,,ii  #aadth ,,congress  #b;d ,session  
,h4 ,r4 #fjgf  ,,in ,,the ,,senate ,,of 
,,the ,,united ,,states  ,december #h1  
#bjaf,received  ,,an ,,act  ,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          
,findings2 sense of congress  7a7       
,findings ,congress makes the following 
findings3  7#a7 ,human space exploration
 can pose significant challenges and is 
full of substantial risk1 which has     
ultimately claimed the lives of #bd     
,national ,aeronautics and ,space       
,administration astronauts serving in   
the line of duty4  7#b7 ,as ,united     
,states government astronauts           
participate in long-duration and        
exploration spaceflight missions they   

may experience increased health risks1  
such as vision impairment1 bone         
demineralization1 and behavioral health 
and performance risks1 and may be       
exposed to galactic cosmic radiation4   
,exposure to high levels of radiation   
and microgravity can result in acute and
 long-term health consequences that can 
increase the risk of cancer and tissue  
degeneration and have potential effects 
on the musculoskeletal system1 central  
nervous system1 cardiovascular system1  
immune function1 and vision4  7#c7 ,to  
advance the goal of long-duration and   
exploration spaceflight missions1       
,united ,states government astronaut    
,scott ,kelly participated in a #a-year 
twins study in space while his identical
 twin brother1 former ,united ,states   
government astronaut ,mark ,kelly1 acted
 as a human control specimen on ,earth1 
providing an understanding of the       
physical1 behavioral1 microbiological1  
and molecular reaction of the human body
 to an extended period of time in space4

  7#d7 ,since the ,administration       
currently provides medical monitoring1  
diagnosis1 and treatment for ,united    
,states government astronauts during    
their active employment1 given the      
unknown long-term health consequences of
 long-duration space exploration1 the   
,administration has requested statutory 
authority from ,congress to provide     
medical monitoring1 diagnosis1 and      
treatment to former ,united ,states     
government astronauts for psychological 
and medical conditions associated with  
human space flight4  7b7 ,sense of      
,congress ,it is the sense of ,congress 
that-- 7#a7 the ,united ,states should  
continue to seek the unknown and lead   
the world in space exploration and      
scientific discovery as the             
,administration prepares for            
long-duration and exploration           
spaceflight in deep space and an        
eventual mission to ,mars2  7#b7 data   
relating to the health of astronauts    
will become increasingly valuable to    

improving our understanding of many     
diseases humans face on ,earth2  7#c7   
the ,administration should provide the  
type of monitoring1 diagnosis1 and      
treatment described in subsection 7a7   
only for conditions the ,administration 
considers unique to the training or     
exposure to the spaceflight environment 
of ,united ,states government astronauts
 and should not require any former      
,united ,states government astronauts to
 participate in the ,administration's   
monitoring2  7#d7 such monitoring1      
diagnosis1 and treatment should not     
replace a former ,united ,states        
government astronaut's private health   
insurance2  7#e7 expanded data acquired 
from such monitoring1 diagnosis1 and    
treatment should be used to tailor      
treatment1 inform the requirements for  
new spaceflight medical hardware1 and   
develop controls in order to prevent    
disease occurrence in the astronaut     
corps2 and  7#f7 the #cdj-;day space    
mission of ,scott ,kelly aboard the     

,,iss-- 7,a7 was pivotal for the goal of
 the ,united ,states for humans to      
explore deep space and ,mars as the     
mission generated new insight into how  
the human body adjusts to               
weightlessness1 isolation1 radiation1   
and the stress of long-duration space   
flight2 and  7,b7 will help support the 
physical and mental well-being of       
astronauts during longer space          
exploration missions in the future4  #c4
 ,medical monitoring and research       
relating to human space flight  7a7 ,in 
general ,subchapter ,,iii of chapter    
#bja of title #ea1 ,united ,states      
,code1 is amended by adding at the end  
the following3  #bjadh4 ,medical        
monitoring and research relating to     
human space flight  7a7 ,in general     
,notwithstanding any other provision of 
law1 the ,administrator may provide for 
the medical monitoring and diagnosis of 
a former ,united ,states government     
astronaut or a former payload specialist
 for conditions that the ,administrator 

considers potentially associated with   
human space flight1 and may provide for 
the treatment of a former ,united       
,states government astronaut or a former
 payload specialist for conditions that 
the ,administrator considers associated 
with human space flight1 including      
scientific and medical tests for        
psychological and medical conditions4   
7b7 ,requirements  7#a7 ,no cost sharing
 ,the medical monitoring1 diagnosis1 or 
treatment described in subsection 7a7   
shall be provided without any           
deductible1 copayment1 or other cost    
sharing obligation4  7#b7 ,access to    
local services ,the medical monitoring1 
diagnosis1 and treatment described in   
subsection 7a7 may be provided by a     
local health care provider if it is     
unadvisable due to the health of the    
applicable former ,united ,states       
government astronaut or former payload  
specialist for that former ,united      
,states government astronaut or former  
payload specialist to travel to the     

