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cility may be admitted for humanitarian reasons to any naval activity having facilities for inpatient care at the discretion of the commanding officer if a naval medical officer determines that movement to a nongovernmental institution is likely to result in loss of life. The patient pays the general rate for hospitalization. Such a patient shall be classified as indigent only after reasonable attempts to collect charges for hospitalization have been unsuccessful in the opinion of the commanding officer. (5 U.S.C. 22; arts 0430, 0627, and 0970, U.S. Navy Regulations; 10 U.S.C. 6011; 24 U.S.C. 14 et seq.)

(b) Recording. First-aid treatment and emergency medical care rendered to members of the civilian population shall, in addition to such medical history as should be routinely recorded, be made the subject of an entry in the daily journal (Officer-of-the-Day Log). (c) Civilians attending National Police Academy. Persons in attendance at the National Police Academy, Marine Barracks, Quantico, Va., may be admitted to the U.S. Naval Hospital at Quantico for emergency hospitalization in the following cases:

(1) Employees of the Federal Bureau of Investigation who are injured in the performance of duty may be entitled to medical care at the expense of the Bureau of Employees' Compensation and should be admitted and reported and beneficiaries of the Bureau of Employees' Compensation. Such employees also may be admitted for treatment of disease and in this case are admitted and reported as civilian humanitarian patients.

(2) Representatives of police organizations of various States, cities, and countries who are in attendance at the National Police Academy may be hospitalized as civilian humanitarian patients with the approval of the Commanding General.

(d) Charges and collections. No charges shall be collected locally from civilians hospitalized as beneficiaries of other Government agencies. When hospitalized and classed as Civilian, Humanitarian, Nonindigent, charges at the general rate shall be collected locally.

§ 728.76 U.S. Navy technicians.

(a) Authority. OPNAV Instruction 5720 series. 1

(b) Authorized care. U.S. Navy technicians may be given medical care while serving with the Navy in a locality where civilian medical care is not obtainable, such as on board a naval vessel or outside the United States. This is not to be construed to include dental treatment except for the relief of pain or other emergency.

(c) Charges and collections. Charges shall be made for subsistence only and collected locally.

§ 728.77 Other persons outside the United States.

(a) Authority. 24 U.S.C. 34, 35; 42 U.S.C. 1701.

(b) Eligibility. When not otherwise authorized, outpatient and inpatient care may be provided at naval medical facilities outside the United States and in Alaska and Hawaii to the following persons:

(1) Officers and employees of any department or agency of the Federal Government.

(2) Employees of a contractor with the United States or his subcontractors.

(3) Dependents of above persons.

(4) In emergencies, other persons designated by the Secretary of the Navy.

(5) Civilian marine seamen who are Federal civilian employees in service of vessels operated by the Military Sea Transportation Service; American seamen aboard vessels chartered by the Military Sea Transportation Service; persons engaged by the United States under personal services contract; civilian employees paid from

'Paragraph 4a of OPNAV Instruction 5720.3A of Nov. 15, 1955, defines a U.S. Navy technician as follows:

a. Technician. A technician is a male civilian citizen of the United States (not an employee of the Naval Establishment) who is accredited to take passage in naval vessels or Government aircraft or to enter overseas areas under naval sponsorship for the purpose of observing the operation or installation of equipment and armament and/or assisting in the maintenance and repair of such equipment, and for scientific research. He is a manufacturer's technician or engineer or a contractor's representative.

nonappropriated funds administered by the Army and Air Force Exchange Service, Army and Air Force Motion Picture Service, Navy exchanges, Marine Corps exchanges, officers' and noncommissioned officers' open messes, enlisted men's clubs, special service activities; persons or organizations of the United States under the jurisdiction of the Department of Defense and conducted for the mental, physical and morale improvement of personnel of the military service and their dependents; persons employed or engaged for personal services by an American employer providing welfare or similar services for the benefit of the Armed Forces authorized by the Secretary of Defense; employees of commercial airlines under contract to the Military Air Transport Service; officers and crews of U.S. airlines; shipwreck or enemy action refugees; humanitarian cases.

(c) Limitation. Medical care for the persons listed in paragraph (b) of this section shall be provided only where reasonably accessible and appropriate non-Federal medical facilities are not available. Hospitalization is authorized for acute medical and surgical conditions. Hospitalization is not authorized for nervous and mental disorders, chronic diseases, or those requiring domiciliary care.

(d) Charges and collections. Charges for hospitalization and outpatient treatment shall be at the extracontinental rate and shall be collected locally.

§ 728.78 Prisoners of war and similar per

sons.

(a) Authority. 31 U.S.C. 649a.

(b) Persons authorized care. Medical care may be provided at naval medical facilities for:

(1) Prisoners of war and other persons in the Navy or Marine Corps custody whose status is determined to be similar to prisoners of war, and persons detained in such custody pursuant to Presidential proclamation.

