Nov. 29, 1989, 103 Stat. 1481, provided that: “The amendment made by subsection (a) [amending this section] shall apply to services provided on or after October 1, 1989.”

Effective Date of 1988 Amendment

Puspan. L. 100–456, div. A, title VI, § 646(c), Sept. 29, 1988, 102 Stat. 1990, provided that: “The amendments made by subsections (a) and (span) [amending this section and section 1086 of this title] shall apply with respect to medical care received after September 30, 1988.”

Effective Date of 1987 Amendment

Puspan. L. 100–180, div. A, title VII, § 721(c), Dec. 4, 1987, 101 Stat. 1115, provided that: “Paragraph (5) of section 1079(span) of title 10, United States Code, as added by subsection (a), and paragraph (4) of section 1086(span) of such title, as added by subsection (span), shall apply with respect to fiscal years beginning after September 30, 1987.”

Puspan. L. 100–180, div. A, title VII, § 726(span), Dec. 4, 1987, 101 Stat. 1117, provided that: “Paragraph (15) of section 1079(a) of such title, as added by subsection (a), shall apply with respect to costs incurred for home monitoring equipment after the date of the enactment of this Act [Dec. 4, 1987].”

Effective Date of 1986 Amendment

Puspan. L. 99–661, div. A, title VI, § 652(e)(4), Nov. 14, 1986, 100 Stat. 3890, provided that: “The amendment made by subsection (d) [amending this section] shall apply only with respect to care furnished under section 1079 of title 10, United States Code, on or after the date of the enactment of this Act [Nov. 14, 1986].”

Effective Date of 1984 Amendment

Puspan. L. 98–525, title VI, § 632(a)(3), Oct. 19, 1984, 98 Stat. 2543, provided that: “The amendments made by this subsection [amending this section and section 1086 of this title] shall apply only to health care furnished after September 30, 1984.”

Amendment by section 1401(e)(4) of Puspan. L. 98–525 effective Oct. 1, 1985, see section 1404 of Puspan. L. 98–525, set out as an Effective Date note under section 520span of this title.

Effective Date of 1983 Amendment

Puspan. L. 98–94, title IX, § 931(c), Sept. 24, 1983, 97 Stat. 649, provided that: “The amendments made by this section [amending this section and section 1086 of this title] shall take effect on October 1, 1983, except that—

“(1) clause (6) of section 1079(a) of title 10, United States Code, as added by subsection (a)(1), shall not apply in the case of inpatient mental health services provided to a patient admitted before January 1, 1983, for so long as that patient remains continuously in inpatient status for medically or psychologically necessary reasons; and
“(2) subsection (k) of section 1079 of such title, as added by subsection (a)(1), shall apply with respect to liver transplant operations performed on or after July 1, 1983.”

Effective Date of 1981 Amendment

Puspan. L. 97–86, title IX, § 906(span), Dec. 1, 1981, 95 Stat. 1117, provided that: “The amendments made by subsection (a) [amending this section and section 1086 of this title] shall apply with respect to claims submitted for payment for services provided after the end of the 30-day period beginning on the date of the enactment of this Act [Dec. 1, 1981].”

Effective Date of 1980 Amendments

Amendment by section 501(13) of Puspan. L. 96–513 effective Sept. 15, 1981, see section 701 of Puspan. L. 96–513, set out as a note under section 101 of this title.

Amendment by section 511 of Puspan. L. 96–513 effective Dec. 12, 1980, see section 701(span)(3) of Puspan. L. 96–513.

Puspan. L. 96–342, title VIII, § 810(c), Sept. 8, 1980, 94 Stat. 1097, provided that: “The amendments made by this section [amending this section] shall apply to medical care provided after September 30, 1980.”

Effective Date of 1978 Amendment

Puspan. L. 95–485, title VIII, § 806(span), Oct. 20, 1978, 92 Stat. 1622, provided that: “the amendments made by subsection (a) [amending this section and section 1086 of this title] shall apply with respect to claims submitted for payment for services provided on or after the first day of the first calendar year beginning after the date of enactment of this Act [Oct. 20, 1978].”

Effective Date of 1971 Amendment

Puspan. L. 92–58, § 2, July 29, 1971, 85 Stat. 157, provided that: “This Act [amending this section] becomes effective as of January 1, 1967. However, no person is entitled to any benefits because of this Act for any period before the date of enactment [July 29, 1971].”

