Office of the Secretary March 4, 2011 – Federal Register Recent Federal Regulation Documents

The Defense Logistics Agency is proposing to amend a system of records notice in its existing inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as amended.

Under the provisions of the Federal Advisory Committee Act of 1972 (5 U.S.C., Appendix, as amended), the Government in the Sunshine Act of 1976 (5 U.S.C. 552b, as amended), and 41 CFR 102-3.150, the Department of Defense announces that the following Federal Advisory Committee meeting of the Department of Defense Task Force on the Care, Management, and Transition of Recovering Wounded, Ill, and Injured Members of the Armed Forces (subsequently referred to as the Task Force) will take place.

This notice is to advise interested parties of an extension to the Military Health System (MHS) demonstration project, under authority of Title 10, U.S. Code, Section 1092, entitled Web-Based TRICARE Assistance Program. This demonstration was effective August 1, 2009, as referenced in the original Federal Register Notice, 74 FR 3667, July 24, 2009. The demonstration was extended to March 31, 2011, as referenced by Federal Register Notice, March 30, 2010. The demonstration project uses existing managed care support contracts (MCSC) to allow Web-based behavioral health and related services including non-medical counseling and advice services to active duty service members (ADSM), their families and members and their dependents enrolled in TRICARE Reserve Select, and those eligible for the Transition Assistance Management Program (TAMP) who reside in the continental United States. The extension is necessary to allow more time to measure the effectiveness of the demonstration in meeting its goal of improving beneficiary access to behavioral health care by incorporating Web-based technology.

This notice is to advise interested parties of the continuation of a Military Health System (MHS) demonstration project entitled ``Disease Management Demonstration Project for TRICARE Standard Beneficiaries''. The original demonstration notice was published on June 13, 2007 (72 FR 32628-32629) and described a demonstration project to provide disease management (DM) services to TRICARE Standard beneficiaries in addition to the TRICARE Prime beneficiaries who were already entitled to such services. TRICARE began the demonstration project in March 2007 for Standard beneficiaries and this demonstration project has enabled the MHS to provide uniform policies and practices on disease and chronic care management throughout the TRICARE network. Additionally, the demonstration has helped determine the effectiveness of DM programs in improving the health status of beneficiaries with targeted chronic diseases or conditions, and any associated cost savings. The TRICARE Management Activity (TMA) chose a phased approach to determine the efficacy and cost effectiveness of its disease management demonstration, beginning with beneficiaries identified with the disease states of asthma, heart failure, and diabetes. TMA now intends to continue the disease management services to TRICARE Standard beneficiaries until a permanent TRICARE disease management benefit (per the John Warner National Defense Authorization Act of 2007, section 734) is implemented. This continuation of the disease management demonstration project will be conducted under the authority provided in 10 U.S.C. 1092.

This notice is to advise interested parties of a Military Health System (MHS) Demonstration project under the authority of Title 10, U.S. Code, Section 1092, entitled Department of Defense TRICARE Access to Care Demonstration Project. The demonstration project is intended to improve access to urgent care including minor illness or injury for Coast Guard beneficiaries enrolled in TRICARE Prime or TRICARE Prime Remote while decreasing emergency room visits and healthcare costs. Under the demonstration, Coast Guard active duty service members (ADSMs) and their family members who are enrolled in TRICARE Prime or TRICARE Prime Remote in the South Region would be allowed to self-refer, without an authorization, to a TRICARE network provider such as an Urgent Care Clinic (UCC) or Convenience Center for up to four urgent care visits per year. No referral from their Primary Care Manager (PCM) or authorization by a Health Care Finder will be required and no Point of Service (POS) deductibles and cost shares shall apply to these four unmanaged visits. Additionally, when outside of the South region, these Coast Guard TRICARE Prime or Prime Remote enrollees may use any TRICARE authorized provider or UCC without incurring POS deductibles and cost shares. The ADSM and family member will be required to notify their PCM of any urgent/acute care visits to other than their PCM within 24 hours of the visit and schedule any follow-up treatment that might be indicated with their PCM. If more than the four (4) authorized urgent care visits are used, or if the beneficiary seeks care from a non TRICARE network or non TRICARE authorized provider, POS deductibles and cost shares as required by Title 32, Code of Federal Regulations (CFR), 199.17(n)(3) may apply. Referral requirements for specialty care and inpatient authorizations will remain as currently required by MHS policy.