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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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