Title 10 — Armed Forces
Part II · Chapter 55 — Medical and Dental Care
§ 1096. Military-civilian health services partnership program; medical surge program
Statutory text
Resources Sharing Agreements.—
The Secretary of Defense may enter into an agreement providing for the sharing of resources between facilities of the uniformed services and facilities of a civilian health care provider or providers that the Secretary contracts with under section 1079, 1086, or 1097 of this title if the Secretary determines that such an agreement would result in the delivery of health care to which covered beneficiaries are entitled under this chapter in a more effective, efficient, or economical manner.
Eligible Resources.—
An agreement entered into under subsection (a) may provide for the sharing of—
personnel (including support personnel);
equipment;
supplies; and
any other items or facilities necessary for the provision of health care services.
Computation of Charges.—
A covered beneficiary who is a dependent, with respect to care provided to such beneficiary in facilities of the uniformed services under a sharing agreement entered into under subsection (a), shall pay the charges prescribed by section 1078 of this title.
Reimbursement for License Fees.—
In any case in which it is necessary for a member of the uniformed services to pay a professional license fee imposed by a government in order to provide health care services at a facility of a civilian health care provider pursuant to an agreement entered into under subsection (a), the Secretary of Defense may reimburse the member for up to $500 of the amount of the license fee paid by the member.
Medical Surge Program.—
The Secretary of Defense, in collaboration with the Secretary of Health and Human Services, shall carry out a program of record known as the Military-Civilian Medical Surge Program to—
support locations that the Secretary of Defense selects under paragraph (3)(B); and
enhance the interoperability and medical surge capability and capacity of the National Disaster Medical System in response to a declaration or other action described in subparagraphs (A) through (F) of paragraph (4).
The Secretary of Defense, acting through the Institute 1 for Defense Health Cooperation at the Uniformed Services University of the Health Sciences (or such successor center), shall oversee the management, staffing, and deployment of the Program, in coordination with the Chairman of the Joint Chiefs of Staff, the Director of the Defense Health Agency, and, for purposes of ensuring that the Program is carried out in a manner that is consistent with paragraph (6), the Secretary of Health and Human Services.
In carrying out subparagraph (A) during a contingency operation, the Secretary of Defense shall ensure that the Program provides support, acting through the Defense Health Agency serving as a combat support agency, to the relevant combatant command.
The Secretary of Defense shall ensure the program is administrated in coordination with the military departments, the Joint Staff, the Defense Health Agency, and the Department of Health and Human Services through semiannual coordination meetings and quarterly updates. On an annual basis, one such meeting shall include the participation of partners specified in paragraph (3)(A).
In carrying out the Program, the Secretary of Defense shall maintain requirements for staffing, specialized training, research, and education, regarding patient regulation, movement, definitive care, and other matters the Secretary determines critical to sustaining the health of members of the armed forces.
In carrying out the Program, the Secretary of Defense shall establish partnerships at locations selected under subparagraph (B) with public, private, and nonprofit health care organizations, health care institutions, health care entities, academic medical centers of institutions of higher education, and hospitals that the Secretary and the Secretary of Health and Human Services determine—
are critical in mobilizing a civilian medical response in support of a wartime contingency or other catastrophic event in the United States; and
have demonstrated technical proficiency in critical national security domains, including high-consequence infectious disease and special pathogen preparedness, and matters relating to defense, containment, management, care, and transportation.
The Secretary of Defense shall select not fewer than eight locations that are operationally relevant to the missions of the Department of Defense under the National Disaster Medical System and are aeromedical or other transport hubs or logistics centers in the United States for partnerships under subparagraph (A). The Secretary may select more than eight locations, including locations outside of the continental United States, if the Secretary determines such additional locations cover areas of strategic and operational relevance to the Department.
The Secretary of Defense and the Secretary of Health and Human Services shall ensure that the partnerships under paragraph (3)(A) allow for civilian medical personnel to quickly and effectively mobilize direct support to military medical treatment facilities and provide support to other requirements of the military health system pursuant to the following:
A declaration of a national emergency under the National Emergencies Act (50 U.S.C. 1621 2 et seq.).
