Download or read book Establishment of Tricare Select and Other Tricare Reforms Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-02 with total page 56 pages. Available in PDF, EPUB and Kindle. Book excerpt: Establishment of TRICARE Select and Other TRICARE Reforms (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the Establishment of TRICARE Select and Other TRICARE Reforms (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 This interim final rule implements the primary features of section 701 and partially implements several other sections of the National Defense Authorization Act for Fiscal Year 2017 (NDAA-17). The law makes significant changes to the TRICARE program, especially to the health maintenance organization (HMO)-like health plan, known as TRICARE Prime; to the preferred provider organization (PPO) health plan, previously called TRICARE Extra which is to be replaced by TRICARE Select; and to the third health care option, known as TRICARE Standard, which will be terminated as of December 31, 2017, and also replaced by TRICARE Select. The statute also adopts a new health plan enrollment system under TRICARE and new provisions for access to care, high value services, preventive care, and healthy lifestyles. In implementing the statutory changes, this interim final rule makes a number of improvements to TRICARE. This book contains: - The complete text of the Establishment of TRICARE Select and Other TRICARE Reforms (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Civilian Health and Medical Program of the Uniformed Services Champus Tricare Reserve Select for Members of the Selected Reserve Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-06-29 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) - TRICARE Reserve Select for Members of the Selected Reserve (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) - TRICARE Reserve Select for Members of the Selected Reserve (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 This interim final rule revises requirements and procedures for TRICARE Reserve Select pursuant to section 701 of the National Defense Authorization Act for FY 2006 (NDAA-06). TRICARE Reserve Select is the premium-based medical coverage program first made available in April 2005 for purchase by members of the Selected Reserve who fulfill the statutory qualification of having served on active duty in support of a contingency operation among other qualifications. By adding two new tiers of premium sharing by the government (50% and 85% member portion) to the existing premium tier (28% member portion), this interim final rule expands availability of TRICARE Reserve Select to include all Selected Reservists pursuant to section 702 of NDAA-06. This book contains: - The complete text of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) - TRICARE Reserve Select for Members of the Selected Reserve (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Tricare Program Overpayments Recovery Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-07 with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt: TRICARE Program - Overpayments Recovery (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the TRICARE Program - Overpayments Recovery (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 This rule amends the CHAMPUS and TRICARE program regulation that governs the recoupment of erroneous payments. Specifically, the rule implements changes required by the Debt Collection Improvement Act (DCIA) of 1996 and the revised Federal Claims Collection Standards (FCCS). This final rule is necessary to comply with the DCIA of 1996 and the revised FCCS. This book contains: - The complete text of the TRICARE Program - Overpayments Recovery (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Defense Health Care DoD Lacks Assurance That Selected Reserve Members are Informed about TRICARE Reserve Select written by Randall B. Williamson and published by DIANE Publishing. This book was released on 2011-10 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt: TRICARE Reserve Select (TRS) provides certain members of theSelected Reserve - reservists considered essential to wartimemissions - with the ability to purchase health care coverage under the Department of Defense's (DoD) TRICARE program after their active duty coverage expires. TRS is similar to TRICARE Standard, a fee-for-service option, and TRICARE Extra, a preferred provider option. This report examines: (1) how DoD ensures that members of the Selected Reserve are informed about TRS; and (2) how DoD monitors and evaluates access to civilian providers for TRS beneficiaries. Charts and tables. This is a print on demand edition of an important, hard-to-find report.
