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 Brooke Army Medical Center (BAMC) and Wilford Hall Medical Center (WHMC), hereinafter referred to as Destination San Antonio, have been designated the Regional Specialized Treatment Service facilities (STSFs) for DRGs 1, 3, 4, 49, 104-107, 110-111, 191, 209, 491, 286, and 357. The application for the STSF designation was submitted by the Lead Agency for TRICARE Region 6 and approved by the Assistant Secretary of Defense (Health Affairs). The Lead Agent will oversee that the STSFs maintain the quality and standards required for specialized treatment services. DoD beneficiaries residing within a 200-mile radius of Destination San Antonio facilities falling into the above patient category must be evaluated by Destination San Antonio staff before receiving care for these DRGs under direct military care or TRICARE/CHAMPUS cost sharing. 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 Destination San Antonio facility 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 a Destination San Antonio facility. If the care for these DRGs cannot be performed at the Destination San Antonio facilities, the TRICARE Managed Care Support Contractor for Region 6 will provide a medical necessity review prior to issuance of an Inpatient Care Authorization or Non-availability Statement.
D002309:Cardiology / Q000191:economics*; D002391:Catchment Area, Health; 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; D013781:Texas; D014195:Travel; D014481:United States