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TRICARE Program Manuals - 2008 Edition (T-3)

These manuals serve for contracts awarded on or after 06/27/2008 for the North, South, and West Regions along with TQMC, CARS, TOP, and TPharm. The manuals will apply to the TDEFIC contract upon direction of the Contracting Officer

TRICARE Operations Manual, Baseline, February 1, 2008

TRICARE Policy Manual, Baseline, February 1, 2008

TRICARE Reimbursement Manual, Baseline, February 1, 2008

TRICARE Systems Manual, Baseline, February 1, 2008

Other Manuals

Authority for the TRICARE Program is the 32 CFR 199. DHA is providing a version of Title 32 to the Code of Federal Regulations, Part 199 (32 CFR 199) and 10 United States Code Chapter 55 as a convenience for the DHA community.

32 CFR 199 (2005), Change 17, November 16, 2007

10 USC 55, Baseline, January 3, 2007

Superceded Manuals

TRICARE Operations Manual, Change 59, February 25, 2008

TRICARE Policy Manual, Change 71, February 25, 2008

TRICARE Reimbursement Manual, Change 72, February 28, 2008

TRICARE Systems Manual, Change 55, February 28, 2008

Page Count: 1,098
Summary of Changes: 1) Implementation of a refined 4-equation case-mix model that recognizes and differentiates payment for episodes of care based on whether a patient is in what is considered to be an early (first and second episode in a sequence of adjacent episodes) or late (the third episode and beyond in a sequence of adjacent episodes) episode of care as well as recognizing whether a patient was a high therapy (14 or more therapy visits) or low therapy (13 or fewer therapy visits). 2) Change in labor related and non-labor related share of HH PPS rates. National 60-day episode payment amount update for CY 2008. 3) Change in Non-Routine Supply (NRS) payment. 4) Add-on payments for Low Utilization Payment Adjustments 5) (LUPAs) that occur as initial episodes or as the only episodes. 6) National updated per visit amounts used to pay LUPAs and compute imputed costs in outlier calculations. This change is published in conjunction with Aug 2002 TRM Change 72.