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TRICARE Operations Manual 6010.59-M, April 1, 2015
Chapter 2
Section 6
Critical Processes (CPs) - Management - Military Treatment Facilities (MTFs)/Enhanced Multi-Service Markets (eMSMs)
Revision:  C-26, May 30, 2018
1.0  Management
1.1  Director, TRICARE Regional Offices (TROs), MTF Commander/eMSM Manager, and Contractor Interface
The contractor shall assist the TRO and MTF Commanders/eMSM Managers in coordinating health care delivery in their Prime Service Areas (PSAs)/markets and in ensuring the optimal use of MTF/eMSM capacities. No later than 60 calendar days following contract award, the contractor shall meet with each MTF Commander/eMSM Manager, Clinic Commander, and the TRO to develop a Memorandum of Understanding (MOU) with each facility/market. An eMSM Manager may opt to have one MOU for the eMSM. Each MOU shall describe the processes expected to be executed in good faith by each party to implement TRICARE program requirements in accordance with the performance based objectives of the Managed Care Support (MCS) contract(s) and Chapter 15, Addendum A.
1.1.1  The contractor shall prepare and present to each facility/market a draft MOU no later than the 120th calendar day prior to the start of the first option period. These MOUs shall be executed no later than 90 calendar days prior to the start of the first option period. Additionally, by the 90th calendar day prior to the start of the first option period, the contractor shall execute an MOU with the TRO which incorporates copies of the contractor’s executed MOUs with each MTF/eMSM as attachments.
1.1.2  The MOU shall follow the format in Chapter 15, Addendum A. Copies of local program documentation may be obtained through the TRO. The contractor shall provide copies of each MOU executed to the Procuring Contracting Officer (PCO) through the TRO, within 10 calendar days following the execution of the MOU by the contractor and the MTF Commander/eMSM Manager. All MOUs shall be approved by the TRO with final approval by the PCO.
1.1.3  As described in Chapter 15, Addendum A, the MOU consists of two parts: a core document that describes major MTF/eMSM support processes which are standard throughout the region and a supplemental attachment that documents operational information that is unique to each MTF/eMSM (i.e., Right of First Refusal (ROFR) capabilities table, Point of Contact (POC) information, after hours care instructions, enrollment guidance, etc.). The core document is not expected to change often, but any such changes will be vetted and incorporated at the annual review at the beginning of each option period. Information in the supplemental attachment may be changed at any time. Once signed at the beginning of an option period, the core MOU document stands and does not need to be affirmed if MTF Commanders/eMSM Managers change.
1.2  MTF/eMSM Visits
The contractor’s key personnel shall conduct site visits to key Government healthcare locations at Intermediate Service Commands, Coast Guard leadership sites, and MTF/eMSM offices. The purpose of these visits, at a minimum, will be to enhance current understanding of available opportunities, develop an understanding of the military healthcare culture, identify any special needs applicable to each type of location and to begin the development of the MOU. Site visits shall be completed in accordance with Figure 2.6-1.
Figure 2.6-1  Site Visits
Days Following Transition Specification Meeting
Required Visit
NLT 30 days
eMSM offices, Intermediate Service Commands, Coast Guard leadership
NLT 100 days
MTFs/eMSMs (Bedded, Non-Bedded, Ambulatory Surgical Center (ASCs))
1.3  MOU With MTF Commanders/eMSM Managers
No later than 30 days following contract award, the outgoing contractor shall provide the incoming contractor the most recent version of all MTF/eMSM MOUs in place at that time for the purpose of ensuring continuity of services to the MTFs/eMSMs and continuity of care for TRICARE beneficiaries. Ninety calendar days prior to the SHCD, the incoming contractor shall have executed an MOU with all MTF Commanders/eMSM Managers in the region. The MOU shall include, but not be limited to, MTF/eMSM Optimization, Customer Service, Education and Health Care Finder (HCF) functions, Government-furnished services, surveillance and reporting, use of facilities, Medical Management, and TRICARE Service Center (TSC) locations (TRICARE Overseas Program (TOP) MOUs only). The contractor shall provide two copies of each executed MOU to the PCO and TRO within 10 calendar days following the execution of the MOU. Details are identified in DD Form 1423, Contract Data Requirements List (CDRL), located in Section J of the applicable contract.
1.4  Resource Sharing Program Management Program
After contract award, the contractor shall provide requesting MTF Commanders/eMSM Managers with a complete cost analysis within 30 calendar days of a written request for consideration of a potential resource sharing opportunity. MTF Commanders/eMSM Managers must provide the contractor specific cost and workload information necessary to perform the requested analysis within 15 calendar days of making the written request. If the necessary data are not provided to the contractor by the 15th calendar day after the written request, the 30 calendar day requirement will be extended on a day-to-day basis. Once the data are provided, the 30 calendar day requirement resumes.
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