Fiscal Year 1999 National Defense Authorization
Act
As a Member of the Senate Armed Services Committee, I have been very active
in writing this crucial piece of legislation that will help to set the
policies and procedures affecting both active Armed Forces personnel and
the nation's veterans.
Chemical Weapons Preparedness
The Persian Gulf War signaled the start of a new era of chemical warfare,
one for which we are ill-prepared. We should have realized from that
experience that our knowledge of chemical warfare agents and our ability
to respond to the threat that they pose to our men and women in the Armed
Services is critically limited. There is a huge gap in Defense policy
and doctrine with respect to addressing the exposure of our veterans to
chemical agents.
My amendment directs the Defense Secretary to develop a research program
-- with a five-year funding plan -- to provide answers that will help to
fill in current gaps in DOD doctrine and policy. The amendment,
which requires a progress report to the Armed Services Committee, calls
for the Secretary to focus on improving detection and protection against,
monitoring, reporting, and retaining records of low level chemical exposures.
Strengthening Health Benefits
Reform of the Military Pharmacy System.
In an effort to ensure that military beneficiaries have access to a comprehensive
pharmacy benefit, the Fiscal Year 1999 Department of Defense Authorization
included a provision to direct the Secretary of Defense to submit a plan
to Congress by March 1, 1999, for a system-wide redesign of the military
pharmacy system. This plan must incorporate private sector pharmacy
"best practices" and assume that all military beneficiaries, including
those eligible for Medicare, are provided with a universal, uniform pharmacy
benefit.
Health Care Services for Military Retirees.
To address growing concerns about the availability of military health care
services for Medicare-eligible military retirees and their families, the
Authorization Bill included a number of provisions designed to evaluate
different options for improving their health care coverage:
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Federal Employees Health Benefits Program (FEHBP). The legislation
establishes a three-year demonstration program to allow Medicare-eligible
retirees and their families to enroll in FEHBP beginning January 1, 2000.
This demonstration will allow up to 66,000 eligible beneficiaries in six
to ten areas around the country to participate in FEHBP under the same
cost-sharing arrangements as other federal employees;
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TRICARE Senior Supplement Demonstration. The bill includes
a provision to test the feasibility of providing TRICARE coverage as a
supplement to Medicare for eligible retirees and their families.
The TRICARE Senior Supplement demonstration program will be similar in
function to a commercial Medicare supplemental insurance policy, and eligible
beneficiaries will have to pay a modest premium to participate in it.
This demonstration program will be conducted at two separate locations
beginning no later than January 1, 2000; and
-
Pharmacy Benefits. The legislation requires the Secretary
of Defense to implement a redesigned pharmacy benefit, as developed under
the pharmacy reform plan directed elsewhere in the bill, to eligible individuals
in two separate areas by October 1, 1999. Under this program, participants
will have access to the entire military and TRICARE pharmacy program, including
the mail-order and retail pharmacy benefits.
Health Care Access Standards.
In light of numerous reports that TRICARE standards for access to primary
care services are not being met in many areas of the country, the Authorization
Bill requires the Secretary of Defense to establish a system to measure
the performance of Military Treatment Facilities (MTFs) and TRICARE contractors
in meeting the standards for timely access to care.
Retiree Dental Program Improvements.
Under current law, dependents of military retirees may enroll in the retiree
dental program only if the retired member also enrolls. Since many
retirees receive dental care through Department of Veterans Affairs programs
or employer-sponsored dental plans, or have medical or dental conditions
that may preclude their use of the dental program, they are forced to enroll
in the military retiree dental program just to ensure coverage for their
dependents. To remedy this situation, the Authorization Bill includes
a provision to allow the dependents of such military retirees to independently
enroll in the retiree dental program.
Claims Processing Reforms.
DOD procedures for settling health services claims occasionally results
in military beneficiaries being subjected to collection actions because
of a cumbersome TRICARE claims processing requirement. In an effort
to protect military beneficiaries from misguided collection actions, the
conferees included a provision to authorize the Secretary of Defense to
require TRICARE contractors to pay all provider claims in a timely manner
and then to seek recovery from third parties who may be liable.
Enrollment-Based Capitation Funding.
Due to concerns about the potential adverse impact of DOD's recently announced
initiative to impose a strict managed-care financing mechanism on MTFs
(known as enrollment-based capitation), the conferees included a provision
to require the Secretary of Defense to report to Congress by March 1, 1999,
on how this funding mechanism will work. Specifically, the report
must explain how enrollment-based capitation will affect the availability
of medical care in military facilities for military beneficiaries not enrolled
in TRICARE Prime, its potential impact on the MTF pharmacy benefit, and
what plans DOD has to ensure the provision of adequate health care and
prescription drugs to non-enrolled military beneficiaries.
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