§ 1092. Studies and demonstration projects relating to delivery of health and medical care

§ 1092. Studies and demonstration projects relating to delivery of health and medical care

(a)

(1) The Secretary of Defense, in consultation with the other administering Secretaries, shall conduct studies and demonstration projects on the health care delivery system of the uniformed services with a view to improving the quality, efficiency, convenience, and cost effectiveness of providing health care services (including dental care services) under this title to members and former members and their dependents. Such studies and demonstration projects may include the following:

(A) Alternative methods of payment for health and medical care services.

(B) Cost-sharing by eligible beneficiaries.

(C) Methods of encouraging efficient and economical delivery of health and medical care services.

(D) Innovative approaches to delivery and financing of health and medical care services.

(E) Alternative approaches to reimbursement for the administrative charges of health care plans.

(F) Prepayment for medical care services provided to maintain the health of a defined population.

(2) The Secretary of Defense shall include in the studies conducted under paragraph (1) alternative programs for the provision of dental care to the spouses and dependents of members of the uniformed services who are on active duty, including a program under which dental care would be provided the spouses and dependents of such members under insurance or dental plan contracts. A demonstration project may not be conducted under this section that provides for the furnishing of dental care under an insurance or dental plan contract.

(3) The Secretary of Defense may include in the studies and demonstration projects conducted under paragraph (1) studies and demonstration projects to provide awards and incentives to members of the armed forces and covered beneficiaries who obtain health promotion and disease prevention health care services under the TRICARE program in accordance with terms and schedules prescribed by the Secretary. Such awards and incentives may include cash awards and, in the case of members of the armed forces, personnel incentives.

(4)

(A) The Secretary of Defense may, in consultation with the other administering Secretaries, include in the studies and demonstration projects conducted under paragraph (1) studies and demonstration projects to provide awards or incentives to individual health care professionals under the authority of such Secretaries, including members of the uniformed services, Federal civilian employees, and contractor personnel, to encourage and reward effective implementation of innovative health care programs designed to improve quality, cost-effectiveness, health promotion, medical readiness, and other priority objectives. Such awards and incentives may include cash awards and, in the case of members of the armed forces and Federal civilian employees, personnel incentives.

(B) Amounts available for the pay of members of the uniformed services shall be available for awards and incentives under this paragraph with respect to members of the uniformed services.

(5) The Secretary of Defense may include in the studies and demonstration projects conducted under paragraph (1) studies and demonstration projects to improve the medical and dental readiness of members of reserve components of the armed forces, including the provision of health care services to such members for which they are not otherwise entitled or eligible under this chapter.

(6) The Secretary of Defense may include in the studies and demonstration projects conducted under paragraph (1) studies and demonstration projects to improve the continuity of health care services for family members of mobilized members of the reserve components of the armed forces who are eligible for such services under this chapter, including payment of a stipend for continuation of employer-provided health coverage during extended periods of active duty.

(b) Subject to the availability of appropriations for that purpose, the Secretary of Defense may enter into contracts or transactions (other than contracts, cooperative agreements, and grants) with public or private agencies, institutions, and organizations to conduct studies and demonstration projects under subsection (a).

(c) The Secretary of Defense may obtain the advice and recommendations of such advisory committees as the Secretary considers appropriate. Each such committee consulted by the Secretary under this subsection shall evaluate the proposed study or demonstration project as to the soundness of the objectives of such study or demonstration project, the likelihood of obtaining productive results based on such study or demonstration project, the resources which were required to conduct such study or demonstration project, and the relationship of such study or demonstration project to other on­going or completed studies and demonstration projects.

(Added Pub. L. 98–94, title IX, § 933(a)(1), Sept. 24, 1983, 97 Stat. 650; amended Pub. L. 98–557, § 19(14), Oct. 30, 1984, 98 Stat. 2870; Pub. L. 105–261, div. A, title X, § 1031(a), Oct. 17, 1998, 112 Stat. 2123; Pub. L. 110–417, [div. A], title VII, § 715, Oct. 14, 2008, 122 Stat. 4505; Pub. L. 117–263, div. A, title VII, § 717(a), Dec. 23, 2022, 136 Stat. 2662.)

