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TRICARE Operations Manual 6010.59-M, April 1, 2015
Chapter 2
Section 6
Critical Processes (CPs) - Management - Markets/Military Medical Treatment Facilities (MTFs)
Revision:  C-127, August 21, 2023
1.0  Management
1.1  Director, TRICARE Regional Offices (TROs), Market/MTF Director, and Contractor Interface
The contractor shall assist the TRO and Market/MTF Directors in coordinating health care delivery in their Prime Service Areas (PSAs)/markets and in ensuring the optimal use of Market/MTF capacities. No later than 60 calendar days following contract award, the contractor shall meet with each Market/MTF Director, Clinic Director, and the TRO to develop a Memorandum of Understanding (MOU) with each facility/market. A Market Director may opt to have one MOU for the Market. 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 day prior to the start of the first option period. These MOUs shall be executed no later than 90 days prior to the start of the first option period. Additionally, by the 90th 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 Market/MTF 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 days following the execution of the MOU by the contractor and the Market/MTF Director. 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 Market/MTF support processes which are standard throughout the region and a supplemental attachment that documents operational information that is unique to each Market/MTF (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 Market/MTF Directors change.
1.2  Market/MTF Visits
The contractor’s key personnel shall conduct site visits to key Government healthcare locations at Intermediate Service Commands, Coast Guard leadership sites, and Market/MTF 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
Market offices, Intermediate Service Commands, Coast Guard leadership
NLT 100 days
Markets/MTFs (Bedded, Non-Bedded, Ambulatory Surgical Center (ASCs))
1.3  MOU With Market/MTF Directors
No later than 30 days following contract award, the outgoing contractor shall provide the incoming contractor the most recent version of all Market/MTF MOUs in place at that time for the purpose of ensuring continuity of services to the Markets/MTFs and continuity of care for TRICARE beneficiaries. Ninety days prior to the SHCD, the incoming contractor shall have executed an MOU with all Market/MTF Directors in the region. The MOU shall include, but not be limited to, Market/MTF 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/Statements of Responsibilities (SORs) only). The contractor shall provide two copies of each executed MOU/SOR to the PCO and TRO within 10 days following the execution of the MOU/SOR. 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 Market/MTF Directors with a complete cost analysis within 30 days of a written request for consideration of a potential resource sharing opportunity. Market/MTF Directors must provide the contractor specific cost and workload information necessary to perform the requested analysis within 15 days of making the written request. If the necessary data are not provided to the contractor by the 15th day after the written request, the 30 day requirement will be extended on a day-to-day basis. Once the data are provided, the 30 day requirement resumes.
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