Page:United States Statutes at Large Volume 110 Part 1.djvu/403

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PUBLIC LAW 104-106—FEB. 10, 1996 110 STAT. 379 of the Uniformed Services Treatment Facilities, known as Option II, on a mandatory basis for all USTF Medicare-eligible beneficiaries and the potential cost savings to the Military Health Care Program that could be achieved under such option. "(B) The Secretary shall submit the plan developed under this paragraph to Congress not later than March 1, 1996. "(C) The plan developed under this paragraph shall be consistent with the requirements specified in paragraph (4). If the plan is not submitted to Congress by the expiration date of the participation agreements entered into under this section, the participation agreements shall remain in effect, at the option of the Uniformed Services Treatment Facilities, until the end of the 180-day period beginning on the date the plan is finally submitted. "(D) For purposes of this paragraph, the term 'USTF Medicare-eligible beneficiaries' means covered beneficiaries under chapter 55 of title 10, United States Code, who are enrolled in a managed health plan offered by the Uniformed Services Treatment Facilities and entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.).". SEC. 726. EQUITABLE IMPLEMENTATION OF UNIFORM COST SHARING 42 USC 248c REQUIREMENTS FOR UNIFORMED SERVICES TREAT- note. MENT FACILITIES. (a) TIME FOR FEE IMPLEMENTATION.— The uniform managed care benefit fee and copayment schedule developed by the Secretary of Defense for use in all managed care initiatives of the military health service system, including the managed care program of the Uniformed Services Treatment Facilities, shall be extended to the managed care program of a Uniformed Services Treatment Facility only after the later of— (1) the implementation of the TRICARE regional program covering the service area of the Uniformed Services Treatment Facility; or (2) October 1, 1996. (b) SUBMISSION OF ACTUARIAL ESTIMATES. —Paragraph (2) of subsection (a) shall operate as a condition on the extension of the uniform managed care benefit fee and copayment schedule to the Uniformed Services Treatment Facilities only if the Uniformed Services Treatment Facilities submit to the Comptroller General of the United States, within 30 days after the date of the enactment of this Act, actuarial estimates in support of their contention that the extension of such fees and copayments will have an adverse effect on the operation of the Uniformed Services Treatment Facilities and the enrollment of participants. (c) EVALUATION.—(1) Except as provided in paragraph (2), not later than 90 days after the date of the enactment of this Act, the Comptroller General shall submit to Congress the results of an evaluation of the effect on the Uniformed Services Treatment Facilities of the extension of the uniform benefit fee and copayment schedule to the Uniformed Services Treatment Facilities. The evaluation shall include an examination of whether the benefit fee and copayment schedule may— (A) cause adverse selection of enrollees; (B) be inappropriate for a fully at-risk program similar to civilian health maintenance organizations; or