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TRICARE Program Manuals - 2015 Edition (T-2017)

These manuals are applicable to the East and West Regional Managed Care Support Contracts (MCSCs) awarded on or after 07/21/2016. Upon direction of the Contracting Officer (CO), all or portions of these manuals may also apply to the TQMC, TCARS, TOP, TPharm, TDP, and TDEFIC.

TRICARE Operations Manual, Baseline, April 1, 2015

TRICARE Policy Manual, Baseline, April 1, 2015

TRICARE Reimbursement Manual (TRM), Baseline, April 1, 2015

TRICARE Systems Manual, Baseline, April 1, 2015

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, Change 190, August 1, 2016

Page Count: 1,614
Summary of Changes: TRICARE Operations Manual Change 170, published on 17 Feb 2016 introduced a policy change for Military Treatment Facility (MTF) directed referrals of greater than 100 miles to non-network providers be coordinated with the TRICARE Regional Offices (TROs) prior to submitting to the Managed Care Support Contractors (MCSCs). The intent of the policy was for referrals where treatment or surgical procedure or inpatient admission was expected to require justification from the MTF and coordination. It was not intended for the TROs to absorb all routine directed referrals nor to take on MCSC's functions of benefit and medical necessity reviews. The TROs have been overwhelmed into reviewing over 100 referrals a week as an unintended consequence of the policy change. This change will further narrow the MTF Directed Referrals that should be coordinated with the TRO and will also assure that the MCSC perform their required functions.

TRICARE Policy Manual, Change 168, August 12, 2016

TRICARE Reimbursement Manual, Change 131, July 19, 2016

TRICARE Systems Manual, Change 89, June 28, 2016

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 71, May 6, 2016

10 USC 55, Change 7, June 8, 2016