[Federal Register Volume 59, Number 170 (Friday, September 2, 1994)]
[Notices]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 94-21705]
[[Page Unknown]]
[Federal Register: September 2, 1994]
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DEPARTMENT OF DEFENSE
Civilian Health and Medical Program of the Uniformed Services
(CHAMPUS); Demonstration Project in Europe
AGENCY: Office of the Secretary, DoD.
ACTION: Notice of a CHAMPUS demonstration project to be implemented in
Europe.
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SUMMARY: Military force reductions in Europe have resulted in
diminished military medical services for many areas, particularly those
where the active duty end strength has fallen below levels which would
support a military health clinic. Service members and their families,
particularly those in remote areas, have experienced significant access
problems in areas where military medical services have either been
substantially reduced or eliminated. Although some military families
currently use civilian providers, differences in U.S. and local
national billing practices have resulted in payment delays which are
unacceptable to host nation providers. Because local systems are not
conducive to calculation and collection of beneficiary deductibles and
cost shares, these payments by beneficiaries are often overlooked or
substantially delayed and have become a source of major dissatisfaction
among local providers. As a result, some local providers have indicated
they are no longer willing to accept CHAMPUS patients while others have
begun to require payment for services in advance. This demonstration is
proposed for the purpose of testing whether special agreements with
host nation medical providers and elimination of CHAMPUS deductible and
cost shares can enhance beneficiary access to required care. Although
earlier demonstration proposals for Europe limited participation to
medically remote or underserved areas, payment issues which have become
barriers to access affect all active duty families in Europe who must
seek care in host nation hospitals and clinics. For this reason, the
demonstration is proposed for the entire region. Demonstration
participants will include family members of all active duty personnel
in the uniformed services located in countries served by OCHAMPUS
EUROPE. Under Title 10, U.S. Code, Section 1092, the Department is
authorized to test different methods of financing delivery of health
care services under CHAMPUS.
DATES: Beginning 1 October 1994, active duty family members in
countries served by OCHAMPUS EUROPE who cannot obtain required services
in military hospitals and clinics may obtain those services from
civilian providers without paying cost shares and deductibles normally
required under standard CHAMPUS. CHAMPUS eligible beneficiaries other
than active duty family members are not eligible for participation.
Standard CHAMPUS is still available for individuals who do not qualify
under this program.
FOR FURTHER INFORMATION CONTACT:
CDR Deborah Kamin, Office of the Assistant Secretary of Defense (Health
Affairs), (703) 697-8975.
SUPPLEMENTARY INFORMATION: Under this CHAMPUS demonstration, active
duty family members who are unable to access services in a military
medical treatment facility (MTF) may obtain both inpatient and
outpatient services through local national medical facilities. Where
possible, written agreements will be executed between these local
national medical facilities and elements of the uniformed services in
areas served by OCHAMPUS EUROPE. Care received under this demonstration
project would require neither the cost share nor the deductible
normally collected for inpatient and outpatient services under standard
CHAMPUS.
While the primary demonstration component, elimination of CHAMPUS
cost shares and deductibles, applies to all active duty families,
development of referral networks and agreements with host nation
providers will be phased, with earliest attention directed at remote or
underserved areas which have experienced significant reduction or
elimination of military medical services. Initial development of
referral networks and agreements will occur in Germany.
Demonstration participation will be restricted to active duty
dependents. Active duty service members will be included in provider
agreements; separate procedures and funding will be used to account and
process payment for care rendered to active duty personnel as required
by current regulation. The Office of the Assistant Secretary of Defense
(Health Affairs) will act as executive agent for purposes of this
demonstration and will assume overall responsibility for demonstration
policy, implementation, and monitoring.
DURATION: This demonstration will operate for one year with two
additional option years. Continuation of the program will depend on a
program evaluation conducted toward the end of the first year of
operation.
It is our hypothesis that specific agreements with local national
providers will clarify relationships and forge stronger links between
U.S. and host nation providers. These links will become more critical
as troop withdrawals continue to affect U.S. military medical presence
and capabilities in Europe. Elimination of the beneficiary cost share
and deductible should ease a major source of conflict with respect to
payment of host nation providers, thereby improving access to care for
our beneficiaries. A decreasing military presence in Europe can be
likened to a shrinking ``market power'' and, hence, less capability for
area commanders to negotiate favorable arrangements and/or access to
local civilian medical services. Formal agreements which clarify DoD's
commitment to payment procedures and deadlines and a streamlined
administrative process without copayments and deductibles should
provide positive incentive for local facilities to accept CHAMPUS
beneficiaries.
EXCLUSIONS TO THE EUROPE DEMONSTRATION PROJECT: Participation in this
demonstration is limited to active duty dependents.
All current CHAMPUS rules, unless this notice specifically provides
otherwise, will continue to apply. This notice reflects the changes
under this demonstration which is expected to start 1 October 1994.
Dated: August 29, 1994.
L.M. Bynum,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 94-21705 Filed 9-1-94; 8:45 am]
BILLING CODE 5000-04-M
