Demonstrations And Pilot Projects (Except Value-Based Initiatives)
Chapter 18
Section 1
General
Revision: C-21,
March 1, 2018
1.0 Purpose Of
And Authority For Demonstrations
Section 1092,
Chapter 55, Title 10 of the United States Code (USC) allows the
Secretary of Defense to conduct studies and demonstration projects.
This section also specifies that the Secretary may enter into contracts
with public or private organizations to conduct these studies and demonstrations.
2.0 Organization
In
the spring of 1985, the Director, TRICARE Management Activity (TMA)
was charged with the responsibility for administering all medical
care demonstrations for the Department of Defense (DoD). This chapter
provides specific instructions regarding processing claims which
are affected by demonstrations.
3.0 Restrictions
On Scope Of Benefits Furnished Under Demonstration Projects
3.1 Proposed new
benefits provided under demonstration authority must receive Defense
Health Agency (DHA) agency coordination in the same manner as any
other proposed TRICARE benefit; and
3.2 Unless specific statutory demonstration
authority provides otherwise, benefits may not be provided under
a demonstration project that would otherwise be considered unproven
under TRICARE Standard through December 31, 2017 or TRICARE Select
starting January 1, 2018.
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