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| DOD/DODOASHA | RIN: 0720-AB59 | Publication ID: Fall 2016 |
| Title: TRICARE; Clarification of Coverage of Durable Equipment and Ordering/Prescribing Durable Equipment; Clarification of Assistive Technology Devices Benefit Under the Extended Care Health Option Program | |
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Abstract:
The Department of Defense (DoD) made several amendments to the TRICARE regulation. Specifically, the rule revised the definitions of durable equipment (DE) and durable medical equipment (DME) to better conform the language in the regulation to the statute; implementing the statutory requirements will not change current policies. This rule also added a definition of assistive technology (AT) devices for purposes of benefit coverage under the TRICARE Extended Care Health Option (ECHO) Program, and removed the restriction under the TRICARE Basic Program that limits ordering or prescribing of DME to only a physician, to allow certain other authorized individual professional providers acting within the scope of their licensure to order or prescribe DME. Finally, the rule incorporated a policy clarification relating to luxury, deluxe, or immaterial features of equipment or devices. Namely, TRICARE cannot reimburse for the luxury, deluxe, or immaterial features of equipment or devices. However, TMA can reimburse for the base or basic equipment or device that meet the beneficiary's needs. Beneficiaries may pay the provider for the luxury, deluxe, or immaterial features themselves, if they desire their equipment or device to have these extra features. |
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| 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 | |
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Legal Deadline:
None |
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Timetable:
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| 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 | |
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Agency Contact: Gail L. Jones Department of Defense Office of Assistant Secretary for Health Affairs 1200 Defense Pentagon, Washington, DC 20301 Phone:303 676-3401 |
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