(2) Prisoners of the Navy or Marine Corps whose punitive discharge has been executed and who are hospitalized beyond execution of sentence.

(c) Charges and collections. No charges shall be made for hospitaliza

tion furnished prisoners of war or similar persons.

Subpart -Adjuncts to Medical Care

§ 728.81 Adjuncts to medical care.

(a) Definition. Adjuncts to medical care include prosthetic devices such as artificial limbs, artificial eyes, hearing aids, orthopedic footwear, spectacles, and similar medical supports or aids which are required for the proper care and treatment of the patient.

(b) Scope. This subpart covers the provision of adjuncts at naval medical facilities. Part 732 of this chapter deals with referrals to civilian sources. [26 FR 12661, Dec. 29, 1961, as amended at 28 FR 7752, July 31, 1963]

§ 728.82 Policy.

(a) Assistance in overcoming physical handicap. Adjuncts to medical care shall be provided at naval medical facilities to eligible persons as inpatients or outpatients when, in the opinion of the medical officer, the device will offer substantial assistance in overcoming the physical handicap and thereby contributing to the well being of the patient.

(b) Period of service. Unless necessary for humanitarian reasons, orthopedic and prosthetic appliances are not to be furnished on an elective basis to members of the naval service with short periods of service when the defect requiring the appliance existed prior to entry into the service and when these members are to be separated from the service because of these defects. For active duty members, the initial allowance of orthopedic footwear and orthopedic alterations to standard footwear shall be in the same quantity as provided in the initial clothing allowance.

(c) Number. The number of orthopedic and prosthetic appliances issued or replaced for authorized recipients shall be based upon the individual's requirements as determined by the medical officer and shall be consistent with the highest standards of modern medicine.

(d) Costs. Costs of adjuncts to medical care are chargeable to the operation and maintenance funds of the

medical facility furnishing the care and adjuncts.

(e) Referral to VA. Retired members of the uniformed services who served in either World War I, World War II, or Korean War, as well as persons otherwise eligible by law who have elected to receive disability compensation from the Veterans' Administration for service-connected disease or injury, should be advised that they may obtain orthopedic and prosthetic appliances for service-connected disabilities from a VA facility.

(f) Dependents. Dependents shall not be provided artificial limbs, artificial eyes, hearing aids and parts, orthopedic footwear, or spectacles.

Exception: Dependents may be provided such items if available from Government stocks at invoice cost under the following situations:

(1) Outside the United States.

(2) At a station within the United States where adequate civilian facilities are not available, and the station has been designated as remote by the Secretary of the Navy upon approval of the Secretary of Defense.

§ 728.83 Chart of adjuncts to medical care.

The chart and following footnotes provide information relative to adjuncts which may be furnished the several categories of patients eligible for medical care at naval medical facilities.

Subpart J-Charges, Collections, and
Reports

§ 728.91 Charges and collections.

Charges for hospitalization and/or subsistence furnished pay patients shall be collected in the manner and at the rate indicated in the table under § 728.94. Detailed information

Beneficiary of other Federal agencies to whom reimbursement

applies

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When, in the opinion of cognizant medica! authority, such appliances are medically indicated for the completion of treatment.

'Further information may be found in BUMED Instruction 6810.4 series.

'Issued at U.S. naval hospitals only for postocular surgery or service-incurred disease or disability where their use is mandatory for retention of personnel in an active status. Not to be issued solely for cosmetic reasons. Further information may be found in BUMED Instruction 6810.4 series.

'Issued at U.S. naval hospitals only for postocular surgery or service-incurred disease or disability when considered justified by the medical officer in charge as offering substantial assistance to the patient in overcoming his handicap and thereby contributing to his well-being. Not to be issued solely for cosmetic purposes.

'Initial issue will include, in addition to the hearing aid, one spare receiver cord, approximately 1 month's supply of batteries, and a statement indicating make, model, type of receiver, serial number, code, part number, "B" battery voltage, and type of "A" and "B" batteries required.

Replacement of hearing aids shall be upon the same basis as the initial issue and except in unusual circumstances shall not be effected within 2 years of the initial furnishing of the last replacement of the appliance.

'Servicing of hearing aids and replacement parts thereof shall be limited to the manufacturer's guarantee and shall be based upon a personal relationship between the recipient and the manufacturer only. 'On custody basis at the discretion of the medical officer.

[26 FR 12661, Dec. 29, 1961, as amended at 27 FR 9451, Sept. 22, 1962]

concerning methods of collection, disposition of locally collected funds, and required reports for naval hospitals and medical centers are contained in the Financial Management Handbook (NAVMED P-5020), and NAVCOMPT Manual and Instructions for station hospitals and dispensaries.

§ 728.92 Rates.