Download or read book Tricare Sub Acute Care Program Uniform Skilled Nursing Facility Benefit Home Health Care Benefit Adopting Medicare Payment Methods Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-07 with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt: TRICARE - Sub-Acute Care Program - Uniform Skilled Nursing Facility Benefit - Home Health Care Benefit - Adopting Medicare Payment Methods (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the TRICARE - Sub-Acute Care Program - Uniform Skilled Nursing Facility Benefit - Home Health Care Benefit - Adopting Medicare Payment Methods (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 This rule partially implements the TRICARE "sub-acute and long-term care program reform" enacted by Congress in the National Defense Authorization Act for Fiscal Year 2002, specifically: Establishment of "an effective, efficient, and integrated sub-acute care benefits program," with skilled nursing facility (SNF) and home health care benefits modeled after those of the Medicare program; adoption of Medicare payment methods for skilled nursing facility, home health care, and certain other institutional health care providers; adoption of Medicare rules on balance billing of beneficiaries, prohibiting it by institutional providers and limiting it by non-institutional providers; and change in the statutory exclusion of coverage for custodial and domiciliary care. This book contains: - The complete text of the TRICARE - Sub-Acute Care Program - Uniform Skilled Nursing Facility Benefit - Home Health Care Benefit - Adopting Medicare Payment Methods (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Civilian Health and Medical Program of the Uniformed Services Inclusion of Tricare Retail Pharmacy Program in Federal Procurement of Pharmaceuticals Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-06-29 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: Civilian Health and Medical Program of the Uniformed Services - Inclusion of TRICARE Retail Pharmacy Program in Federal Procurement of Pharmaceuticals (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the Civilian Health and Medical Program of the Uniformed Services - Inclusion of TRICARE Retail Pharmacy Program in Federal Procurement of Pharmaceuticals (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 Section 703 of the National Defense Authorization Act for Fiscal Year 2008 (NDAA-08) states with respect to any prescription filled on or after the date of enactment, the TRICARE Retail Pharmacy Program shall be treated as an element of the DoD for purposes of procurement of drugs by Federal agencies under section 8126 of title 38, United States Code (U.S.C.), to the extent necessary to ensure pharmaceuticals paid for by the DoD that are provided by network retail pharmacies under the program to eligible covered beneficiaries are subject to the pricing standards in such section 8126. DoD issued a final rule on March 17, 2009, implementing the law. On November 30, 2009, the U.S. District Court for the District of Columbia remanded the final rule to DoD (without vacating the rule) for DoD to consider in its discretion whether to readopt the current iteration of the rule or adopt another approach. This final rule is the product of that reconsideration. DoD is readopting the 2009 final rule, with some revision. This book contains: - The complete text of the Civilian Health and Medical Program of the Uniformed Services - Inclusion of TRICARE Retail Pharmacy Program in Federal Procurement of Pharmaceuticals (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Civilian Health and Medical Program of the Uniformed Services Champus Tricare Inclusion of Tricare Retail Pharmacy Program Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-06-29 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) - TRICARE - Inclusion of TRICARE Retail Pharmacy Program (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) - TRICARE - Inclusion of TRICARE Retail Pharmacy Program (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 Section 703 of the National Defense Authorization Act for Fiscal Year 2008 (NDAA-08) states with respect to any prescription filled on or after the date of enactment of the NDAA, the TRICARE Retail Pharmacy Program shall be treated as an element of the DoD for purposes of procurement of drugs by Federal agencies under section 8126 of title 38, United States Code (U.S.C.), to the extent necessary to ensure pharmaceuticals paid for by the DoD that are provided by network retail pharmacies under the program to eligible covered beneficiaries are subject to the pricing standards in such section 8126. NDAA-08 was enacted on January 28, 2008. The statute requires implementing regulations. This final rule is to implement section 703 of the NDAA-08. This book contains: - The complete text of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) - TRICARE - Inclusion of TRICARE Retail Pharmacy Program (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Tricare Mental Health and Substance Use Disorder Treatment Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-07 with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt: TRICARE - Mental Health and Substance Use Disorder Treatment (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the TRICARE - Mental Health and Substance Use Disorder Treatment (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 This final rule modifies the TRICARE regulation to reduce administrative barriers to access to mental health benefit coverage and to improve access to substance use disorder (SUD) treatment for TRICARE beneficiaries, consistent with earlier Department of Defense and Institute of Medicine recommendations, current standards of practice in mental health and addiction medicine, and governing laws. This rule seeks to eliminate unnecessary quantitative and non-quantitative treatment limitations on SUD and mental health benefit coverage and align beneficiary cost-sharing for mental health and SUD benefits with those applicable to medical/surgical benefits, expand covered mental health and SUD treatment under TRICARE to include coverage of intensive outpatient programs and treatment of opioid use disorder and to streamline the requirements for mental health and SUD institutional providers to become TRICARE authorized providers, and to develop TRICARE reimbursement methodologies for newly recognized mental health and SUD intensive outpatient programs and opioid treatment programs. This book contains: - The complete text of the TRICARE - Mental Health and Substance Use Disorder Treatment (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Tricare Hospital Outpatient Prospective Payment System Opps Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-07 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: TRICARE - Hospital Outpatient Prospective Payment System (OPPS) (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the TRICARE - Hospital Outpatient Prospective Payment System (OPPS) (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 This final rule implements a prospective payment system for hospital outpatient services similar to that furnished to Medicare beneficiaries, as set forth in Section 1833(t) of the Social Security Act. The rule also recognizes applicable statutory requirements and changes arising from