|
1.
|
INTRODUCTION
|
|
|
This
Memorandum of Understanding (MOU) supports the requirements of the
TRICARE Program as detailed in the TRICARE Manuals and the Managed
Care Support Contract (#__________________) and including all contract
modifications as they are executed.
|
|
|
|
2.
|
PURPOSE
|
|
|
The
MOU’s purpose is to establish management processes expected to be
executed in good faith by each party to implement TRICARE program
requirements. This MOU does not change, add or delete any requirements
of the contract. No contract requirements are waived by this MOU.
Any action taken under this agreement does not increase or decrease
the contract price or cost unless the change to the contract is
authorized by the Contracting Officer (CO). In the event that there
is an inconsistency between the contract and the MOU, the contract,
as interpreted by the CO, is the primary document for guidance.
|
|
|
|
3.
|
STRUCTURE
|
|
|
Each
Military Treatment Facility (MTF)/Enhanced Multi-Service Market
(eMSM) MOU consists of a core document which reflects uniform approaches
common to all aspects of healthcare delivery across the region,
complimented by attachments to provide operational guidance unique
to each specific MTF/eMSM and/or TRICARE Regional Office (TRO).
Multi-market processes will be described in each affected MTF/eMSM-specific
MOU.
|
|
|
|
4.
|
MOU
MANAGEMENT
|
|
|
This
section describes the performance-based objectives of MOU management,
coordination of actions, limits of authority, and MOU revisions.
|
|
|
|
5.
|
PERFORMANCE
BASED OBJECTIVES
|
|
|
This
MOU describes the processes by which the parties implement the performance-based objectives
outlined in the contract (#________________________). It reflects
uniform approaches across the entire region and provides for site-specific
information unique to each MTF/eMSM that defines the protocols,
instructions and details of each area of understanding.
|
|
|
|
6.
|
COORDINATION
OF ACTIONS
|
|
|
The
MOU reflects the actions expected to be taken by the contractor
and/or the MTF Commander/eMSM Manager and the degree to which each
party will coordinate with the other before taking certain action.
Actions include:
|
|
|
a.
b.
c.
d.
|
Actions
by MTF Commander/eMSM Manager without contractor input
Actions by MTF Commander/eMSM Manager after
contractor coordination
Actions
by contractor with MTF Commander/eMSM Manager’s coordination
Actions by contractor without MTF Commander/eMSM
Manager’s input
|
|
|
|
7.
|
LIMITS
OF AUTHORITY
|
|
|
All
parties of this MOU understand that only the CO has the authority
to alter or modify the requirements and specifications of the contractor
in any way. All attachments and operational guidance shall be implemented
only upon CO direction.
|
|
|
|
8.
|
MOU
REVISIONS
|
|
|
Any
partner of the MOU may propose revisions to the MOU at any time.
Minor administrative changes (such as names telephones and/or e-mail
addresses) may be implemented immediately by mutual agreement. Proposed
changes shall be submitted to the appropriate Director, TROs, by
any partner. Changes that are administrative in nature only will
be implemented by the first business day of the following month
or as soon as is reasonable thereafter. All other changes will be implemented
by the 15th day of the following month, unless otherwise agreed
upon. Once a MOU change is agreed upon, the contractor shall prepare
all MOU documents for appropriate signatures and CO approval.
|
|
|
|
9.
|
MEETINGS
|
|
|
a.
b.
c.
d.
e.
|
TRO
Meetings (i.e., TRO/contractor meetings/responsibilities)
MTF/eMSM-Specific Meetings (i.e., prime service
area executive committee meetings)
eMSM (enhanced Multi-Service Market) Meetings
(as appropriate)
Working
Group Meetings
Defense Health
Agency (DHA) Meetings (other than identified above)
|
|
|
|
10.
|
OPERATIONAL
ANNEXES
|
|
|
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
|
Access
to Data
Government furnished
facilities, equipment and/or services
Enrollment Processes
Referrals and Authorizations
Right of First Refusal (ROFR)
Medical Management
Utilization Management
Clinical Quality Management
Case Management Referral Process
Education & Customer Services
MTF/eMSM Optimization
Contingency Planning
Network Implementation
Behavioral Health/Substance Abuse
|
|
|
o.
p.
q.
|
Population
Health Improvement Processes
Operational
Issue Resolution
Points
of Contact
|
|
|
|
11.
|
ADDITIONAL
TRO OPERATIONAL ANNEXES
|
|
|
a.
b.
c.
d.
e.
|
Priority
Correspondence
Special Projects
Special Programs
Other Operational Annexes as Required
Regional MTF/eMSM MOUs
|
|
|
|
12.
|
Each
MOU shall also contain the following provision: “Contract personnel
working in the Department of Defense (DoD) MTFs/eMSMs shall comply
with all local Employee Health Program (EHP) and Federal Occupational
Safety and Health Act (OSHA) Bloodborne Pathogens (BBP) Program
requirements.”
|
|
|
|
13.
|
TABLE
OF REVISIONS TO THE MOU
|
|
|
|
14.
|
TERM
|
|
|
a.
|
This
MOU expires at midnight (insert local time zone) on the last day
of the last exercised Option Period of DoD Contract Number ___________________.
|
|
|
b.
|
Annual
Review of MTF/eMSM MOU. Prior to the end of each Option Period of
DoD Contract Number _____________________ (except for the final
exercised Option Period), the contractor will obtain written affirmation
from the MTF Commander/eMSM Manager that the Commander has reviewed
the current MTF/eMSM MOU and agrees that no modifications are necessary. Copies
of these affirmations will be provided in the Performance Assessment
Tool.
|
|
|
|
|
|
|
|
(Signature)
|
(Date)
|
|
(Signature)
|
(Date)
|
|
Printed Name and Title
Contractor
|
|
MTF Commander/eMSM Manager or Representative
(Not Required if this is a Regional Office MOU)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Approved
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Signature)
|
(Date)
|
|
(Signature)
|
(Date)
|
|
Procuring
Contracting Officer (PCO)
|
|
Director,
TROs
|