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DOD/DODOASHA

RIN: 0720-AB42

Publication ID: Fall 2011

Title: TRICARE; Reimbursement for Travel for Specialty Care Under Exceptional Circumstances
Abstract: This proposed rule implements section 634 of the National Defense Authorization Act for Fiscal Year 2010 which amends section 1074i of title 10, United States Code to permit reimbursement for reasonable travel expenses for active duty members of the uniformed Services and their dependents, and accompaniment, to a specialty care provider under such exceptional circumstances as the Secretary of Defense may proscribe. The Department of Defense through its military treatment facilities and its robust managed care program, TRICARE Prime, is able to fulfill the medical needs of the majority of its active duty members and their families. However, in some locations where active duty members and their families live due to the duty assignment of the member, the medical resources in the military treatment facilities and the managed care networks may not meet all of the specialty care needs of these members and their families within normal access standards. Reimbursement of reasonable travel expenses for required specialty care that is more than 100 miles from the primary care manager's office is currently a benefit under paragraph (a) of section 1074i, title 10 United States Code for any covered beneficiary enrolled in the TRICARE Prime program, including the active duty members and their dependents. However this proposed rule extends a travel reimbursement for active duty members of the armed forces and their families who, because of an exceptional circumstance involving the duty assignment of the active duty member of the armed forces, are required to travel less than 100 miles but more than 60 minutes in drive time to access needed specialty care. This travel reimbursement benefit is limited to those active duty members and their dependents, and accompaniment, enrolled in Prime or TRICARE Prime Remote. The Director, TRICARE Management Activity, shall issue procedures and guidelines under which authorization for reimbursement of travel expenses will be issued after verification that the member, family member, and/or accompaniment, must travel less than 100 miles but more than 60 minutes drive time from the military treatment facility or their primary care manager's office to receive required specialty care.
Agency: Department of Defense(DOD)	Priority: Substantive, Nonsignificant
RIN Status: Previously published in the Unified Agenda	Agenda Stage of Rulemaking: Final Rule Stage
Major: No	Unfunded Mandates: No
CFR Citation: 32 CFR 199
Legal Authority: 5 USC 301 10 USC ch 55

Legal Deadline: None

Timetable:

Action	Date	FR Cite
NPRM	01/13/2011	76 FR 2290
NPRM Comment Period End	03/14/2011
Final Action	04/00/2012

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: LTC Kathleen Larkin Department of Defense Office of Assistant Secretary for Health Affairs 1200 Defense Pentagon, Washington, DC 20301 Phone:703 681-0039 Fax:703 681-1219 Email: kathleen.larkin@tma.osd.mil