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TRICARE Operations Manual 6010.62-M, April 2021
Market Directors/Military Medical Treatment Facility (MTF) Directors, And Contractor Interfaces
Chapter 15
Section 1
Market Directors, Military Medical Treatment Facility (MTF) Directors, and Contractor Interfaces
All TRICARE requirements regarding Government and contractor interfaces shall apply to the Managed Care Support Program (MCSP) unless specifically changed, waived, or superseded by the provisions of this section; the TRICARE Manuals; or the TRICARE contract for Managed Care Support Services (MCSS) in the 50 United States (US) and District of Columbia (hereinafter referred to as the MCS contract).
2.1  The contractor shall enter into a Memorandum of Understanding (MOU) with the Healthcare Operations (HCO) Directorate prior to the start of health care delivery (SHCD) to coordinate health care delivery (HCD) for optimization of Markets and MTF capacities.
2.1.1  In this MOU the contractor shall describe the Market and MTF support processes which are standard throughout the contractor’s geographic area of responsibility. This MOU is expected to be executed in good faith by each party to operate the TRICARE Program in accordance with the performance-based objectives of the MCS contract and TRICARE Manuals.
2.1.2  Prior to the start of each subsequent option period the contractor shall initiate a review of the MOU to determine if changes are warranted.  If the contractor or the Government Designated Authority (GDA) determines the MOU warrants revision during the review, a new MOU will need to be renegotiated by both parties. The contractor shall generate the new MOU and submit to the GDA for renegotiation.  If changes are not necessary, the MOU remains in effect as previously negotiated.
2.1.3  If a situation occurs prior to the annual review which warrants a modification, a new MOU will need to be renegotiated by both parties. Either the contractor or the GDA can request a revision to the MOU. The contractor shall prepare a new MOU and submit to the GDA for renegotiation.
2.1.4  For reporting requirements, see DD Form 1423, Contract Data Requirements List (CDRL), located in Section J of the applicable contract.
2.2  The contractor shall also enter into Statement of Responsibility (SOR) with each Market Director and each standalone MTF Director to address individual Market and MTF specific issues and procedures.
2.2.1  Each standalone MTF with oversight and control of subordinate military clinics (a parent and child Defense Medical Information System (DMIS) relationship) shall provide a single SOR between the parent MTF and the contractor. For reporting requirements, see DD Form 1423, CDRL, located in Section J of the applicable contract.
2.2.2  Signed SORs shall be in effect for the duration of the contract or until the GDA, or the contractor determines a change is warranted but not more frequent than quarterly.
2.2.3  SORs shall include a process for ongoing, regular communication between each Market Director or standalone MTF Director, and the contractor regarding anticipated changes that may affect HCD for beneficiaries (e.g., deployments, increase or decrease in Market or MTF capacity and capabilities, change in troop strength or number).
2.2.4  SORs executed with each standalone MTF shall identify MTF hours and days of operation, to include any holiday or training days, and other unique issues regarding MTF operation (e.g., inclement weather procedures) and ensure that the SOR is updated as such changes occur.
2.3  All contact information shall be maintained separately and not be included in the SOR or MOU.
2.4  The contractor shall maintain contact information of key personnel for contractor facilities and all Government entities within the contractor’s geographic area of responsibility (names, telephone numbers, fax numbers, and email addresses) and notify the GDA of any changes within one business day.
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