A public health emergency declared under section 319 of the Public Health Service Act (42 U.S.C. 247d).
A declaration of war by Congress.
A contingency operation.
The President’s exercise of executive powers under the War Powers Resolution (50 U.S.C. 1541 et seq.).
Any other emergency or major disaster as declared by the President.
Not later than 180 days after the date of the enactment of the National Defense Authorization Act for Fiscal Year 2026, and annually thereafter, the Secretary of Defense shall submit to the Committee on Armed Services and the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Armed Services and the Committee on Energy and Commerce of the House of Representatives a report on the status, readiness, and operational capabilities of the Program. Each report shall include an assessment of personnel readiness, resource availability, interagency coordination efforts, and recommendations for continued improvements to the Program.
Nothing in this section shall be construed to authorize the Secretary of Defense to control, direct, limit, or otherwise affect the authorities of the Secretary of Health and Human Services with respect to the leadership and administration of the National Disaster Medical System, public health and medical preparedness and response, staffing levels, or resource allocation.
In this subsection:
The term “institution of higher education” means a four-year institution of higher education (as defined in section 101(a) of the Higher Education Act of 1965 (20 U.S.C. 1001(a))).
The term “National Disaster Medical System” means the system established under section 2812 of the Public Health Service Act (42 U.S.C. 300hh–11).
The term “Program” means the Military-Civilian Medical Surge Program established under paragraph (1).
Footnotes
Legislative history
Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.
Department of Defense Authorization Act, 1987
Pub. L. 99–661 div. A title VII § 701(a)(1) · 100 Stat. 3816
Enacted · 10 U.S.C. § 1096
Added Pub. L. 99–661, div. A, title VII, § 701(a)(1), Nov. 14, 1986, 100 Stat. 3894
Source evidence
Code source credit
Added Pub. L. 99–661, div. A, title VII, § 701(a)(1), Nov. 14, 1986, 100 Stat. 3894Enacted provision · exact public law section
(1) Chapter 55 of title 10, United States Code, is amended by adding at the end the following new sections: “§ 1096. Military-civilian health services partnership program “(a) Resources Sharing Agreements.— The Secretary of Defense may enter into an agreement providing for the sharing of resources between facilities of the uniformed services and facilities of a civilian health care provider or providers that the Secretary contracts 10 USC 1079, 1086, 1097. with under section 1079, 1086, or 1097 of this title if the Secretary determines that such an agreement would result in the delivery of health care to which covered beneficiaries are entitled under this chapter in a more effective, efficient, or economical manner. “(b) Eligible Resources.— An agreement entered into under subsection (a) may provide for the sharing of— “(1) personnel (including support personnel); “(2) equipment; “(3) supplies; and “(4) any other items or facilities necessary for the provision of health care services. “(c) Computation of Charges.— A covered beneficiary, with respect to care provided to such beneficiary in facilities of the uniformed services under a sharing agreement entered into under subsection (a), shall pay— “(1) in the case of a dependent, the charges prescribed by section 1078 of this title; and 10 USC 1078. “(2) in the case of a member or former member entitled to retired or retainer pay, the charges prescribed by section 1075 of this title. 10 USC 1075. “§ 1097. Contracts for medical care for retirees, dependents, and survivors: alternative delivery of health care “(a) In General.— The Secretary of Defense, after consulting with the other administering Secretaries, may contract for the delivery of health care to which covered beneficiaries are entitled under this chapter. The Secretary may enter into a contract under this section with any of the following: “(1) Health maintenance organizations. “(2) Preferred provider organizations. “(3) Individual providers, individual medical facilities, or insurers. “(4) Consortiums of such providers, facilities, or insurers. “(b) Scope of Coverage Under Health Care Plans.