[Federal Register Volume 63, Number 227 (Wednesday, November 25, 1998)]
[Notices]
[Pages 65180-65181]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-31423]


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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 Naval Medical 
Center, San Diego (NMCSD), has been designated a regional Specialized 
Treatment Services Facility (STSF) for TRICARE Region Nine. The 
application for this STSF designation was submitted by the Lead Agent 
for TRICARE Region Nine and approved by the Assistant Secretary of 
Defense (Health Affairs). The Lead Agent will ensure that the STSF 
maintains the quality and standards required for specialized treatment 
services. This designation covers the following Diagnostic Related 
Groups:

001--Craniotomy, Age Greater than 17, Except for Trauma
003--Craniotomy, Age 0-17
004--Spinal Procedures
049--Major Head and Neck Procedures
104--Cardiac Valve Procedure with Cardiac Catheterization
105--Cardiac Valve Procedure without Cardiac Catheterization

[[Page 65181]]

106--Coronary Bypass with Cardiac Catheterization
107--Coronary Bypass without Cardiac Catheterization
110--Major Cardiovascular Procedures with CC
111--Major Cardiovascular Procedures without CC
191--Pancreas, Liver and Shunt Procedures with CC
209--Major Joint and Limb Reattachment Procedures of Lower Extremity
286--Adrenal and Pituitary Procedures
357--Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy
491--Major Joint and Limb Reattachment of Upper Extremity

    DoD beneficiaries who reside in the NMCSD STS Catchment Area for 
TRICARE Region Nine must be evaluated by NMCSD before receiving 
TRICARE/CHAMPUS cost sharing for the procedures that fall under the 
above Diagnostic Related Groups. Travel and lodging for the patient 
and, if stated to be medically necessary by a referring physician, for 
one nonmedical attendant, will be reimbursed by NMCSD in accordance 
with the provisions of the Joint Federal Travel Regulation. Although 
evaluation in person is preferred, it is possible to conduct the 
evaluation telephonically if the patient is unable to travel to NMCSD. 
If the procedure cannot be performed at NMCSD, the TRICARE Managed Care 
Support Contractor for Region Nine will provide a medical necessity 
review prior to issuance of a Nonavailability Statement or other 
similar authorizations. The NMCSD Catchment Area covering TRICARE 
Region Nine is defined by zip codes in the Defense Medical Information 
System STS Facilities Catchment Area Directory. The Catchment Area 
includes zip codes within TRICARE Region Nine in California and Yuma, 
Arizona, that fall within a 200 mile radius of NMCSD.

EFFECTIVE DATE: March 1, 1999.

FOR FURTHER INFORMATION CONTACT:
LT Karen Leahy, NMCSD, (619) 532-5344; or Major Kelly Wolgast, Office 
of the Lead Agent, TRICARE Region Nine, (619) 532-6169; or Lt. Col. 
Teresa Sommese, TRICARE Management Activity, (703) 681-3628, extension 
5029; or Mr. Tariq Shahid, TRICARE Management Activity, (303) 676-3801.

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. 98-31423 Filed 11-24-98; 8:45 am]
BILLING CODE 5000-04-M