Page:United States Statutes at Large Volume 105 Part 2.djvu/450

 105 STAT. 1402 PUBLIC LAW 102-190—DEC. 5, 1991 10 USC 1086 note. Contracts. lieu thereof "Section 10790") of this title shall apply to a plan contracted for under this section, except that". (2) Section 1713(d) of title 38, United States Code, is amended by striking out "the second sentence of section 1086(c)" and inserting in lieu thereof "section 1086(d)(l)". (c) APPLICATION OF AMENDMENTS.— Subsection (d) of section 1086 of title 10, United States Code, as amended by this section, shall apply with respect to health care benefits or services received by a person described in such subsection on or after the date of enactment of this Act. PART B—HEALTH CARE MANAGEMENT SEC. 711. MODIFICATION OF AREA RESTRICTION ON PROVISION OF NONEMERGENCY INPATIENT HOSPITAL CARE UNDER CHAMPUS. Section 1079(a)(7) of title 10, United States Code, is amended by striking out "except that" and all that follows through the semicolon and inserting in lieu thereof the following: "except that— "(A) those services may be provided in any case in which another insurance plan or program provides primary coverage for those services; and "(B) the Secretary of Defense may WEiive the 40-mile radius restriction with regard to the provision of a particular service before October 1, 1993, if the Secretary determines that the use of a different geographical area restriction will result in a more cost-effective provision of the service;". SEC. 712. MANAGED HEALTH CARE NETWORKS. (a) AUTHORIZATION OF SUCH NETWORKS.— Section 1079 of title 10, United States Code, is amended by adding at the end the following new subsection: "(n) The Secretary of Defense may enter into contracts (or amend existing contracts) with fiscal intermediaries under which the intermediaries agree to organize and operate, directly or through subcontractors, managed health care networks for the provision of health care under this chapter. The managed health care networks shall include cost containment methods, such as utilization review and contracting for care on a discounted basis.". (b) DEUVERY OF HEALTH CARE SERVICES IN THE TIDEWATER REGION OF VIRGINIA. — (1) Using the authority provided in section 1092 of title 10, United States Code, and section 1079(n) of that title (as added by subsection (a)), the Secretary of Defense shall undertake a program to provide for the delivery of health care services to members of the Armed Forces serving on active duty and covered beneficiaries under chapter 55 of that title in the Tidewater region of Virginia. Such program shall— (A) incorporate the primary features of managed health care with cost containment initiatives, including utilization review, preadmission screening, establishment of provider networks, and contracting for care with civilian providers on a discounted basis; and (B) shall be based on the catchment area mangigement demonstratipn projects required by section 731(a) of the National Defense Authorization Act for Fiscal Years 1988 and 1989 (Public Law 100-180; 101 Stat. 1117). (2) The Secretary of Defense shall ensure that—

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