,lyndon ,b4 ,johnson ,space ,center1 as 
determined by the ,administrator4  7#c7 
,secondary payment ,payment or          
reimbursement for the medical           
monitoring1 diagnosis1 or treatment     
described in subsection 7a7 shall be    
secondary to any obligation of the      
,united ,states government or any third 
party 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 that may be provided 
by the ,administrator for medical       
monitoring1 diagnosis1 or treatment     
under subsection 7a7 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 by the ,administrator on   
behalf of the former ,united ,states    
government astronaut or former payload  
specialist involved to the extent such  

items or services are authorized to be  
provided by the ,administrator for such 
medical monitoring1 diagnosis1 or       
treatment under subsection 7a74  7#d7   
,conditional payment ,the ,administrator
 may provide for conditional payments   
for or provide medical monitoring1      
diagnosis1 or treatment described in    
subsection 7a7 that is obligated to be  
paid for or provided by the ,united     
,states or any third party under any    
other provision of law or contractual   
agreement to pay for or provide such    
medical monitoring1 diagnosis1 or       
treatment if--  7,a7 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  7,b7 such payment 7or
 such provision of services7 by the     
,administrator is conditioned on        
reimbursement by the ,united ,states or 

such third party1 respectively1 for such
 medical monitoring1 diagnosis1 or      
treatment4  7c7 ,exclusions ,the        
,administrator may not-- 7#a7 provide   
for medical monitoring or diagnosis of a
 former ,united ,states government      
astronaut or former payload specialist  
under subsection 7a7 for any            
psychological or medical condition that 
is not potentially associated with human
 space flight2  7#b7 provide for        
treatment of a former ,united ,states   
government astronaut or former payload  
specialist under subsection 7a7 for any 
psychological or medical condition that 
is not associated with human space      
flight2 or  7#c7 require a former       
,united ,states government astronaut or 
former payload specialist to participate
 in the medical monitoring1 diagnosis1  
or treatment authorized under subsection
 7a74  7d7 ,privacy ,consistent with    
applicable provisions of ,federal law   
relating to privacy1 the ,administrator 
shall protect the privacy of all medical

 records generated under subsection 7a7 
and accessible to the ,administration4  
7e7 ,regulations ,the ,administrator    
shall promulgate such regulations as are
 necessary to carry out this section4   
7f7 ,definition of ,united ,states      
government astronaut ,in this section1  
the term ,united ,states government     
astronaut has the meaning given the term
 government astronaut in section #ejijb1
 except it does not include an          
individual who is an international      
partner astronaut4  7g7 ,data use and   
disclosure ,the ,administrator may use  
or disclose data acquired in the course 
of medical monitoring1 diagnosis1 or    
treatment of a former ,united ,states   
government astronaut or a former payload
 specialist under subsection 7a71 in    
accordance with subsection 7d74 ,former 
,united ,states government astronaut or 
former payload specialist participation 
in medical monitoring1 diagnosis1 or    
treatment under subsection 7a7 shall    
constitute consent for the              

,administrator to use or disclose such  
data4  4  7b7 ,clerical amendment ,the  
table of contents for chapter #bja of   
title #ea1 ,united ,states ,code is     
amended by inserting after the item     
relating to section #bjadg the          
following3  #bjadh4 ,medical monitoring 
and research relating to human space    
flight  4  7c7 ,annual reports  7#a7 ,in
 general ,each fiscal year1 not later   
than the date of submission of the      
,president's annual budget request for  
that fiscal year under section #aaje of 
title #ca1 ,united ,states ,code1 the   
,administrator of the ,national         
,aeronautics and ,space ,administration 
shall publish a report1 in accordance   
with applicable ,federal privacy laws1  
on the activities of the ,national      
,aeronautics and ,space ,administration 
under section #bjadh of title #ea1      
,united ,states ,code1 as added by      
subsection 7a74  7#b7 ,contents ,each   
report under paragraph 7#a7 shall       
include a detailed cost accounting of   

the ,administration's activities under  
such section #bjadh of title #ea1       
,united ,states ,code1 and a #e-year    
budget estimate4  7#c7 ,submission to   
,congress ,the ,administrator shall     
submit to the appropriate committees of 
,congress each report under paragraph   
7#a7 not later than the date of         
submission of the ,president's annual   
budget request for that fiscal year     
under section #aaje of title #ca1       
,united ,states ,code4  7d7 ,cost       
estimate  7#a7 ,requirement ,not later  
than #ij days after the date of         
enactment of this ,act1 the             
,administrator of the ,national         
,aeronautics and ,space ,administration 
shall enter into an arrangement with an 
independent external organization to    
undertake an independent cost estimate  
of the cost to the ,national            
,aeronautics and ,space ,administration 
and the ,federal ,government to         
implement and administer the activities 
of the ,national ,aeronautics and ,space

 ,administration under section #bjadh of
 title #ea1 ,united ,states ,code1 as   
added by subsection 7a74 ,the           
independent external organization may   
not be an entity of the ,national       
,aeronautics and ,space ,administration1
 such as the ,office of ,safety and     
,mission ,assurance4  7#b7 ,submittal to
 ,congress ,not later than #a 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  7e7 ,privacy study    
7#a7 ,study ,the ,administrator of the  
,national ,aeronautics and ,space       
,administration shall carry out a study 
on any potential privacy or legal issues
 related to the possible sharing beyond 
the ,federal ,government of data        
acquired under the activities of the    

,national ,aeronautics and ,space       
,administration under section #bjadh of 
title #ea1 ,united ,states ,code1 as    
added by subsection 7a74  7#b7 ,report  
,not later than #bgj days after the date
 of the enactment of this ,act1 the     
,administrator shall submit to the      
,committee on ,science1 ,space1 and     
,technology of the ,house of            
,representatives and the ,committee on  
,commerce1 ,science1 and ,transportation
 of the ,senate a report containing the 
results of the study carried out under  
paragraph 7#a74  7f7 ,inspector ,general
 audit ,the ,inspector ,general of the  
,national ,aeronautics and ,space       
,administration shall periodically audit
 or review1 as the ,inspector ,general  
considers necessary to prevent waste1   
fraud1 and abuse1 the activities of the 
,national ,aeronautics and ,space       
,administration under section #bjadh of 
title #ea1 ,united ,states ,code1 as    
added by subsection 7a74  ,passed the   
,house of ,representatives ,december #g1

 #bjaf4,karen ,l4 ,haas1,clerk