10 USC 1079b – Procedures for charging fees for care provided to civilians; retention and use of fees collected
(a)
Terms Used In 10 USC 1079b
- Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
(b)
(c)
(B) Except with respect to the copays, coinsurance, deductibles, and nominal fees specified in subparagraph (A)—
(i) the Secretary of Defense may bill only the covered payer for care provided to a civilian described in subparagraph (A); and
(ii) payment received by the Secretary from the covered payer of a civilian for care provided under this section that is provided to the civilian shall be considered payment in full for such care.
(2) If a civilian specified in subsection (a) does not meet the criteria under paragraph (1), is underinsured, or has a remaining balance and is at risk of financial harm, the Director of the Defense Health Agency shall reduce each fee that would otherwise be charged to the civilian under this section according to a sliding fee discount program, as prescribed by the Director of the Defense Health Agency.
(3) If a civilian specified in subsection (a) does not meet the criteria under paragraph (1) or (2), the Director of the Defense Health Agency shall implement an additional catastrophic waiver to prevent severe financial harm.
(4) The modified payment plan under this subsection may not be administered by a Federal agency other than the Department of Defense.
(d)
(1) trauma consortium activities;
(2) administrative, operating, and equipment costs; and
(3) readiness training.
(e)
(1) The term “covered payer” means a third-party payer or other insurance, medical service, or health plan.
(2) The terms “third-party payer” and “insurance, medical service, or health plan” have the meaning given those terms in section 1095(h) of this title.