— A contract entered into under this section may provide for the delivery of— “(1) selected health care services; “(2) total health care services for selected covered beneficiaries; or “(3) total health care services for all covered beneficiaries who reside in a geographical area designated by the Secretary. “(c) Charges for Health Care.— The Secretary of Defense may prescribe by regulation a premium, deductible, copayment, or other charge for health care provided under this section. “§ 1098. Incentives for participation in cost-effective health care plans “(a) Waiver of Limitations and Copayments.— Subject to subsections Contracts. (b) and (c), the Secretary of Defense, with respect to any plan contracted for under the authority of section 1079 or 1086 of this title, may waive, in whole or in part— 10 USC 1079, 1086. “(1) any limitation set out in the second sentence of section 1079(a) of this title; or “(2) any requirement for payment by the patient under section 1079(b) or 1086(b) of this title. “(b) Determination and Report.— (1) Subject to paragraph (3), the Secretary may waive a limitation or requirement as authorized by subsection (a) if the Secretary determines that during the period of the waiver such a plan will— “(A) be less costly to the Government than a plan subject to such limitations or payment requirements; or “(B) provide better services than those provided by a plan subject to such limitations or payment requirements at no additional cost to the Government. “(2) The Secretary shall submit to the Committees on Armed Reports. Services of the Senate and House of Representatives a report with respect to a waiver under paragraph (1), including a comparison of costs of and benefits available under— “(A) a plan with respect to which the limitations and payment requirements are waived; and “(B) a plan with respect to which there is no such waiver “(3) A waiver under paragraph (1) may not take effect until the end of the 180-day period beginning on the date on which the Secretary submits the report required by paragraph (2) with respect to such waiver. “§ 1099. Health care enrollment system “(a) Establishment of System.— The Secretary of Defense, after consultation with the other administering Secretaries, shall establish a system of health care enrollment for covered beneficiaries who reside in the United States. “(b) Description of System.— Such system shall— “(1) allow covered beneficiaries to elect a health care plan from eligible health care plans designated by the Secretary of Defense; or “(2) if necessary in order to ensure full use of facilities of the uniformed services in a geographical area, assign covered beneficiaries who reside in such area to such facilities. “(c) Health Care Plans Available Under System.— A health care plan designated by the Secretary of Defense under the system described in subsection (a) shall provide all health care to which a covered beneficiary is entitled under this chapter. Such a plan may consist of any of the following: “(1) Use of facilities of the uniformed services. “(2) The Civilian Health and Medical Program of the Uniformed Services. “(3) Contracts. Any other health care plan contracted for by the Secretary of Defense. “(4) Any combination of the plans described in paragraphs (1), (2), and (3). “(d) Regulations.— The Secretary of Defense, after consultation with the other administering Secretaries, shall prescribe regulations to carry out this section. “§ 1100. Military Health Care Account “(a) Establishment of Account.— (1) There is hereby established in the Department of Defense an account to be known as the ‘Military Health Care Account’. All sums appropriated to carry out the functions of the Secretary of Defense with respect to the Civilian Health and Medical Program of the Uniformed Services shall be appropriated to the account. “(2) Amounts appropriated to the account shall remain available until obligated or expended under subsection (b) or (c). “(b) Contracts. Obligation of Amounts From Account by Secretary of Defense.— The Secretary of Defense may obligate or expend funds from the account for purposes of entering into a contract under 10 USC 1079, 1086, 1092; ante, p. 3895. section 1079, 1086, 1092, or 1097 of this title to the extent amounts are available in the account. “(c) Allocation of Amounts in Account for Provision of Medical Care by Service Secretaries.