House Passes Castro-Authored NDAA Amendment to End Surprise Medical Billing at Brooke Army Medical Center

Press Release

Today, the U.S. House of Representatives voted to pass an amendment to the Fiscal Year 2023 National Defense Authorization Act (FY 2023 NDAA) authored by Congressman Joaquin Castro (TX-20) that directs the Secretary of Defense to waive extraordinary medical charges for civilians who receive care at Brooke Army Medical Center (BAMC) and other military medical treatment facilities. The House is expected to pass the full FY 2023 NDAA tomorrow evening.

"The outrageous billing practices at BAMC need to end," said Congressman Castro. "For years, military doctors, nurses, and other medical professionals have honed their trauma skills by treating critically injured civilians from San Antonio and the surrounding communities. We are proud to support our nation's military readiness, but my constituents should not be stuck with sky-high medical bills. As Congress makes progress to end surprise medical billing, my amendment will make sure that patients at military hospitals are not left behind."

BAMC is the flagship medical training institution for the U.S. Army and one of two Level 1 Trauma Centers in San Antonio. Approximately 85 percent of the trauma patients treated at BAMC are civilians from the local community.

Under current federal law, BAMC and other military medical providers are not authorized to contract with private insurers. As a result, many insurers treat BAMC as an out-of-network provider and reimburse at lower rates or deny claims entirely. If private insurers do not cover BAMC charges, the facility bills patients directly and forwards unpaid bills to the U.S. Treasury for collection. In recent years, BAMC has garnered headlines for surprise medical bills that reached into the six figures.

In 2020, Congressman Castro successfully secured an amendment in the FY 2021 NDAA that allowed the Secretary of Defense to waive civilian medical bills at military hospitals. Despite this regulatory flexibility, BAMC continued to send burdensome medical bills to patients. The amendment introduced by Congressman Castro in this year's NDAA would require the Secretary to waive most civilian medical bills incurred at military hospitals and implement a sliding-scale payment discount program for remaining fees.

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