TRICARE; the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); specialized treatment services (STS) program--DoD. Notice.
This notice is to advise interested parties that Dwight D. Eisenhower Army Medical Center (EAMC), Fort Gordon, Georgia, has been designated a regional Specialized Treatment Services facility (STSF) for Neurosurgery, Orthopedic Surgery, General Surgery, Peripheral Vascular Surgery, and Head and Neck Surgery. The application for this STSF designation was submitted by the Lead Agent for TRICARE Region 3 and approved by the Assistant Secretary of Defense (Health Affairs). The Lead Agent will oversee that the STSF maintains the quality and standards required for specialized treatment services. This designation covers the following Diagnostic Related Groups: 001--Craniotomy, Age Greater than 17, Except for Trauma 004--Spinal Procedures 049--Major Head and Neck Procedures 191--Pancreas, Liver and Shunt Procedures with CC 110--Major Cardiovascular Procedures with CC 111--Major Cardiovascular Procedures without CC 286--Adrenal and Pituitary Procedures 209--Major Joint and Limb Reattachment Procedures of Lower Extremity 491--Major Joint and Limb Reattachment of Upper Extremity DoD beneficiaries who reside in the EAMC STS Catchment Area must be evaluated by EAMC before receiving TRICARE/CHAMPUS cost sharing for procedures that fall under the above Diagnostic Related Groups, in accordance with TRICARE/CHAMPUS Nonavailability Statement policy. Travel and lodging for the patient and, if stated to be medically necessary by a referring physician, for a nonmedical attendant, will be reimbursed by EAMC in accordance with the provisions of the Joint Federal Travel Regulation. Although evaluation in person is preferred, it is possible to conduct the evaluation telephonically if the patient is unable to travel to EAMC. If the procedure cannot be performed at EAMC, Humana Military Healthcare Services will provide a medical necessity review prior to issuance of a Nonavailability Statement or other similar authorizations. The EAMC STSF Catchment Area is defined by zip codes in the Defense Medical Information System STS Facilities Catchment Area Directory. The Catchment Area includes zip codes within TRICARE Region 3 that fall within a 200-mile radius of EAMC.
D002391:Catchment Area, Health; D003953:Diagnosis-Related Groups; D005845:Georgia; D006077:Government Agencies; D006264:Health Benefit Plans, Employee / Q000331:legislation & jurisprudence*; D006772:Hospitals, Military / Q000191:economics / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D006801:Humans; D012040:Regional Health Planning / Q000331:legislation & jurisprudence; D013043:Specialties, Surgical / Q000191:economics*