Rates to be charged for hospitalization and hospital rations furnished pay patients are promulgated by BUMED Instruction 6320.4 series. The rates are defined as follows:

(a) Interagency. The per diem rate prescribed by the Bureau of the Budget for reimbursement between uniformed services when members or retired members of the uniformed services are hospitalized in a facility of a service other than their own. Also, for use in all cases of reimbursement between Federal agencies for patients authorized care completely at Government expense unless a different rate is established by or pursuant to a specific requirement of law.

(b) General. The per diem rate prescribed by the Bureau of the Budget for reimbursement between uniformed services when dependents of members or retired or deceased members are hospitalized in a facility of a service that is not that of the member. Also for use for patients authorized to receive care partially at Government expense or at no expense to the Government unless a different rate is established by or pursuant to a specific requirement of law.

(c) Dependents. The per diem rate prescribed by the Dependents' Medical Care Act to be collected locally from the patient or sponsor for hospitalization furnished dependents of members or retired or deceased members.

(d) Hospital ration. The per diem rate prescribed periodically by the Chief, Bureau of Medicine and Surgery, as the value of one hospital ration.

(e) Extracontinental and Alaska. The rate established by Executive Order 9411 (3 CFR 1943-48 Comp., p. 290) for hospitalization or outpatient service for other than dependents of the uniformed services:

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(a) General. Reports of hospitalization of pay patients at naval hospitals and medical centers shall be submitted to the Bureau as prescribed by the Financial Management Handbook. Station hospitals and dispensaries shall submit reports as required by NAV COMPT Manual and Instructions.

(b) Report of Treatment Furnished Pay Patients, Hospitalization Furnished (Part A), DD Form 7, Report Symbol MED-6322-1-(1) General. This report, accompanied by appropriate substantiation if necessary, shall be submitted in accordance with existing instructions.

(2) Preparation instructions. The numbered spaces on the report form shall be completed to show the following information:

(a) 1-Installation providing hospitalization. Enter name and location of the Navy and/or Marine Corps activity submitting the report. Comply with current security regulations, when applicable.

(b) 2-Month and year covered by this report. Enter the calendar month and year of the report period.

(c) 3-Category of patients. Enter category of patients reported. A separate report shall be utilized and submitted in the case of each different category of pay patient.

(d) 4—Authority for admission. State regulation or directive authorizing admission. In cases where documentary authorization is required, attach copy of authorization to the DD Form 7 at time of submission of report.

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total for the category. Item 11 shall be blank.)

(† 6—Grade. Complete as appropriate.

(g) 7—Organization. Enter organization of each pay patient, military or other Federal agency, as applicable, unless other information is required by regulations. For merchant seamen, enter the name of vessel to which attached; if vessel is not prefixed by the letters USNS, include name of owner or operator.

(h) 8-Diagnosis. Enter title in language commonly accepted by professional usage, preferably in terms of titles listed in the Joint Armed Forces Statistical Classification and Basic Diagnostic Nomenclature of Diseases and Injuries (NAVMED P-1294).

(i) 9-Admission date. Enter month, day, and year in that order. No sick days shall be accrued for pay patients admitted and discharged from the sicklist on the same day, nor shall fractional days be considered.

(j) 10-Discharge date. Enter month, day, and year in that order. If a patient is remaining on the sicklist at the end of the month being reported, enter only the notation "Remaining" in this column.

(k) 11-Total. Enter the total days for the month reported for each individual patient. When for any reason a patient being reported is subsisted out or on leave during the period reported,

information to that effect shall be so reported on the DD Form 7, to show the total days hospitalized and total days subsisted out or on leave. Use abbreviation "SO" for subsisted out and "OL" for on leave. Sick days shall be computed in all cases by excluding the day of admission and including the day of discharge.

(1) 12-Date. Enter the date of certification of report by the commanding officer or his duly authorized representative.

(m) 13—Certified correct. Enter the name, grade, and organization of the commanding officer or his duly authorized representative certifying the accuracy and completeness of the report. Signature required on original form only.

(n) 14-Total days

hospitalized.

Enter grand total of all days hospitalized irrespective of days subsisted out and/or on leave. This figure shall be verified to insure that all computations have been entered correctly.

(3) Footnote data for station hospitals and dispensaries. All DD Forms 7 shall show as a footnote the appropriation, subhead, allotment, budget project, and expenditure account to be credited and the accounting number of the activity accounting for the receivable.

§ 728.94 Table of pay patients, charges, and collections

(a) Members, uniformed services and reserve components, and retired members uniformed services

(1) Navy and Marine Corps:

Charges

(a) Officers, active duty only (including aviation cadets)..... Hospital ration'

(b) Officers, training duty, in a pay status.

(c) Officers, training duty, not in a pay status

Subsistence2. Hospital ration' Subsistence2.

Collections

Bureau, checkage on S&A 534 by local command.'

Local.'

Do.

Do.

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