Effective Date of 1966 Amendment

For effective date of amendment by Puspan. L. 89–614, see section 3 of Puspan. L. 89–614, set out as a note under section 1071 of this title.

Waiver of Copayments for Preventive Services for Certain TRICARE Beneficiaries

Puspan. L. 110–417, [div. A], title VII, § 711, Oct. 14, 2008, 122 Stat. 4500, as amended by Puspan. L. 111–383, div. A, title X, § 1075(e)(11), Jan. 7, 2011, 124 Stat. 4375, provided that:

“(a)Waiver of Certain Copayments.—Subject to subsection (span) and under regulations prescribed by the Secretary of Defense, the Secretary shall—
“(1) waive all copayments under sections 1079(span) and 1086(span) of title 10, United States Code, for preventive services for all beneficiaries who would otherwise pay copayments; and
“(2) ensure that a beneficiary pays nothing for preventive services during a year even if the beneficiary has not paid the amount necessary to cover the beneficiary’s deductible for the year.
“(span)Exclusion for Medicare-Eligible Beneficiaries.—Subsection (a) shall not apply to a medicare-eligible beneficiary.
“(c)Refund of Copayments.—
“(1)Authority.—Under regulations prescribed by the Secretary of Defense, the Secretary may pay a refund to a medicare-eligible beneficiary excluded by subsection (span), subject to the availability of appropriations specifically for such refunds, consisting of an amount up to the difference between—
“(A) the amount the beneficiary pays for copayments for preventive services during fiscal year 2009; and
“(B) the amount the beneficiary would have paid during such fiscal year if the copayments for preventive services had been waived pursuant to subsection (a) during that year.
“(2)Copayments covered.—The refunds under paragraph (1) are available only for copayments paid by medicare-eligible beneficiaries during fiscal year 2009.
“(d)Definitions.—In this section:
“(1)Preventive services.—The term ‘preventive services’ includes, taking into consideration the age and gender of the beneficiary:
“(A) Colorectal screening.
“(B) Breast screening.
“(C) Cervical screening.
“(D) Prostate screening.
“(E) Annual physical exam.
“(F) Vaccinations.
“(G) Other services as determined by the Secretary of Defense.
“(2)Medicare-eligible.—The term ‘medicare-eligible’ has the meaning provided by section 1111(span)(3) of title 10, United States Code.”

Plan for Providing Health Coverage Information to Members, Former Members, and Dependents Eligible for Certain Health Benefits

Puspan. L. 108–136, div. A, title VII, § 724, Nov. 24, 2003, 117 Stat. 1534, provided that:

“(a)Health Information Plan Required.—The Secretary of Defense shall develop a plan to—
“(1) ensure that each household that includes one or more eligible persons is provided information concerning—
“(A) the extent of health coverage provided by sections 1079 or 1086 of title 10, United States Code, for each such person;
“(B) the costs, including the limits on such costs, that each such person is required to pay for such health coverage;
“(C) sources of information for locating TRICARE-authorized providers in the household’s locality; and
“(D) methods to obtain assistance in resolving difficulties encountered with billing, payments, eligibility, locating TRICARE-authorized providers, collection actions, and such other issues as the Secretary considers appropriate;
“(2) provide mechanisms to ensure that each eligible person has access to information identifying TRICARE-authorized providers in the person’s locality who have agreed to accept new patients under section 1079 or 1086 of title 10, United States Code, and to ensure that such information is periodically updated;
“(3) provide mechanisms to ensure that each eligible person who requests assistance in locating a TRICARE-authorized provider is provided such assistance;
“(4) provide information and recruitment materials and programs aimed at attracting participation of health care providers as necessary to meet health care access requirements for all eligible persons; and
“(5) provide mechanisms to allow for the periodic identification by the Department of Defense of the number and locality of eligible persons who may intend to rely on TRICARE-authorized providers for health care services.
“(span)Implementation of Plan.—The Secretary of Defense shall implement the plan required by subsection (a) with respect to any contract entered into by the Department of Defense after May 31, 2003, for managed health care.
“(c)Definitions.—In this section:
“(1) The term ‘eligible person’ means a person eligible for health benefits under section 1079 or 1086 of title 10, United States Code.
“(2) The term ‘TRICARE-authorized provider’ means a facility, doctor, or other provider of health care services—
“(A) that meets the licensing and credentialing certification requirements in the State where the services are rendered;
“(B) that meets requirements under regulations relating to TRICARE for the type of health care services rendered; and
“(C) that has accepted reimbursement by the Secretary of Defense as payment for services rendered during the 12-month period preceding the date of the most recently updated provider information provided to households under the plan required by subsection (a).
“(d)Submission of Plan.—Not later than March 31, 2004, the Secretary shall submit to the Committees on Armed Services of the Senate and House of Representatives the plan required by subsection (a), together with a schedule for implementation of the plan.”

