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1.
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INTRODUCTION
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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.
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2.
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PURPOSE
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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.
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3.
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STRUCTURE
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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.
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4.
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MOU MANAGEMENT
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This section
describes the performance-based objectives of MOU management, coordination
of actions, limits of authority, and MOU revisions.
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5.
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PERFORMANCE
BASED OBJECTIVES
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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.
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6.
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COORDINATION
OF ACTIONS
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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:
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a.
b.
c.
d.
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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
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7.
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LIMITS OF AUTHORITY
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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.
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8.
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MOU REVISIONS
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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.
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9.
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MEETINGS
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a.
b.
c.
d.
e.
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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)
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10.
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OPERATIONAL
ANNEXES
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a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
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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
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o.
p.
q.
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Population Health
Improvement Processes
Operational
Issue Resolution
Points of Contact
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11.
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ADDITIONAL TRO
OPERATIONAL ANNEXES
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a.
b.
c.
d.
e.
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Priority Correspondence
Special
Projects
Special Programs
Other
Operational Annexes as Required
Regional MTF/eMSM
MOUs
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12.
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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.”
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13.
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TABLE OF REVISIONS
TO THE MOU
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14.
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TERM
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a.
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This MOU expires
at midnight (insert local time zone) on the last day of the last
exercised Option Period of DoD Contract Number ___________________.
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b.
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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.
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(Signature)
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(Date)
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(Signature)
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(Date)
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Printed
Name and Title
Contractor
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MTF
Commander/eMSM Manager or Representative (Not Required if this is
a Regional Office MOU)
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Approved
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(Signature)
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(Date)
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(Signature)
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(Date)
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Procuring Contracting
Officer (PCO)
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Director, TROs
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