— (1) The Secretary of a military department shall, before the beginning of a fiscal year quarter, provide to the Secretary of Defense an estimate of the amounts necessary to pay for charges for benefits under the program for covered beneficiaries under the jurisdiction of the Secretary for that quarter. “(2) The Secretary of Defense shall, subject to amounts provided in advance in appropriation Acts, make available to each Secretary of a military department the amount from the account that the Secretary of Defense determines is necessary to pay for charges for benefits under the program for covered beneficiaries under the jurisdiction of such Secretary for that quarter. “(d) Expenditure of Amounts From Account by Service Secretaries.— The Secretary of a military department shall provide medical and dental care to covered beneficiaries under the jurisdiction of the Secretary for a fiscal year quarter from amounts appropriated to the Secretary and from amounts from the account made available for that quarter to the Secretary by the Secretary of Defense. If the Secretary of a military department exhausts the amounts from the account made available to the Secretary for a fiscal year quarter, the Secretary shall transfer to the account from amounts appropriated to the Secretary an amount sufficient to provide medical and dental care to covered beneficiaries under the jurisdiction of the Secretary for the remainder of the fiscal year quarter. “(e) Regulations.— The Secretary of Defense shall prescribe regulations to carry out this section. “(f) Definitions.— In this section: “(1) The term ‘account’ means the Military Health Care Account established in subsection (a). “(2) The term ‘program’ means the Civilian Health and Medical Program of the Uniformed Services. “§ 1101. Diagnosis-related groups “(a) Establishment of DRGs.— The Secretary of Defense, after consultation with the other administering Secretaries, shall establish by regulation the use of diagnosis-related groups as the primary criteria for allocation of resources to facilities of the uniformed services. “(b) Exception for Mobilization Missions.— Diagnosis-related groups shall not be used to allocate resources to the facilities of the uniformed services to the extent that such resources are required by such facilities for mobilization missions. “(c) Content of Regulations.— (1) Such regulations shall establish a system of diagnosis-related groups similar to the system established under section 1886(d)(4) of the Social Security Act (42 U.S.C. 1395ww(d)(4)). Such regulations shall include the following: “(1) A classification of inpatient treatments by diagnosis-related groups and a similar classification of outpatient treatment. “(2) A methodology for classifying specific treatments within such groups. “(3) An appropriate weighting factor for each such diagnosis-related group which reflects the relative resources used by a facility of a uniformed service with respect to treatments classified within that group compared to treatments classified within other groups.”.National Defense Authorization Act for Fiscal Year 1995
Pub. L. 103–337 div. A title VII § 712 · 108 Stat. 2663
Added · 10 U.S.C. § 1096(d)
Pub. L. 103–337 added subsec. (d)
Source evidence
Code amendment note
Subsec. (d). Pub. L. 103–337 added subsec. (d).Enacted provision · exact public law section
SEC. 712. AUTHORITY FOR REIMBURSEMENT OF PROFESSIONAL LICENSE FEES UNDER RESOURCE SHARING AGREEMENTS. Section 1096 of title 10, United States Code, is amended by adding at the end the following: “(d) Reimbursement for License Fees.— In any case in which it is necessary for a member of the uniformed services to pay a professional license fee imposed by a government in order to provide health care services at a facility of a civilian health care provider pursuant to an agreement entered into under subsection (a), the Secretary of Defense may reimburse the member for up to $500 of the amount of the license fee paid by the member.”.Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005
Pub. L. 108–375 div. A title VI § 607(b) · 118 Stat. 1811
Inserted · 10 U.S.C. § 1096(c)
Pub. L. 108–375 inserted “who is a dependent” after “covered beneficiary”
Substituted · 10 U.S.C. § 1096(c)
Pub. L. 108–375 substituted “shall pay the charges prescribed by section 1078 of this title.” for “shall pay—
Source evidence
Code amendment note
Subsec. (c). Pub. L. 108–375 inserted “who is a dependent” after “covered beneficiary” and substituted “shall pay the charges prescribed by section 1078 of this title.” for “shall pay—“(1) in the case of a dependent, the charges prescribed by section 1078 of this title; and “(2) in the case of a member or former member entitled to retired or retainer pay, the charges prescribed by section 1075 of this title.”