Editorial Notes

Amendments

2022—Subsec. (b). Pub. L. 117–263 inserted “or transactions (other than contracts, cooperative agreements, and grants)” after “contracts”.

2008—Subsec. (a)(3) to (6). Pub. L. 110–417 added pars. (3) to (6).

1998—Subsec. (a)(3). Pub. L. 105–261 struck out par. (3) which read as follows: “The Secretary of Defense shall submit to Congress from time to time written reports on the results of the studies and demonstration projects conducted under this subsection and shall include in such reports such recommendations for improving the health-care delivery systems of the uniformed services as the Secretary considers appropriate.”

1984—Subsec. (a)(1). Pub. L. 98–557 substituted reference to other administering Secretaries for reference to Secretary of Health and Human Services.

Statutory Notes and Related Subsidiaries

Effective Date

Pub. L. 98–94, title IX, § 933(b), Sept. 24, 1983, 97 Stat. 651, provided that: “Section 1092 of title 10, United States Code, as added by subsection (a), shall take effect on October 1, 1983.”

Pilot Program on Treatment of Members of the Armed Forces for Post-Traumatic Stress Disorder Related to Military Sexual Trauma

Pub. L. 115–232, div. A, title VII, § 702, Aug. 13, 2018, 132 Stat. 1804, provided that: “(a) In General.—The Secretary of Defense may carry out a pilot program to assess the feasibility and advisability of using intensive outpatient programs to treat members of the Armed Forces suffering from post-traumatic stress disorder resulting from military sexual trauma, including treatment for substance abuse, depression, and other issues related to such conditions. “(b) Discharge Through Partnerships.—The pilot program authorized by subsection (a) shall be carried out through partnerships with public, private, and non-profit health care organizations, universities, and institutions that—“(1) provide health care to members of the Armed Forces; “(2) provide evidence-based treatment for psychological and neurological conditions that are common among members of the Armed Forces, including post-traumatic stress disorder, traumatic brain injury, substance abuse, and depression; “(3) provide health care, support, and other benefits to family members of members of the Armed Forces; and “(4) provide health care under the TRICARE program (as that term is defined in section 1072 of title 10, United States Code). “(c) Program Activities.—Each organization or institution that participates in a partnership under the pilot program authorized by subsection (a) shall—“(1) carry out intensive outpatient programs of short duration to treat members of the Armed Forces suffering from post-traumatic stress disorder resulting from military sexual trauma, including treatment for substance abuse, depression, and other issues related to such conditions; “(2) use evidence-based and evidence-informed treatment strategies in carrying out such programs; “(3) share clinical and outreach best practices with other organizations and institutions participating in the pilot program; and “(4) annually assess outcomes for members of the Armed Forces individually and among the organizations and institutions participating in the pilot program with respect to the treatment of conditions described in paragraph (1). “(d) Evaluation Metrics.—Before commencement of the pilot program, the Secretary shall establish metrics to be used to evaluate the effectiveness of the pilot program and the activities under the pilot program. “(e) Reports.—“(1) Initial report.—Not later than 180 days after the date of the enactment of this Act [Aug. 13, 2018], the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report on the pilot program authorized by subsection (a). The report shall include a description of the pilot program and such other matters on the pilot program as the Secretary considers appropriate. “(2) Final report.—Not later than 180 days after the cessation of the pilot program under subsection (f), the Secretary shall submit to the committees of Congress referred to in paragraph (1) a report on the pilot program. The report shall include the following:“(A) A description of the pilot program, including the partnerships under the pilot program as described in subsection (b). “(B) An assessment of the effectiveness of the pilot program and the activities under the pilot program. “(C) Such recommendations for legislative or administrative action as the Secretary considers appropriate in light of the pilot program, including recommendations for extension or making permanent the authority for the pilot program. “(f) Termination.—The Secretary may not carry out the pilot program authorized by subsection (a) after the date that is three years after the date of the enactment of this Act [Aug. 13, 2018].”