Medicare's continuing experience with this system including certain related provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The Department is publishing this rule to implement an existing statutory requirement for adoption of Medicare payment methods for institutional care which will ultimately provide incentives for hospitals to furnish outpatient services in an efficient and effective manner. This book contains: - The complete text of the TRICARE - Hospital Outpatient Prospective Payment System (OPPS) (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Tricare Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical Access Hospitals Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-07 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tricare - Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical Access Hospitals (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the Tricare - Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical Access Hospitals (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 This Final Rule implements for Sole Community Hospitals (SCHs) the statutory provision at title 10, United States Code (U.S.C.), section 1079(j)(2) that TRICARE payment methods for institutional care be determined, to the extent practicable, in accordance with the same reimbursement rules as those that apply to payments to providers of services of the same type under Medicare. This Final Rule implements a reimbursement methodology similar to that applicable to Medicare beneficiaries for inpatient services provided by SCHs. It will be phased in over a several-year period. This Final Rule also provides for special reimbursement for labor/delivery and nursery services in SCHs and creates a possible General Temporary Military Contingency Payment Adjustment (GTMCPA) for inpatient services in SCHs and for Critical Access Hospitals (CAHs). This book contains: - The complete text of the Tricare - Reimbursement of Sole Community Hospitals and Adjustment to Reimbursement of Critical Access Hospitals (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Tricare Outpatient Hospital Prospective Payment System Opps Us Department of Defense Regulation Dod 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-07 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: TRICARE - Outpatient Hospital Prospective Payment System (OPPS) (US Department of Defense Regulation) (DOD) (2018 Edition) The Law Library presents the complete text of the TRICARE - Outpatient Hospital Prospective Payment System (OPPS) (US Department of Defense Regulation) (DOD) (2018 Edition). Updated as of May 29, 2018 This interim final rule implements a prospective payment system for hospital outpatient services similar to that furnished to Medicare beneficiaries, as set forth in section 1833(t) of the Social Security Act. The rule also recognizes applicable statutory requirements and changes arising from Medicare's continuing experience with this system including certain related provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The Department is publishing this rule as an interim final rule to implement existing statutory requirements for adoption of Medicare payment methods for institutional care. Interim final rule publication will ensure the expeditious implementation of a proven hospital OPPS, providing incentives for hospitals to furnish outpatient services in an efficient and effective manner. However, public comments are invited and will be considered for possible revisions to the final rule. This book contains: - The complete text of the TRICARE - Outpatient Hospital Prospective Payment System (OPPS) (US Department of Defense Regulation) (DOD) (2018 Edition) - A table of contents with the page number of each section
Download or read book Defense Health Care written by United States. Government Accountability Office and published by . This book was released on 2011 with total page 31 pages. Available in PDF, EPUB and Kindle. Book excerpt: TRICARE Reserve Select (TRS) provides certain members of the Selected Reserve, reservists considered essential to wartime missions, with the ability to purchase health care coverage under the Department of Defense's (DOD) TRICARE program after their active duty coverage expires. TRS is similar to TRICARE Standard, a fee-for service option, and TRICARE Extra, a preferred provider option. The National Defense Authorization Act for Fiscal Year 2008 directed GAO to review TRS education and access to care for TRS beneficiaries. This report examines (1) how DOD ensures that members of the Selected Reserve are informed about TRS and (2) how DOD monitors and evaluates access to civilian providers for TRS beneficiaries. GAO reviewed and analyzed documents and evaluated an analysis of claims conducted by DOD. GAO also interviewed officials with the TRICARE Management Activity (TMA), the DOD entity responsible for managing TRICARE; the regional TRICARE contractors; the Office of Reserve Affairs; and the seven reserve components. GAO recommends that the Secretary of Defense direct the Assistant Secretary of Defense for Reserve Affairs to develop a policy requiring each reserve component to designate a centralized point of contact for TRS education. DOD partially concurred with this recommendation, citing a concern about regional coordination. GAO modified the recommendation.
Download or read book Defense Health Care written by Frederick Duncan and published by . This book was released on 2019-04 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt: For over a decade, Congress and DOD have led a series of efforts to address the governance structure of the Military Health System. In chapter1, GAO examines (1) measures DOD uses to assess the quality of direct and purchased care, and (2) the extent to which DOD has established performance standards related to the measures and corrective action requirements for providers who do not meet those standards. As reported in chapter 2, or more than a decade, partially in response to congressional mandates, DOD has worked to address inefficiencies in the Military Health System to control costs. Chapter 3 examines the military departments planning processes for determining (1) operational medical personnel requirements, including an assessment of the mix of federal civilian, contractor, and active and reserve medical personnel; and (2) the most appropriate workforce mix at MTFs and any challenges in executing their desired workforce mix. The National Defense Authorization Act (NDAA) for Fiscal Year 2008 directed DOD to conduct surveys of nonenrolled beneficiaries and civilian providers about access to care under the TRICARE Standard and Extra options. It also directed GAO to review the surveys results. Additionally, the NDAA for Fiscal Year 2017 included a provision for GAO to review access to care under TRICARE Extra. Chapter 4 addresses both provisions. The NDAA 2017 made several changes to the TRICARE program, including the establishment of a new preferred provider network health plan option called TRICARE Select. The NDAA 2017 made several changes to the TRICARE program, including the establishment of a new preferred provider network health plan option called TRICARE Select. GAO examined program policies, procedures, and contracts and interviewed DOD officials and TRICARE regional contractors as reported in chapter 5.
