Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE program; uniform HMO benefit; special health care delivery programs--DoD. Final rule.
This final rule establishes requirements and procedures for implementation of the TRICARE Program, the purpose of which is to implement a comprehensive managed health care delivery system composed of military medical treatment facilities and CHAMPUS. Principal components of the final rule include: establishment of a comprehensive enrollment system; creation of a triple option benefit, including a Uniform HMO Benefit required by law; a series of initiatives to coordinate care between military and civilian delivery systems, including Resource Sharing Agreements, Health Care Finders, PRIMUS and NAVCARE Clinics, and new prescription pharmacy services; and a consolidated schedule of charges, incorporating steps to reduce differences in charges between military and civilian services. This final rule also includes provisions establishing a special civilian provider program authority for active duty family members overseas. The TRICARE Program is a major reform of the MHSS that will improve services to beneficiaries while helping to contain costs.
D005245:Fee Schedules; D006077:Government Agencies; D006264:Health Benefit Plans, Employee / Q000331:legislation & jurisprudence*; D006279:Health Maintenance Organizations / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D006772:Hospitals, Military / Q000331:legislation & jurisprudence*; D008887:Military Medicine / Q000191:economics; D011907:Rate Setting and Review / Q000331:legislation & jurisprudence; D014481:United States