Pilot Program on Expansion of Use of Physician Assistants To Provide Mental Health Care to Members of the Armed Forces

Pub. L. 114–328, div. A, title VII, § 742, Dec. 23, 2016, 130 Stat. 2237, provided that: “(a) In General.—The Secretary of Defense may conduct a pilot program to assess the feasibility and advisability of expanding the use by the Department of Defense of physician assistants specializing in psychiatric medicine at medical facilities of the Department of Defense in order to meet the increasing demand for mental health care providers at such facilities through the use of a psychiatry fellowship program for physician assistants. “(b) Report on Pilot Program.—“(1) In general.—If the Secretary conducts the pilot program under this section, not later than 90 days after the date on which the Secretary completes the conduct of the pilot program, the Secretary shall submit to the Committees on Armed Services of the Senate and the House of Representatives a report on the pilot program. “(2) Elements.—The report submitted under paragraph (1) shall include the following:“(A) A description of the implementation of the pilot program, including a detailed description of the education and training provided under the pilot program. “(B) An assessment of potential cost savings, if any, to the Department of Defense resulting from the pilot program. “(C) A description of improvements, if any, to the access of members of the Armed Forces to mental health care resulting from the pilot program. “(D) A recommendation as to the feasibility and advisability of extending or expanding the pilot program.”

Pilot Program on Display of Wait Times at Urgent Care Clinics and Pharmacies of Military Medical Treatment Facilities

Pub. L. 114–328, div. A, title VII, § 744, Dec. 23, 2016, 130 Stat. 2239, as amended by Pub. L. 115–91, div. A, title VII, § 717, Dec. 12, 2017, 131 Stat. 1439, provided that: “(a) Pilot Program Authorized.—Beginning not later than one year after the date of the enactment of this Act [Dec. 23, 2016], the Secretary of Defense shall carry out a pilot program for the display of wait times in urgent care clinics and pharmacies of military medical treatment facilities selected under subsection (b). “(b) Selection of Facilities.—“(1) Categories.—The Secretary shall select not fewer than four military medical treatment facilities from each of the following categories to participate in the pilot program:“(A) Medical centers. “(B) Hospitals. “(C) Ambulatory care centers. “(2) OCONUS locations.—Of the military medical treatment facilities selected under each category described in subparagraphs (A) through (C) of paragraph (1), not fewer than one shall be located outside of the continental United States. “(3) Contractor-operated facilities.—The Secretary may select Government-owned, contractor-operated facilities among those military medical treatment facilities selected under paragraph (1). “(c) Urgent Care Clinics.—“(1) Placement.—With respect to each military medical treatment facility participating in the pilot program with an urgent care clinic, the Secretary shall place in a conspicuous location at the urgent care clinic an electronic sign that displays the current average wait time determined under paragraph (2) for a patient to be seen by a qualified medical professional. “(2) Determination.—In carrying out paragraph (1), the Secretary shall determine the average wait time to display under such paragraph by using a formula derived from best practices in the health care industry. “(d) Pharmacies.—“(1) Placement.—With respect to each military medical treatment facility participating in the pilot program with a pharmacy, the Secretary shall place in a conspicuous location at the pharmacy an electronic sign that displays the current average wait time to receive a filled prescription for a pharmaceutical agent. “(2) Determination.—In carrying out paragraph (1), the Secretary shall determine the average wait time to display under such paragraph by using a formula derived from best practices in the health care industry. “(e) Duration.—The Secretary shall carry out the pilot program for a period that is not more than two years. “(f) Report.—“(1) Submission.—Not later than 90 days after the completion of the pilot program, the Secretary shall submit to the Committees on Armed Services of the House of Representatives and the Senate a report on the pilot program. “(2) Elements.—The report under paragraph (1) shall include—“(A) the costs for displaying the wait times under subsections (c) and (d); “(B) any changes in patient satisfaction; “(C) any changes in patient behavior with respect to using urgent care and pharmacy services; “(D) any changes in pharmacy operations and productivity; “(E) a cost-benefit analysis of posting such wait times; and “(F) the feasibility of expanding the posting of wait times in emergency departments in military medical treatment facilities. “(g) Qualified Medical Professional Defined.—In this section, the term ‘qualified medical professional’ means a doctor of medicine, a doctor of osteopathy, a physician assistant, or an advanced registered nurse practitioner.”

Pilot Program on Incentive Programs To Improve Health Care Provided Under the TRICARE Program