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Policy/Guidance : Letters

Compliance Toolkit

OASD(HA) Memorandum “Use of CPT Code 99199”
This memorandum establishes MHS medical coding and billing policy effective 1 Oct 2004 that CPT® code 99199 is to be used to represent the institutional portion of an ambulatory procedure visit (APV). (posted 20 October 2014)
OASD HA Memorandum - Use of CPT Code 99199 pdf 52.3 KB

Policy for Billing of Observation Services in Military Treatment Facilities
This memorandum cancels the TMA policy memorandum titled, "Policy for Reporting and Billing of Observation Services," dated 11 August 2010, and implements a new policy for billing observation services provided in fixed MTFs. (posted 5 August 2011)
Billing for Observation Services pdf 113.0 KB

Medical Services Account Collections Credited in Year Received
This policy, effective January 1, 2006, directs MTFs to credit MSA collections in the year of receipt rather than in the year services were rendered. (posted 16 Oct 2009)
MSA In Year Received pdf 702.4 KB

Health Affairs Policy Memo: National Defense Authorization Act for Fiscal Year 2009 Permanent Prohibition Against Requiring Certain Injured Members to Pay for Meals Provided by Military Treatment Facilities(posted 6 Feb 2009)
Meals for Injured Members pdf 221.7 KB

Defense Health Program Accounts Receivable Policy
This memorandum (issued 2 May 2008) establishes policy for the recognition, collection, and reporting of accounts receivable to improve the accuracy of financial statements and prepare the Defense Health Program (DHP)-funded activities for audit readiness. Compliance by each Financial Statement Reporting Entity (FSRE) is required by September 30, 2008. (posted 23 May 2008)
Accounts Receivable Reporting Policy Letter pdf 240.1 KB
Write Off of Aged Accounts Receivable Due from the Public pdf 263.1 KB

Policy Guidance for Provision of Medical Care Provided to DoD Civilian Employees Injured or Wounded While Forward Deployed in Support of Hostilities (24 September 2007) (posted 24 September 2007)
DoD Civilians Wounded or Injured While Forward Deployed pdf 120.8 KB

Policy for Pharmacy Copayments and Elimination of Copayments for Active Duty Family Members (2001)
This policy introduced Pharmacy copayments and announced the elimination of copayments for care provided to Active Duty personnel family members enrolled in TRICARE Prime.
Pharmacy Co-Pays and Elimination of Prime ADFM Co-Pays pdf 99.1 KB

HA Policy 08-007
Policy for Billing and Collections for Third Party Collection Program, Medical Services Accounts, and Medical Affirmative Claims in Military Treatment Facilities
HA 08-007 Third Party Collection Program pdf 61.4 KB

HA Policy 08-002
Policy for Billing for Care Furnished by Military Treatment Facilities to Federal Employees for On-the-Job Injuries and for Occupational Health (posted 4-8-08)
HA 08-002 Billing for Care for On the Job Injuries and Occ Health pdf 94.5 KB

HA Policy 07-026
Policy for Billing Non-Department of Defense Beneficiary Newborns
HA 07-026 - Billing Non-DoD Beneficiary Newborns pdf 330.0 KB

HA Policy 07-005
Policy of Military Treatment Facilities Not Billing for Telephone Calls
HA 07-005 MTF Not Billing for Telephone Calls pdf 94.6 KB

HA Policy 05-020
Policy for Cosmetic Surgery Procedures in the Military Health System
HA 05-020 Cosmetic Surgery Procedures in the MHS pdf 222.6 KB

Compliance Toolkit

A compliance program is one of the elements of the Internal Control Review within an MTF. Attached below are several documents to help with your compliance program. Please contact your Service UBO Manager if you need guidance relative to your compliance program.
Anti-Fraud Program at Military Treatment Facilities (MTFs) pdf 58.2 KB
Compliance Plan Implementation Policy pdf 4954.5 KB
Code of Conduct doc 26.0 KB
Certification Memo doc 25.5 KB
Sample Compliance Committee Charter doc 27.5 KB
MSA Claim Post-Submission Review Worksheet doc 37.0 KB
TPCP Claim Post Submission Review Worksheet doc 50.5 KB [updated 08-25-14]
MAC Claim Post-Submission Review Worksheet doc 37.0 KB
Compliance Audit Requirements pdf 51.2 KB
Compliance Audit Checklist Template doc 475.0 KB [updated 08-25-14]
Annual Review of Compliance Program Effectiveness Checklist doc 151.0 KB
Model Compliance Document doc 89.0 KB

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