FY2022 NDAA: Care for Anomalous Health Incident Victims
INSIGHTi
FY2022 NDAA: Care for Anomalous Health
Incident Victims
February 7, 2022
Background
Since 2016, a number of U.S. diplomatic, military, and intelligence personnel and their family members
have reported experiencing a range of unexplained medical symptoms after being potentially exposed to
certain auditory or sensory disturbances. The first reported incidence of these symptoms occurred in late
2016, when a cluster of U.S. Government (USG) employees assigned to U.S. Embassy Havana, Cuba,
and their families, described experiencing a sudden onset of perceived loud sounds, sensations of head
pressure or vibrations, head or ear pain, hearing loss or ringing, dizziness, unsteady gait, visual
disturbances, or cognitive deficit. U.S. government employees stationed in other locations (e.g., China,
Russia, and United States) have reported similar incidents. The Department of Defense (DOD) and other
federal entities refer to these events as “anomalous health incidents” (AHIs). Other observers refer to
these unexplained health effects as “Havana Syndrome.”
To date, the Department of State (DOS) has asked the U.S. Centers for Disease Control and Prevention
and the National Academies of Science, Engineering, and Medicine to further examine why AHIs occur,
who is at-risk, and what the short- and long-term health effects are. Their findings have informed ongoing
inquiries by DOS, DOD, the Intelligence Community, and other federal entities as they continue to
investigate AHIs through numerous interagency efforts (e.g., Health Incidents Response Task Force, Joint
Intelligence Community Council).
Certain USG departments and agencies have established medical screening and referral programs to assist
AHI-affected individuals. For example, the DOS Bureau of Medical Services conducts “localized
screening at posts of concern” and supports affected DOS employees with a “Care Coordination Team.”
Other AHI-affected individuals (e.g., other USG employees or family members) may seek care that could
be covered by other health payers (e.g., Federal Employees Health Benefits program, TRICARE, Veterans
Health Administration, or private health insurance).
Congress recently enacted several bills to assist AHI-affected individuals with accessing federal health
care services and disability compensation, including:
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Helping American Victims Afflicted by Neurological Attacks (HAVANA) Act of 2021
(P.L. 117-46);
Section 1110 of the Fiscal Year (FY) 2021 William M. (Mac) Thornberry National
Defense Authorization Act (NDAA; P.L. 116-283); and
Sections 901 and 7019(e) of the Further Consolidated Appropriations Act, 2020 (P.L.
116-94).
Table 1 lists the proposed and enacted AHI-related health care provisions included in the FY2022
National Defense Authorization Act (NDAA; P.L. 117-81).
Table 1. FY2022 NDAA Legislative Proposals
Senate Armed Services
House-Passed H.R. 4350
Committee-Reported S. 2792
Enacted Legislation (P.L. 117-81)
No related provision.
Section 741 would have directed the
Section 732 adopts the Senate
Secretary of Defense (SECDEF) to
provision.
provide U.S. Government (USG)
employees and their family members
who are AHI victims, access to medical
assessment and treatment at the
National Intrepid Center of Excellence,
Intrepid Spirit Centers, or other
appropriate military treatment facility
(MTF) on a space-available basis. The
provision would also require the DOD
Trauma Registry to include
demographic and clinical information of
AHI victims assessed or treated at an
MTF.
Section 722 would have required DOD No related provision.
Section 910 adopts the House
to establish a “cross-functional team”
provision with an amendment that
to (1) address the national security
makes technical and conforming
challenges posed by AHIs, and (2)
changes.
ensure AHI victims receive care
through the Military Health System or
other DOD health program.
Section 4501 would have authorized
Section 4501 would authorize $30.0
Section 4501 authorizes $30.0 mil ion,
$114.9 mil ion, in the Defense Health
mil ion, in the Defense Health Program
in the Defense Health Program
Program account, “Consolidated
account, “In-House Care” Sub-Activity
account, “Consolidated Health
Health Support” SAG/BLI, for AHI-
Group/Budget Line Item (SAG/BLI), for Support” SAG/BLI, for AHI-related
related care.
