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DOD/DODOASHA RIN: 0720-AB61 Publication ID: Spring 2015 
Title: TRICARE; Coverage of Care Related to Non-Covered Initial Surgery or Treatment  
Abstract:

The Department of Defense (DoD) published this rule to allow coverage for otherwise covered services and supplies required in the treatment of complications (unfortunate sequelae), as well as medically necessary and appropriate follow-on care, resulting from a non-covered incident of treatment provided pursuant to a properly granted Supplemental Health Care Program waiver. This rule was necessary to protect TRICARE beneficiaries from incurring financial hardships due to the current regulatory restrictions that prohibit TRICARE coverage of the treatment of complications resulting from non-covered medical procedures, even when those procedures were provided while the beneficiary was an active duty member and were authorized by the Director, TRICARE Management Activity (TMA), based on a determination that a waiver authorizing the original non-covered surgery or treatment was necessary to assure adequate availability of health care to the active duty member. Additionally, with respect to care that is related to a non-covered initial surgery or treatment, the rule eliminated any confusion regarding what services and supplies will be covered by TRICARE, and under what circumstances they will be covered.

 
Agency: Department of Defense(DOD)  Priority: Substantive, Nonsignificant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Completed Actions 
Major: No  Unfunded Mandates: No 
CFR Citation: 32 CFR 199   
Legal Authority: 5 U.S.C. 301    10 U.S.C. ch 55   
Legal Deadline:  None
Timetable:
Action Date FR Cite
NPRM  10/22/2013  78 FR 62506   
NPRM Comment Period End  12/23/2013 
Final Action  12/31/2014  79 FR 78703   
Final Action Effective  01/30/2015 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Small Entities Affected: No  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Patricia Lynn Toppings
Department of Defense
Office of Assistant Secretary for Health Affairs
4800 Mark Center Drive, Suite 02G09,
Alexandria, VA 22350-3100
Phone:571 372-0485
Email: patricia.l.toppings.civ@mail.mil