Report on Actions To Establish Special Reimbursement Rates

Puspan. L. 106–398, § 1 [[div. A], title VII, § 757(span)(1)], Oct. 30, 2000, 114 Stat. 1654, 1654A–199, directed the Secretary of Defense, not later than Mar. 31, 2001, to submit to the Committees on Armed Services of the Senate and the House of Representatives and the General Accounting Office a report on actions taken to carry out sections 1079(h)(5) and 1097span of this title.

Programs Relating to Sale of Pharmaceuticals

Puspan. L. 102–484, div. A, title VII, § 702, Oct. 23, 1992, 106 Stat. 2431, as amended by Puspan. L. 103–160, div. A, title VII, § 721, Nov. 30, 1993, 107 Stat. 1695; Puspan. L. 103–337, div. A, title VII, § 706, Oct. 5, 1994, 108 Stat. 2800; Puspan. L. 106–398, § 1 [[div. A], title VII, § 711(span)], Oct. 30, 2000, 114 Stat. 1654, 1654A–176, directed the Secretary of Defense to conduct a demonstration project that would permit eligible persons to obtain prescription pharmaceuticals by mail, directed the Secretary to include in each managed health care program awarded or renewed after Jan. 1, 1993, a program to supply prescription pharmaceuticals through a managed care network of retail pharmacies, directed the Secretary to submit to Congress a report regarding the demonstration project not later than two years after its establishment and an additional report regarding the programs not later than Jan. 1, 1994, and provided for termination of section 702 of Puspan. L. 102–484 no later than one year after Oct. 30, 2000.

Correction of Omission in Delay of Increase of CHAMPUS Deductibles Related to Operation Desert Storm

Puspan. L. 102–484, div. A, title VII, § 721, Oct. 23, 1992, 106 Stat. 2438, provided that during the period beginning on Apr. 1, 1991, and ending on Sept. 30, 1991, the annual deductibles specified in this section or section 1086 of this title applicable to CHAMPUS beneficiaries who had served on active duty in the Persian Gulf theater of operations in connection with Operation Desert Storm would not exceed the annual deductibles in effect on Nov. 4, 1990, and provided for the credit or reimbursement of excess amounts paid.

Temporary CHAMPUS Provisions for Dependents of Operation Desert Shield/Desert Storm Active Duty Personnel

Puspan. L. 102–172, title VIII, § 8085, Nov. 26, 1991, 105 Stat. 1192, provided that any CHAMPUS health care provider could voluntarily waive the patient copayment for medical services provided from Aug. 2, 1990, until the termination of Operation Desert Shield/Desert Storm for dependents of active duty personnel, provided that the Government’s share of medical services was not increased during such time period.

Similar provisions were contained in Puspan. L. 102–28, § 105, Apr. 10, 1991, 105 Stat. 165.

Puspan. L. 102–25, title III, § 312, Apr. 6, 1991, 105 Stat. 85, provided that the annual deductibles specified in subsec. (span) of this section, as in effect on Nov. 4, 1990, would apply until Oct. 1, 1991, in the case of health care provided under that section to the dependents of a member of the uniformed services who had served on active duty in the Persian Gulf theater of operations in connection with Operation Desert Storm, and that patient copayment requirements could be waived upon the provider’s certification to the Secretary of Defense that the amount charged the Federal Government for such health care had not been increased above the amount that the provider would have charged the Federal Government for such health care had the payment not been waived.

Transitional Health Care for Members, or Dependents of Members, Upon Release of Member From Active Duty in Connection With Operation Desert Storm

For provision authorizing transitional health care, including health benefits contracted for under subsec. (a) of this section, for members, or dependents of members, upon release of member from active duty in connection with Operation Desert Storm, see section 313 of Puspan. L. 102–25, set out as a note under section 1076 of this title.