Each TMA Manual distributed on the web currently incorporates all published changes. Although changes are published, they are not implemented by the contractors until they receive direction to do so by the Contracting Officer. Each TRICARE Manual on the web incorporates all changes by the date of publication. Although changes are published, they may not be implemented by the contractor until directed to do so by the Contracting Officer.

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The TRICARE Operations Manual (TOM) is incorporated by reference into the Managed Care Support Contracts (MCSCs) and is the primary vehicle for operational guidelines and instructions to the contractor. The TOM provides a mechanism for clarifying and modifying existing contractual requirements, adding new specifications/requirements and deleting obsolete information. All or portions of the TOM may also be incorporated by reference into other TRICARE contracts.