10 U.S.C. § 129c: Medical personnel: limitations on reductions

For any fiscal year, the Secretary of Defense may not make a reduction in the number of medical personnel of the Department of Defense described in subsection (b) unless the Secretary makes a certification for that fiscal year described in subsection (c). 95 percent of the number of such personnel at the end of the immediately preceding fiscal year; or 90 percent of the number of such personnel at the end of the third fiscal year preceding the fiscal year. the number of medical personnel being reduced is excess to the current and projected needs of the Department of Defense; and such reduction will not result in an increase in the cost of health care services provided under the Civilian Health and Medical Program of the Uniformed Services under chapter 55 of this title. Whenever the Secretary of Defense directs that there be a reduction in the total number of military medical personnel of the Department of Defense, the Secretary shall require that the reduction be carried out so as to ensure that the reduction is not exclusively or disproportionately borne by any one of the armed forces and is not exclusively or disproportionately borne by either the active or the reserve components. the members of the armed forces covered by the term “medical personnel” as defined in section 115a(e)(2) 1 of this title; and 1 See References in Text note below. the civilian personnel of the Department of Defense assigned to military medical facilities. Except as provided in paragraph (2), and in addition to the limitation under section 719 of the National Defense Authorization Act for Fiscal Year 2020 ( Public Law 116–92 ; 133 Stat. 1454 ), as most recently amended by section 731 of the National Defense Authorization Act for Fiscal Year 2022 ( Public Law 117–81 ; 135 Stat. 1795 ), during the 10-year period beginning on the date of the enactment of this Act [ Dec. 23, 2022 ], neither the Secretary of Defense nor a Secretary concerned may reduce military medical end strength authorizations, and following such period, neither may reduce such authorizations unless the Secretary of Defense issues a waiver pursuant to paragraph (6). Administrative billets of a military department that have remained unfilled since at least October 1, 2018 . Billets identified as non-clinical in the budget of the President for fiscal year 2020 submitted to Congress pursuant to section 1105(a) of title 31 , United States Code, except that the number of such billets may not exceed 1,700. Medical headquarters billets of the military departments not assigned to, or providing direct support to, operational commands. The National Defense Strategy submitted under section 113(g) of title 10 , United States Code. The National Military Strategy prepared under section 153(b) of such title. The campaign plans of the combatant commands. Theater strategies. The joint medical estimate under section 732 of the John S. McCain National Defense Authorization Act for Fiscal Year 2019 ( Public Law 115–232 ; 132 Stat. 1817 ). The plan of the Department of Defense on integrated medical operations, as updated pursuant to paragraph (1) of section 724(a) of the National Defense Authorization Act for Fiscal Year 2022 ( Public Law 117–81 ; 135 Stat. 1793 ; 10 U.S.C. 1096 note). The plan of the Department of Defense on global patient movement, as updated pursuant to paragraph (2) of such section 724(a). The biosurveillance program of the Department of Defense established pursuant to Department of Defense Directive 6420.02 (relating to biosurveillance). Requirements for graduate medical education. The report of the COVID–19 Military Health System Review Panel under section 731 of the William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021 ( Public Law 116–283 ; 134 Stat. 3698 ). The report of the Inspector General of the Department of Defense titled ‘Evaluation of Department of Defense Military Medical Treatment Facility Challenges During the Coronavirus Disease-2019 (COVID-19) Pandemic in Fiscal Year 2021 (DODIG-2022-081)’ and published on April 5, 2022 . Reports of the Comptroller General of the United States relating to military health system reforms undertaken on or after January, 1, 2017, including any such reports relating to military medical manning and force composition mix. Such other reports as may be determined appropriate by the Secretary of Defense. A certification of the completion of a comprehensive review of military medical manning, including with respect to the medical corps (or other health- or medical-related component of a military department), designator, profession, occupation, and rating of medical personnel. A justification for any proposed increase, realignment, reduction, or other change to the specialty or occupational composition of military medical end strength authorizations, which may include compliance with a requirement or recommendation set forth in a strategy, plan, or other matter specified in paragraph (3). A certification that, in the case that any change to such specialty or occupational composition is required, a vacancy resulting from such change may not be filled with a position other than a health- or medical-related position until such time as there are no military medical billets remaining to fill the vacancy. A risk analysis associated with the potential realignment or reduction of any military medical end strength authorizations. An identification of any plans of the Department to backfill military medical personnel positions with civilian personnel. A plan to address persistent vacancies for civilian personnel in health- or