Enacted provision · exact public law section
(b) Conforming Amendment Regarding Military-Civilian Health Services Partnership Program.— Section 1096(c) of such title is amended— (1) by inserting “who is a dependent” after “covered beneficiary”; and (2) by striking “shall pay” and all that follows through the period at the end of paragraph (2) and inserting “shall pay the charges prescribed by section 1078 of this title.”.Pub. L. 119–60 § 712(1) · 139 Stat. 919
Inserted · 10 U.S.C. § 1096
Pub. L. 119–60, § 712(1), inserted “; medical surge program” after “program” in section catchline
Unresolved: Pub. L. 119–60 was not found in the local Statutes at Large index.
Source evidence
Code amendment note
Pub. L. 119–60, § 712(1), inserted “; medical surge program” after “program” in section catchline.Pub. L. 119–60 § 712(2) · 139 Stat. 919
Added · 10 U.S.C. § 1096(e)
Pub. L. 119–60, § 712(2), added subsec. (e)
Unresolved: Pub. L. 119–60 was not found in the local Statutes at Large index.
Source evidence
Code amendment note
Subsec. (e). Pub. L. 119–60, § 712(2), added subsec. (e).
4 of 6 references resolved to an enrolled provision · 2 unresolved
Editorial Notes
References in Text
The National Emergencies Act, referred to in subsec. (e)(4)(A), is Pub. L. 94–412, , 90 Stat. 1255, which is classified principally to chapter 34 (§ 1601 et seq.) of Title 50, War and National Defense. For complete classification of this Act to the Code, see Short Title note set out under section 1601 of Title 50 and Tables.
The War Powers Resolution, referred to in subsec. (e)(4)(E), is Pub. L. 93–148, , 87 Stat. 555, which is classified generally to chapter 33 (§ 1541 et seq.) of Title 50, War and National Defense. For complete classification of this Resolution to the Code, see Short Title note set out under section 1541 of Title 50 and Tables.
The date of the enactment of the National Defense Authorization Act for Fiscal Year 2026, referred to in subsec. (e)(5), is the date of enactment of Pub. L. 119–60, which was approved .
Amendments1994–2025 · 3 rounds
2025
Pub. L. 119–60, § 712(1), inserted “; medical surge program” after “program” in section catchline.
Subsec. (e). Pub. L. 119–60, § 712(2), added subsec. (e).
2004
Subsec. (c). Pub. L. 108–375 inserted “who is a dependent” after “covered beneficiary” and substituted “shall pay the charges prescribed by section 1078 of this title.” for “shall pay—
“(1) in the case of a dependent, the charges prescribed by section 1078 of this title; and
“(2) in the case of a member or former member entitled to retired or retainer pay, the charges prescribed by section 1075 of this title.”
1994
Subsec. (d). Pub. L. 103–337 added subsec. (d).
Statutory Notes and Related Subsidiaries
Development and Update of Certain Policies Relating to Military Health System and Integrated Medical Operations
Pub. L. 117–81, div. A, title VII, § 724, , 135 Stat. 1793, provided that:
“(a) In General.—
By not later than , the Secretary of Defense, in coordination with the Secretaries of the military departments and the Chairman of the Joint Chiefs of Staff, shall develop and update certain policies relating to the military health system and integrated medical operations of the Department of Defense as follows:
“(1) Updated plan on integrated medical operations in continental united states.—
The Secretary of Defense shall develop an updated plan on integrated medical operations in the continental United States and update the Department of Defense Instruction 6010.22, titled ‘National Disaster Medical System (NDMS)’ (or such successor instruction) accordingly. Such updated plan shall—
“(A) be informed by the operational plans of the combatant commands and by the joint medical estimate under section 732 of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Public Law 115–232; 132 Stat. 1817);
“(B) include an updated bed plan, to include bed space available through the military health system and through hospitals participating in the National Disaster Medical System established pursuant to section 2812 of the Public Health Service Act (42 U.S.C. 300hh–11);
“(C) include a determination as to whether combat casualties should receive medical care under the direct care or purchased care component of the military health system and a risk analysis in support of such determination;
“(D) identify the manning levels required to furnish medical care under the updated plan, including with respect to the levels of military personnel, civilian employees of the Department, and contractors of the Department; and
“(E) include a cost estimate for the furnishment of such medical care.