AHI-related care.
care.
Section 746 would have required
Section 1053 would have required
Not adopted.
SECDEF to brief certain congressional
SECDEF to brief the congressional
committees, no later than March 1,
defense committees on DOD efforts
2022, on AHIs affecting
to address AHIs. The briefings would
servicemembers and DOD civilian
have been required every 90 days for a
employees, related force health
period of two years.
protection measures, DOD
engagements with other federal
entities, and recommendations for
improving identification and reporting
of AHIs.
Source: CRS analysis of H.R. 4350, S. 2792, and P.L. 117-81.
Note: AHI-related provisions unrelated to health care (i.e., Section 6603 of the enacted bil ) are not included in this table.
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Discussion
Chapter 55 of Title 10, U.S. Code authorizes TRICARE beneficiaries (i.e., servicemembers, military
retirees, and their family members) as those eligible to receive health care in MTFs. Nonbeneficiaries
(e.g., DOD civilian employees, DOD contractors, or other individuals) may receive limited MTF care
when authorized in statute or regulation. Section 732 of the enacted bill adopts Senate Section 741, and
requires SECDEF to provide certain USG employees and their families experiencing AHI symptoms with
access to medical assessments and care, on a space-available basis, at the National Intrepid Center of
Excellence, an Intrepid Spirit Center, or an appropriate MTF. The provision requires SECDEF to develop
a process, within 60 days after enactment, and in coordination with other relevant federal agencies, that
ensures eligible USG employees and their families may access DOD care in a timely manner. This section
also requires a modification to the DOD Joint Trauma Registry to include demographic, condition-
producing event, diagnosis, treatment, and outcome data of individuals assessed or treated at DOD
medical facilities for AHI-related symptoms.
Section 4501 of the enacted bill authorizes $30 million in the “Consolidated Health Support” SAG/BLI of
the Defense Health Program subaccount for “anomalous health incidents care capacity.”
Section 910 of the enacted bill adopts House Section 722, and requires DOD to establish a cross-
functional team (CFT) to address the national security challenges posed by AHIs and ensure that
individuals entitled to DOD health care receive timely access to treatment for AHI-related symptoms. The
provision requires SECDEF to select an Under Secretary of Defense to lead the CFT, with a senior
military officer as the team’s deputy. CFT duties include assisting SECDEF with addressing AHI
challenges, integrating DOD efforts with those of the interagency, and other efforts as determined
necessary by the Secretary. The provision requires SECDEF to provide an initial briefing to the
congressional defense and intelligence committees, no later than 45 days after enactment, on the progress
toward establishing the CFT, the team’s roles and responsibilities, and efforts made to address its duties.
Beginning in March 2022 and every 60 days thereafter for a one-year period, SECDEF is also required to
brief the congressional committees on the Department’s AHI-related efforts.
House Section 746 and Senate Section 1053 were not adopted in the enacted bill. The House provision
would have required DOD to brief certain congressional committees on AHIs affecting servicemembers
and DOD civilians, efforts to protect those individuals, and interagency engagements on this topic. The
Senate provision would have required DOD to brief the congressional defense committees, on a quarterly-
basis, on efforts to investigate, attribute, and mitigate AHIs, as well as the process to ensure timely
assessment and treatment of USG personnel affected by AHIs. In the Joint Explanatory Statement
accompanying the FY2022 NDAA, the conferees stated that while this issue is addressed in other
provisions of the bill, they emphasize the importance of regular engagements with the Armed Services
Committees “regarding the threat posed by anomalous health incidents and efforts to ensure prompt
medical care for those affected by such incidents.”
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Author Information
Bryce H. P. Mendez
Analyst in Defense Health Care Policy
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