,i #aadth ,,congress #b;d ,session ,h4 ,r4 #fjgf ,,in ,,the ,,house ,,of ,,representatives ,september #bj1 #bjaf,mr4 ,babin 7for himself1 ,ms4 ,edwards1 ,mr4 ,smith of ,texas1 ,ms4 ,eddie ,bernice ,johnson of ,texas1 ,mr4 ,posey1 ,mr4 ,bridenstine1 and ,mr4 ,abraham7 introduced the following bill2 which was referred to the ,committee on ,science1 ,space1 and ,technology ,a ,,bill ,to require the ,administrator of the ,national ,aeronautics and ,space ,administration to establish a program for the medical monitoring1 diagnosis1 and treatment of astronauts1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,to ,research1 ,evaluate1 ,assess1 and ,treat ,astronauts ,act or the ,,treat ,astronauts ,act4 #b4 ,definitions ,in this ,act3 7#a7 ,administrator ,the term ,administrator means the ,administrator of ,,nasa4 7#b7 ,crewmember ,the term crewmember means an individual certified by the ,administrator to be-- 7,a7 a former ,,nasa astronaut or payload specialist who has flown on at least one orbital space mission2 or 7,b7 a management ,,nasa astronaut who has flown on at least one orbital space mission and is currently employed by the ,federal ,government4 7#c7 ,,nasa ,the term ,,nasa means the ,national ,aeronautics and ,space ,administration4 7#d7 ,program ,the term ,program means the medical monitoring1 diagnosis1 and treatment program established under section #c4 7#e7 ,space flight-associated medical condition ,the term space flight-associated medical condition means-- 7,a7 for purposes of medical monitoring or diagnosis under the ,program1 a psychological or medical condition that the ,administrator determines is potentially associated with human space flight2 and 7,b7 for purposes of medical treatment under the ,program1 a psychological or medical condition that the ,administrator determines is associated with human space flight4 #c4 ,program for the medical monitoring1 diagnosis1 and treatment of astronauts 7a7 ,establishment of program ,the ,administrator shall1 subject to section #f and subsections 7a77#b7 and 7b77#c7 of section #d1 establish a program that satisfies the requirements described in subsection 7b7 to provide for the medical monitoring1 diagnosis1 and treatment of crewmembers for space flight-associated medical conditions4 7b7 ,program requirements ,the requirements described in this subsection are the following3 7#a7 ,no cost sharing ,medical monitoring1 diagnosis1 and treatment shall be provided under the ,program without any deductibles1 copayments1 or other cost sharing obligation for crewmembers participating in the ,program4 7#b7 ,access to local services ,the ,administrator shall design the ,program to facilitate reasonable access of a crewmember to medical monitoring1 diagnosis1 and treatment under the ,program1 including1 at the option of the crewmember-- 7,a7 directly through ,,nasa2 or 7,b7 from a health care provider who the crewmember selects and who enters into an agreement with the ,administrator1 with respect to the provision by the provider of medical monitoring1 diagnosis1 and treatment services1 as applicable1 to such crewmember under the ,program1 under which-- 7i7 the provider agrees to comply with the protocols issued under subsection 7c7 with respect to such provision of such services to such crewmember2 7ii7 the provider agrees to submit data with respect to such provision of such services to such crewmember1 as required by the ,administrator for purposes of subsection 7d72 7iii7 the provider agrees to receive such training as the ,administrator may require with respect to such medical monitoring1 treatment1 and diagnosis2 and 7iv7 the ,administrator agrees to provide payment to such provider for the provision of such services to such crewmember in accordance with payment rates established by the ,administrator under the ,program1 which shall be not less than the reasonable costs of such services4 7#c7 ,secondary payer 7,a7 ,in general ,subject to subparagraph 7,b71 payment or reimbursement for 7or the provision of7 medical monitoring1 diagnosis1 or treatment under the ,program shall be secondary to any obligation of the ,united ,states or any third party 7including any ,state or local governmental entity1 private insurance carrier1 or employer7 under any other provision of law or contractual agreement to pay for or provide such medical monitoring1 diagnosis1 or treatment4 ,any costs for items and services covered under the ,program that are not paid for or provided under such other provision of law or contractual agreement1 due to the application of deductibles1 copayments1 coinsurance1 other cost sharing1 or otherwise1 are reimbursable under the ,program to the extent that they are covered under the ,program4 7,b7 ,conditional payment ,the ,administrator may1 under the ,program1 provide for conditional payments for 7or provide7 medical monitoring1 diagnosis1 or treatment services that is obliged to be paid for or provided by the ,united ,states or any third party described in subparagraph 7,a7 under any other provision of law or contractual agreement if-- 7i7 payment for 7or the provision of7 such medical monitoring1 diagnosis1 or treatment services has not been made 7or provided7 or cannot reasonably be expected to be made 7or provided7 promptly by the ,united ,states or such third party1 respectively2 and 7ii7 such payment 7or such provision of services7 by the ,administrator under the ,program is conditioned on reimbursement by the ,united ,states or such third party1 respectively1 for such medical monitoring1 diagnosis1 or treatment4 7,c7 ,consultation ,in carrying out this paragraph1 the ,administrator may consult with other ,federal officials with experience coordinating health care payments with third-party payers4 7#d7 ,voluntary participation in program 7,a7 ,in general ,participation by a crewmember under the ,program1 including with respect to the provision of medical monitoring1 diagnosis1 and treatment to such crewmember1 shall be voluntary and pursuant to the written consent of such crewmember4 ,such consent provided by a crewmember shall constitute consent of the crewmember for the ,administrator to use or disclose data acquired in the course of medical monitoring1 diagnosis1 and treatment of such crewmember under the ,program in accordance with subsection 7d74 7,b7 ,consent not a condition for employment or benefits ,providing any consent under