Download or read book Defense health care written by United States. General Accounting Office and published by . This book was released on 2003 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Testifying before Congress in 2002, military beneficiary groups and civilian managed care support contractors described problems with the processing of TRICARE claims for civilian-provided care. These problems included slow payments and procedures that made claims processing inefficient. The Bob Stump National Defense Authorization Act of 2003 required GAO to review improvements to TRICARE claims processing and continuing impediments to claims processing efficiency. Specifically, GAO describes (1) efforts to improve claims processing and changes in processing timeliness and (2) Department of Defense (DOD) procedures and data that continue to affect claims processing efficiency. To identify improvements to claims processing and impediments to processing efficiency, GAO analyzed 1999 and 2002 claims data for changes in processing timeliness. GAO also interviewed and analyzed claims processing documentation from DOD officials, managed care support contractors, and claims processors. In an effort to improve TRICARE claims processing, DOD and its managed care support (MCS) contractors have made changes that are designed to make it more efficient. First, they have jointly identified--and then eliminated or changed--certain DOD requirements they deemed inefficient and nonessential to accurate claims processing. For example, contractors are no longer required to hold claims with incomplete information and request the missing information from the provider or beneficiary. Instead, contractors may now return some claims with missing information. In another change, DOD eliminated preauthorization requirements for certain procedures and gave the MCS contractors more latitude for determining when preauthorizations are appropriate. To encourage providers to submit their claims electronically, DOD gave MCS contractors the authority to decide whether to adjudicate electronically submitted claims sooner than those submitted on paper. Further, MCS contractors have worked with their claims processors to implement new technologies for data input, claims routing, customer service, and claims submission. Finally, MCS contractors and their claims processors have improved the timeliness with which they process claims. In fiscal year 2002, claims processors processed over 97 percent of claims in 30 days or less--an improvement over fiscal year 1999, when 91 percent of claims were processed in 30 days or less. Although DOD and its MCS contractors have made changes to improve claims processing, some DOD procedures and inaccuracies in its data continue to create inefficiencies in TRICARE claims processing. Some DOD procedures may create inefficiencies by inadvertently increasing the demand for customer service, which claims processors are required to provide. Additionally, inaccuracies in DOD eligibility data--data that are needed to process TRICARE claims--can contribute to claims processing delays or rework if, for example, claims must be reprocessed when errors are identified. Finally, some DOD procedures lead to rework for claims processors, either in the form of reprocessing claims or reprogramming processing software. For example, when DOD makes program changes to TRICARE to alter or create a health benefit, it does not adhere to any schedule. In 2002, DOD made 123 program changes on 19 different dates throughout the year. Given the fact that implementing these changes often involves reprogramming and testing processing software, this approach can create rework for claims processors when DOD issues similar or related changes on separate occasions.
Download or read book Strengthening the Military Family Readiness System for a Changing American Society written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-10-25 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: The U.S. military has been continuously engaged in foreign conflicts for over two decades. The strains that these deployments, the associated increases in operational tempo, and the general challenges of military life affect not only service members but also the people who depend on them and who support them as they support the nation â€" their families. Family members provide support to service members while they serve or when they have difficulties; family problems can interfere with the ability of service members to deploy or remain in theater; and family members are central influences on whether members continue to serve. In addition, rising family diversity and complexity will likely increase the difficulty of creating military policies, programs and practices that adequately support families in the performance of military duties. Strengthening the Military Family Readiness System for a Changing American Society examines the challenges and opportunities facing military families and what is known about effective strategies for supporting and protecting military children and families, as well as lessons to be learned from these experiences. This report offers recommendations regarding what is needed to strengthen the support system for military families.
Download or read book Recognition of Contingent Liabilities Arising from Litigation written by United States. Office of Management and Budget and published by U.S. Government Printing Office. This book was released on 1999 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managerial Cost Accounting Concepts and Standards for the Federal Government written by United States. Federal Accounting Standards Advisory Board and published by . This book was released on 1995 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:
