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TRICARE Operations Manual 6010.59-M, April 1, 2015
TRICARE Medicare Eligible Program (TMEP)
Chapter 20
Section 14
Reports
Revision:  C-108, May 18, 2022
The TMEP contractor shall comply with all TRICARE requirements in Chapter 14 regarding Reports unless specifically changed, waiver, or superseded by this section (as indicated below), the TRICARE Policy Manual (TPM), TRICARE Reimbursement Manual (TRM), TRICARE Systems Manual (TSM), or TMEP contract.
1.0  Contract Data Requirements Lists (CDRLs), Plans And Access
1.1  The TMEP contractor shall comply with the requirements in Chapter 14, Section 1.
1.2  The contractor shall ensure reports contain accurate and complete data. The contractor shall prepare written procedures describing the source of the information as well as the specific steps followed in the collection and preparation of data for each report. The contractor shall support all reports with sufficient documentation and audit trails for Defense Health Agency (DHA) on-site and desktop audit inspections.
2.0  Special Reports
2.1  The TMEP contractor shall comply with the requirements in Chapter 14, Section 2 except for Chapter 14, Section 2, paragraph 2.0, related to reports to Market/Military Treatment Facility (MTF) Directors.
2.2  The TMEP contractor shall comply with the requirements in Chapter 14, Section 2, paragraph 3.0 with the following exception. The contractor shall report issues identified through the contractor’s Quality Management (QM)/Quality Improvement (QI) Program in accordance with CDRL.
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