“(2) Updated plan on global patient movement.—
The Secretary of Defense shall develop an updated plan on global patient movement and update the Department of Defense Instruction 5154.06, relating to medical military treatment facilities and patient movement (or such successor instruction) accordingly. Such updated plan shall—
“(A) be informed by the operational plans of the combatant commands and by the joint medical estimate under section 732 of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 (Public Law 115–232; 132 Stat. 1817);
“(B) include a risk assessment with respect to patient movement compared against overall operational plans;
“(C) include a description of any capabilities-based assessment of the Department that informed the updated plan or that was in progress during the time period in which the updated plan was developed;
“(D) identify the manning levels, equipment and consumables, and funding levels, required to carry out the updated plan; and
“(E) address airlift capability, medical evacuation capability, and access to ports of embarkation.
“(3) Assessment of biosurveillance and medical research capabilities.—
The Secretary of Defense shall conduct an assessment of the biosurveillance and medical research capabilities of the Department of Defense. Such assessment shall include the following:
“(A) An identification of the location and strategic value of the overseas medical laboratories and overseas medical research programs of the Department.
“(B) An assessment of the current capabilities of such laboratories and programs with respect to force health protection and evidence-based medical research.
“(C) A determination as to whether such laboratories and programs have the capabilities, including as a result of the geographic location of such laboratories and programs, to provide force health protection and evidence-based medical research, including by actively monitoring for future pandemics, infectious diseases, and other potential health threats to members of the Armed Forces.
“(D) The current biosurveillance and medical research capabilities of the Department.
“(E) The current manning levels of the biosurveillance and medical research entities of the Department, including an assessment of whether such entities are manned at a level necessary to support the missions of the combatant commands (including with respect to missions related to pandemic influenza or homeland defense).
“(F) The current funding levels of such entities, including a risk assessment as to whether such funding is sufficient to sustain the manning levels necessary to support missions as specified in subparagraph (E).
“(b) Interim Briefing.—
Not later than , the Secretary of Defense, in coordination with the Secretaries of the military departments and the Chairman of the Joint Chiefs of Staff, shall provide to the Committees on Armed Services of the House of Representatives and the Senate an interim briefing on the progress of implementation of the plans and assessment required under subsection (a).
“(c) Report.—
Not later than , the Secretary of Defense shall submit to the Committees on Armed Services of the House of Representatives and the Senate a report describing each updated plan and assessment required under subsection (a).”
Pilot Program on Civilian and Military Partnerships To Enhance Interoperability and Medical Surge Capability and Capacity of National Disaster Medical System
Pub. L. 116–92, div. A, title VII, § 740, , 133 Stat. 1465, as amended by Pub. L. 116–283, div. A, title VII, § 741, , 134 Stat. 3705, provided that:
“(a) In General.—
Beginning not later than , the Secretary of Defense shall carry out a pilot program to establish partnerships with public, private, and nonprofit health care organizations, health care institutions, health care entities, academic medical centers of institutions of higher education, and hospitals in collaboration with the Secretary of Veterans Affairs, the Secretary of Health and Human Services, the Secretary of Homeland Security, and the Secretary of Transportation to enhance the interoperability and medical surge capability and capacity of the National Disaster Medical System under section 2812 of the Public Health Service Act (42 U.S.C. 300hh–11).
“(b) Duration.—
The Secretary of Defense shall carry out the pilot program under subsection (a) for a period of not more than five years.
“(c) Lead Official for Design and Implementation of Pilot Program.—
“(1) In general.—
The Assistant Secretary of Defense for Health Affairs shall be the lead official for the design and implementation of the pilot program under subsection (a).
“(2) Resources.—
The Assistant Secretary of Defense for Health Affairs shall leverage the resources of the Defense Health Agency for execution of the pilot program under subsection (a) and shall coordinate with the Chairman of the Joint Chiefs of Staff for the duration of the pilot program, including for the duration of any period of design or planning for the pilot program.