subparagraph 7,a7 shall not be a condition for-- 7i7 employment with ,,nasa2 or 7ii7 receiving any salary or benefits1 either for current or former crewmembers4 ,for purposes of clause 7ii71 medical monitoring1 diagnosis1 and treatment under the ,program shall not be considered a benefit4 7c7 ,protocols ,the ,administrator shall issue such uniform protocols for the provision of medical monitoring1 diagnosis1 and treatment furnished under the ,program4 7d7 ,data collection1 usage1 and disclosures2 ,privacy protections 7#a7 ,uniform data collection ,under the ,program1 subject to paragraph 7#c71 the ,administrator shall provide-- 7,a7 for the uniform collection of data1 including data on space flight-associated medical conditions and the identification of new space flight-associated conditions2 7,b7 that such data shall be collected with respect to all crewmembers provided medical monitoring1 diagnosis1 or treatment under the ,program for such conditions2 7,c7 for the integration of such data into the medical monitoring1 diagnosis1 and treatment activities under the ,program2 7,d7 for the analysis of1 and regular reports to the ,administrator on1 such data2 and 7,e7 notwithstanding section #g7;a71 that the ,administrator may retain access to such data4 7#b7 ,uses and disclosures of information ,the ,administrator may1 subject to paragraph 7#c71 use or disclose data acquired in the course of medical monitoring1 diagnosis1 and treatment of any crewmember under the ,program for the following purposes3 7,a7 ,the medical monitoring1 diagnosis1 and treatment of such crewmember under the ,program4 7,b7 ,other medical monitoring1 diagnosis1 or treatment under the ,program4 7,c7 ,other scientific and research purposes4 7,d7 ,for purposes of analysis and reports under section #d4 7,e7 ,any other purpose deemed appropriate by the ,administrator4 7#c7 ,privacy protections ,the data collection1 analysis1 integration1 use1 disclosure1 and retention under this subsection shall be conducted 7and such data maintained7 in a manner that protects the confidentiality of individually identifiable health information consistent with applicable ,federal law1 including regulations4 #d4 ,reports and cost estimate 7a7 ,annual reports 7#a7 ,requirement ,consistent with applicable privacy protections under ,federal law1 including regulations1 for each fiscal year of the ,program1 the ,administrator shall prepare and publish a report on activities conducted under the ,program1 as well as plans for activities to be conducted under the ,program during the subsequent fiscal year4 ,each such report shall include detailed cost accounting of such activities and five-year budget estimates4 ,each report for a fiscal year shall be submitted1 not later than the date of submission of the ,president's annual budget request for such fiscal year1 to the ,committee on ,science1 ,space1 and ,technology of the ,house of ,representatives and the ,committee on ,commerce1 ,science1 and ,transportation of the ,senate4 7#b7 ,failure to submit report 7,a7 ,in general ,subject to subparagraph 7,b71 no funds are authorized to be appropriated for a fiscal year to carry out the ,program unless the ,administrator has submitted the report required under paragraph 7#a7 for that fiscal year by the deadline established under such paragraph4 7,b7 ,treatment of ongoing procedures ,in the case of a fiscal year 7after the first fiscal year for which the ,program has been implemented7 with respect to which no funds would be authorized to carry out the ,program pursuant to subparagraph 7,a71 notwithstanding subparagraph 7,a71 there are authorized to be appropriated1 subject to section #f1 for such fiscal year such sums as may be necessary to provide that any crewmember receiving under the ,program diagnosis services or a course of treatment that began on a date prior to the first day of such fiscal year shall continue to be provided such diagnosis services or course of treatment1 respectively 7and payment under the ,program for such diagnosis services or course of treatment1 respectively1 shall continue7 after such date until completion of such diagnosis services or course of treatment1 respectively4 7b7 ,cost estimate 7#a7 ,requirement ,not later than #ij days after the date of enactment of this ,act1 the ,administrator shall enter into an arrangement with an independent external organization to undertake an independent cost estimate of the cost to ,,nasa and the ,federal ,government to implement and administer the ,program4 ,the independent external organization may not be a ,,nasa entity1 such as the ,office of ,safety and ,mission ,assurance4 7#b7 ,submittal to ,congress ,not later than one year after the date of the enactment of this ,act1 the ,administrator shall submit the independent cost estimate undertaken pursuant to paragraph 7#a7 to the ,committee on ,science1 ,space1 and ,technology of the ,house of ,representatives and the ,committee on ,commerce1 ,science1 and ,transportation of the ,senate4 7#c7 ,provision of services ,the ,administrator may not implement the ,program until the date that is #ij days after the date of submission of the independent cost estimate under paragraph 7#b74 #e4 ,inspector ,general audit ,the ,inspector ,general of ,,nasa shall conduct1 as appropriate1 periodic audits or reviews of the ,program as is necessary to prevent waste1 fraud1 and abuse4 #f4 ,funding ,the ,program shall be carried out1 to the extent and in such amounts as are provided in advance by appropriation ,acts1 using existing funding available for ,agency ,management and ,operations in the ,safety1 ,security and ,mission ,services account of the ,national ,aeronautics and ,space ,administration4 #g4 ,sunset 7a7 ,in general ,subject to subsection 7b71 the ,program shall terminate on the date that is #aj years after the date of implementation of the ,program4 7b7 ,grandfather ,in the case of a crewmember receiving under the ,program diagnosis services or treatment services that began on a date prior to the date of termination described in subsection 7a71 the ,administrator shall provide that such diagnosis services or course of treatment1 respectively1 for such crewmember 7and payment for such diagnosis services or course of treatment1 respectively7 may1 subject to section #f1 continue after such date until completion of such diagnosis services or course of treatment1 respectively4