98-31421. TRICARE; the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Specialized Treatment Services (STS) Program

[Federal Register Volume 63, Number 227 (Wednesday, November 25, 1998)]
[Notices]
[Pages 65179-65180]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-31421]


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DEPARTMENT OF DEFENSE

Office of the Secretary


TRICARE; the Civilian Health and Medical Program of the Uniformed 
Services (CHAMPUS); Specialized Treatment Services (STS) Program

AGENCY: Office of the Secretary, DoD.

ACTION: Notice.

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SUMMARY: This notice is to advise interested parties that St. Joseph 
Hospital, 5665 Peachtree Dunwoody Road NE, Atlanta, GA 30342; The 
Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 
29425; Tampa General Hospital, Davis Island, P.O. Box 1289, Tampa FL 
33601; St. Thomas Hospital, 3401 West End Avenue, Suite 120, Nashville, 
TN 37203; The University of Alabama at Birmingham, Transplant Center, 
102 Mortimer Jordan Hall, 1825 University Boulevard, Birmingham, AL 
35294-2010; Egleston Children's Hospital, 1405 Clifton Road NE, 
Atlanta, GA 30322-1101; and Jackson Memorial Hospital, 1611 NW 12th 
Avenue, Miami, FL 33136-1094, have been designated as Regional 
Specialized Treatment Services Facilities (STSFs) for various 
Transplant procedures. The application for the STSF designation for 
these facilities was submitted by the Humana Military Health Services, 
Inc. (HMHS) in coordination with the Lead Agents for TRICARE Regions 3 
and 4 and approved by the Assistant Secretary of Defense (Health 
Affairs). The HMHS will oversee that these STSFs maintain the quality 
and standards required for specialized treatment services. This 
designation covers the following Diagnosis Related Groups:

103--Heart Transplant (Medical University of South Carolina, University 
of Alabama-Birmingham, Egleston Children's Hospital, Jackson Memorial 
Hospital, St. Joseph Hospital, St. Thomas Hospital, and Tampa General 
Hospital)
480--Liver Transplants (Medical University of South Carolina, 
University of Alabama-Birmingham, Egleston Children's Hospital, and 
Jackson Memorial Hospital)
495--Lung Transplant (University of Alabama-Birmingham)
495--Heart-Lung Transplant (University of Alabama-Birmingham)

    As part of the STS program within TRICARE Regions 3 and 4, HMHS 
will assume responsibility for transportation, food and lodging for 
patients within a radius ranging from over 40 miles and up to 200 miles 
from designated STS Transplantation Centers. Under this plan, HMHS will 
reimburse patients the mileage allowance for travel, pay up to the per 
diem allowed by the government for food and lodging, or the actual 
cost, whichever is less, and will adjust per diems and mileage 
allowances according to government regulations. Whenever possible, HMHS 
will also make lodging arrangements for the patients and one non-
medical attendant.

[[Page 65180]]

DoD beneficiaries who reside in the catchment areas of the designated 
STS facilities must be evaluated by the appropriate facility prior to 
receiving TRICARE/CHAMPUS cost sharing for procedures that fall under 
the above Diagnosis Related Groups. Evaluation in person is preferred, 
and travel and lodging expenses for the evaluation will be reimbursed 
as stated above. It may be possible to conduct the evaluation 
telephonically if the patient is unable to travel to the appropriate 
facility. If a needed procedure cannot be performed by one of the above 
facilities, HMHS will provide a medical necessity review prior to 
issuance of a Nonavailability Statement or other similar 
authorizations. The Catchment Area for each transplant STS includes zip 
codes within TRICARE Regions 3 and 4 that fall within a 200 mile radius 
of the facility.

EFFECTIVE DATE: March 1, 1999.

FOR FURTHER INFORMATION CONTACT:
Richard Mancini, Director of Network Development, Humana Military 
Healthcare Services, Inc., 500 West Main St., Louisville, KY 40202, 
telephone [phone]; LCDR Leesa Kent, Office of the Lead Agent, 
TRICARE Region 3, [phone]; Colonel Joe Taylor, Office of the 
Lead Agent, TRICARE Region 4, [phone]; Lt. Col. Teresa Sommese, 
TRICARE Management Activity, [phone], extension 5029; or Mr. 
Tariq Shahid, TRICARE Management Activity, [phone].

SUPPLEMENTARY INFORMATION: In FR DOC 93-27050, appearing in the Federal 
Register on November 5, 1993 (Vol. 58, FR 58955-58964), the final rule 
on the STS Program was published. Included in the final rule was a 
provision that a notice of all military and civilian STS facilities be 
published in the Federal Register annually. This notice is issued under 
the authority of 10 U.S.C. 1105 and 32 CFR 199.4(a)(10).

    Dated: November 19, 1998.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 98-31421 Filed 11-24-98; 8:45 am]
BILLING CODE 5000-04-M