“(d) Locations.—
“(1) In general.—
The Secretary of Defense shall carry out the pilot program under subsection (a) at not fewer than five locations in the United States that are located at or near an organization, institution, entity, center, or hospital specified in subsection (a) with established expertise in disaster health preparedness and response and trauma care that augment and enhance the effectiveness of the pilot program.
“(2) Phased selection of locations.—
“(A) Initial selection.—
Not later than , the Assistant Secretary of Defense for Health Affairs, in consultation with the Secretary of Veterans Affairs, the Secretary of Health and Human Services, the Secretary of Homeland Security, and the Secretary of Transportation, shall select not fewer than two locations at which to carry out the pilot program.
“(B) Subsequent selection.—
Not later than the end of the one-year period following selection of the locations under subparagraph (A), the Assistant Secretary of Defense for Health Affairs, in consultation with the Secretaries specified in subparagraph (A), shall select not fewer than two additional locations at which to carry out the pilot program until not fewer than five locations are selected in total under this paragraph.
“(3) Consideration for locations.—
In selecting locations for the pilot program under subsection (a), the Secretary shall consider—
“(A) the proximity of the location to civilian or military transportation hubs, including airports, railways, interstate highways, or ports;
“(B) the proximity of the location to an organization, institution, entity, center, or hospital specified in subsection (a) with the ability to accept a redistribution of casualties during times of war;
“(C) the proximity of the location to an organization, institution, entity, center, or hospital specified in subsection (a) with the ability to provide trauma care training opportunities for medical personnel of the Department of Defense; and
“(D) the proximity of the location to existing academic medical centers of institutions of higher education, facilities of the Department, or other institutions that have established expertise in the areas of—
“(i) highly infectious disease;
“(ii) biocontainment;
“(iii) quarantine;
“(iv) trauma care;
“(v) combat casualty care;
“(vi) the National Disaster Medical System under section 2812 of the Public Health Service Act (42 U.S.C. 300hh–11);
“(vii) disaster health preparedness and response;
“(viii) medical and public health management of biological, chemical, radiological, or nuclear hazards; or
“(ix) such other areas of expertise as the Secretary considers appropriate.
“(4) Priority for locations.—
In selecting locations for the pilot program under subsection (a), the Secretary shall give priority to locations that would facilitate public-private partnerships with academic medical centers of institutions of higher education, hospitals, and other entities with facilities that have an established history of providing clinical care, treatment, training, and research in the areas described in paragraph (3)(D) or other specializations determined important by the Secretary for purposes of the pilot program.
“(e) Requirements.—
In establishing partnerships under the pilot program under subsection (a), the Secretary, in collaboration with the Secretary of Veterans Affairs, the Secretary of Health and Human Services, the Secretary of Homeland Security, and the Secretary of Transportation, shall establish requirements under such partnerships for staffing, specialized training, medical logistics, telemedicine, patient regulating, movement, situational status reporting, tracking, and surveillance.
“(f) Evaluation Metrics.—
The Secretary of Defense shall establish metrics to evaluate the effectiveness of the pilot program under subsection (a).
“(g) Reports.—
“(1) Initial report.—
“(A) In general.—
Not later than 180 days after the commencement of the pilot program under subsection (a), the Secretary shall submit to the appropriate congressional committees a report on the pilot program.
“(B) Elements.—
The report under subparagraph (A) shall include the following:
“(i) A description of the pilot program.
“(ii) The requirements established under subsection (e).
“(iii) The evaluation metrics established under subsection (f).
“(iv) Such other matters relating to the pilot program as the Secretary considers appropriate.
“(2) Final report.—
Not later than 180 days after the completion of the pilot program under subsection (a), the Secretary shall submit to the appropriate congressional committees a report on the pilot program.
“(h) Definitions.—
In this section:
“(1) The term ‘appropriate congressional committees’ means—
“(A) The Committee on Armed Services, the Committee on Transportation and Infrastructure, the Committee on Veterans’ Affairs, the Committee on Homeland Security, and the Committee on Energy and Commerce of the House of Representatives.