medical-related positions, and a risk analysis associated with the hiring, onboarding, and retention of such civilian personnel, taking into account provider shortfalls across the United States. A comprehensive plan to mitigate any risk identified pursuant to subparagraph (D) or (F), including with respect to funding necessary for such mitigation across fiscal years. take into consideration the funding required for any such proposed modification; and include distinct processes for proposed increases and proposed decreases, respectively, to the medical manning force mix of each military department. the report requirement under paragraph (3), the certification requirement under paragraph (4), and the process requirement under paragraph (5) have been completed; the Secretary determines that the waiver is necessary and in the interests of the national security of the United States; and the waiver is issued in writing. Not later than five days after issuing a waiver under subparagraph (A), the Secretary of Defense shall submit to the Committees on Armed Services of the House of Representatives and the Senate a notification of the waiver (including the text of the waiver and a justification for the waiver) and provide to such committees a briefing on the components of the waiver. The term ‘medical personnel’ has the meaning given such term in section 115a(e) of title 10 , United States Code [now 10 U.S.C. 115a(f) ]. The term ‘Secretary concerned’ has the meaning given that term in section 101(a) of such title. The term ‘theater strategy’ means an overarching construct outlining the vision of a combatant commander for the integration and synchronization of military activities and operations with other national power instruments to achieve the strategic objectives of the United States.” A Secretary of a military department may not convert any military medical or dental position to a civilian medical or dental position until the Secretary submits to the Committees on Armed Services of the Senate and the House of Representatives a certification that the conversions within that department will not increase cost or decrease quality of care or access to care. Such a certification may not be submitted before June 1, 2006 . the methodology used by the Secretary in making the determinations necessary for the certification, including the extent to which the Secretary took into consideration the findings of the Comptroller General in the report under subsection (b)(3); the results of a market survey in each affected area of the availability of civilian medical and dental care providers in such area in order to determine whether the civilian medical and dental care providers available in such area are adequate to fill the civilian positions created by the conversion of military medical and dental positions to civilian positions in such area; and any action taken by the Secretary in response to recommendations in the Comptroller General report under subsection (b)(3). The Comptroller General shall conduct a study on the effect of conversions of military medical and dental positions to civilian medical or dental positions on the defense health program. The number of military medical and dental positions, by grade and specialty, planned for conversion to civilian medical or dental positions. The number of military medical and dental positions, by grade and specialty, converted to civilian medical or dental positions since October 1, 2004 . The ability of the military health care system to fill the civilian medical and dental positions required, by specialty. The degree to which access to health care is affected in both the direct and purchased care system, including an assessment of the effects of any increased shifts in patient load from the direct care to the purchased care system, or any delays in receipt of care in either the direct or purchased care system because of lack of direct care providers. The degree to which changes in military manpower requirements affect recruiting and retention of uniformed medical and dental personnel. The degree to which conversion of the military positions meets the joint medical and dental readiness requirements of the uniformed services, as determined jointly by all the uniformed services. The effect of the conversions of military medical positions to civilian medical and dental positions on the defense health program, including costs associated with the conversions, with a comparison of the estimated costs versus the actual costs incurred by the number of conversions since October 1, 2004 . The effectiveness of the conversions in enhancing medical and dental readiness, health care efficiency, productivity, quality, and customer satisfaction. Not later than May 1, 2006 , the Comptroller General shall submit to the Committees on Armed Services of the Senate and House of Representatives a report containing the results of the study under this section. The term ‘military medical or dental position’ means a position for the performance of health care functions within the Armed Forces held by a member of the Armed Forces. The term ‘civilian medical or dental position’ means a position for the performance of health care functions within the Department of Defense held by an employee of the Department or of a contractor of the Department. The term ‘affected area’ means an area in which military medical or dental positions were converted to civilian medical or dental positions before October 1, 2004 , or in which such conversions are scheduled to occur in the future. The term ‘uniformed services’ has the meaning given that term in section 1072(1) of title 10 , United States Code.”