99-18514. TRICARE; the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); Specialized Treatment Services (STS) Program

[Federal Register Volume 64, Number 139 (Wednesday, July 21, 1999)]
[Notices]
[Page 39119]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-18514]


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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 advice interested parties that the VA Palo 
Alto Health Care System (VAPAHCS) and the San Francisco VA Medical 
Center (SFVAMC), located in TRICARE Region Ten, have been designated as 
Regional Specialized Treatment Services Facilities (STSFs) for Cardiac 
Surgery. Both of these facilities are members of the Veterans 
Integrated Service Network 21 (VISN 21) of the Veterans Health 
Administration (VHA). The application for the STSF designation was 
submitted by VISN 21 and approved by the Assistant Secretary of Defense 
(Health Affairs). The Lead Agent for Region Ten will ensure the STSFs 
maintain the quality and standards required for specialized treatment 
services. The designation covers the following Related Groups:

104--Cardiac valve procedure with cardiac catheterization
105--Cardiac valve procedure without PTCA
106--Coronary bypass with PTCA
107--Coronary bypass with cardiac catheterization
108--Other cardiothoracic procedures
109--Coronary bypass without cardiac catheterization

    Travel and lodging for the patient and, if stated to be medically 
necessary by a referring physician, for one non-medical attendant, will 
be reimbursed by the VAPAHCS or SFVAMC in accordance with the 
provisions of the Joint Federal Travel Regulation. Patients will be 
referred to the STSFs based on patient/provider preference and, if no 
preference is indicated, the referrals will occur on a one-for-one 
rotational basis between the VAPAHCS and the SFVAMC. DoD beneficiaries 
who reside in the Regional STSF Catchment Area for VAPAHCS and SFVAMC 
in TRICARE Region Ten must receive cardiac surgery services for the 
above DRGs from these facilities unless a Nonavailability Statement 
(NAS) or an authorization is issued. Evaluation by VAPAHCS or SFVAMC in 
person is preferred, and travel and lodging expenses for the evaluation 
will be reimbursed as stated above. It is possible to conduct the 
evaluation telephonically if the patient is unable to travel to VAPAHCS 
or SFVAMC. If the procedure cannot be performed at the VAPAHCS and 
SFVAMC, these facilities will provide a medical necessity review prior 
to issuance of a NAS or authorization.
    The Regional STSF Catchment Area for VAPAHCS and SFVAMC covering 
Region Ten will be defined by zip codes in the Defense Medical 
Information System STSF Catchment Area Directory. The Catchment Area 
includes zip codes within TRICARE Region Ten that fall within a 200-
mile radius of the midpoint of a line between the VAPAHCS and SFVAMC.

EFFECTIVE DATE: On or after October 1, 1999.

FOR FURTHER INFORMATION CONTACT: Mr. Eric Raffin, CHE, VAPAHCS, at 
[phone]; or Lieutenant Colonel Pam Cygan, TRICARE Region Ten 
Lead Agent Office, at [phone]; or Lieutenant Colonel 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: July 14, 1999.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 99-18514 Filed 7-20-99; 8:45 am]
BILLING CODE 5001-10-M