“(B) The Committee on Armed Services, the Committee on Commerce, Science, and Transportation, the Committee on Veterans’ Affairs, the Committee on Homeland Security and Governmental Affairs, and the Committee on Health, Education, Labor, and Pensions of the Senate.
“(2) The term ‘institution of higher education’ means a four-year institution of higher education, as defined in section 101(a) of the Higher Education Act of 1965 (20 U.S.C. 1001(a)).”
Establishment of High Performance Military-Civilian Integrated Health Delivery Systems
Pub. L. 114–328, div. A, title VII, § 706, , 130 Stat. 2206, provided that:
“(a) In General.—
Not later than , the Secretary of Defense shall establish military-civilian integrated health delivery systems through partnerships with other health systems, including local or regional health systems in the private sector—
“(1) to improve access to health care for covered beneficiaries;
“(2) to enhance the experience of covered beneficiaries in receiving health care;
“(3) to improve health outcomes for covered beneficiaries;
“(4) to share resources between the Department of Defense and the private sector, including such staff, equipment, and training assets as may be required to carry out such integrated health delivery systems;
“(5) to maintain services within military treatment facilities that are essential for the maintenance of operational medical force readiness skills of health care providers of the Department; and
“(6) to provide members of the Armed Forces with additional training opportunities to maintain such readiness skills.
“(b) Elements of Systems.—
Each military-civilian integrated health delivery system established under subsection (a) shall—
“(1) deliver high quality health care as measured by leading national health quality measurement organizations;
“(2) achieve greater efficiency in the delivery of health care by identifying and implementing within each such system improvement opportunities that guide patients through the entire continuum of care, thereby reducing variations in the delivery of health care and preventing medical errors and duplication of medical services;
“(3) improve population-based health outcomes by using a team approach to deliver case management, prevention, and wellness services to high-need and high-cost patients;
“(4) focus on preventive care that emphasizes—
“(A) early detection and timely treatment of disease;
“(B) periodic health screenings; and
“(C) education regarding healthy lifestyle behaviors;
“(5) coordinate and integrate health care across the continuum of care, connecting all aspects of the health care received by the patient, including the patient’s health care team;
“(6) facilitate access to health care providers, including—
“(A) after-hours care;
“(B) urgent care; and
“(C) through telehealth appointments, when appropriate;
“(7) encourage patients to participate in making health care decisions;
“(8) use evidence-based treatment protocols that improve the consistency of health care and eliminate ineffective, wasteful health care practices; and
“(9) improve coordination of behavioral health services with primary health care.
“(c) Agreements.—
“(1) In general.—
In establishing military-civilian integrated health delivery systems through partnerships under subsection (a), the Secretary shall seek to enter into memoranda of understanding or contracts between military treatment facilities and health maintenance organizations, health care centers of excellence, public or private academic medical institutions, regional health organizations, integrated health systems, accountable care organizations, and such other health systems as the Secretary considers appropriate.
“(2) Private sector care.—
Memoranda of understanding and contracts entered into under paragraph (1) shall ensure that covered beneficiaries are eligible to enroll in and receive medical services under the private sector components of military-civilian integrated health delivery systems established under subsection (a).
“(3) Value-based reimbursement methodologies.—
The Secretary shall incorporate value-based reimbursement methodologies, such as capitated payments, bundled payments, or pay for performance, into memoranda of understanding and contracts entered into under paragraph (1) to reimburse entities for medical services provided to covered beneficiaries under such memoranda of understanding and contracts.
“(4) Quality of care.—
Each memorandum of understanding or contract entered into under paragraph (1) shall ensure that the quality of services received by covered beneficiaries through a military-civilian integrated health delivery system under such memorandum of understanding or contract is at least comparable to the quality of services received by covered beneficiaries from a military treatment facility.
“(d) Covered Beneficiary Defined.—
In this section, the term ‘covered beneficiary’ has the meaning given that term in section 1072 of title 10, United States Code.”