cluding crowns or inlays, or the use of gold or other precious metals for fillings. As soon as possible, the authorizing officer should be provided with complete information, i.e., name of non-federal medical/dental facility, date(s), nature and extent of treatment or care, etc., obtained in order that he may make arrangements for transfer of the member to a federal facility, or to take such other action as may be appropriate. Except as provided in this paragraph, care from non-federal sources may be provided at Navy expense only when authorized in advance as set forth below.

(b) Non-emergency care. When the district medical officer or district dental officer of the naval district where the care is to be rendered believes that civilian medical/dental care is appropriate, he may authorize treatment from civilian sources. In overseas areas, commanding officers may authorize care from other than U.S. naval sources when no naval or other U.S. military medical/dental facilities are available. If at all practicable, when ships are in NATO SOFA ports, required care shall be obtained from military facilities of the host country when U.S. facilities are not available.

(c) Care which may be authorized(1) Medical care. Includes consultations and treatment provided by physicians or medical facilities as well as medical procedures not involving treatment when directed by the Bureau of Medicine and Surgery. Treatment includes hospital care, surgery, nursing, medicine, laboratory and X-ray services, physical therapy, eye examir.ations, etc.

(2) Dental care. Includes: (i) All types of treatment rendered (including operative, restorative, and oral surgical) to relieve pain and abort infection. (ii) Prosthetic treatment rendered to restore extensive loss of masticatory function or the replacement of anterior teeth for esthetic reasons. (iii) Repair of existing dental prosthesis in instances where neglect of the repair would result in unserviceability of the prosthesis. (iv) Any type of treatment rendered as an adjunct to medical/surgical care. (v) All X-rays, drugs, etc., required to accomplish treatment in all the above categories.

(3) Eye refractions and spectacles. Includes refractions of eyes by physicians and optometrists and the repair and furnishing of spectacles. A refraction may be obtained only when federal facilities are not available, and no suitable prescription is in the Health Record. The prescription from the refractionist with proper facial measurements must be sent to the appropriate dispensing activity set forth in BUMED Instruction 6810.4E. When a member has no suitable spectacles and the lack thereof, combined with the delay resulting from obtaining them from a military source, would prevent the performance of duty; the repair, replacement, or procurement of spectacles from civilian sources may be authorized. Procurement under these circumstances requires prior approval. Neither examination for nor procurement of contact lenses is authorized by this part.

§ 732.13 Requests for authorization.

Requests should normally be submitted by letter except in unusual circumstances when message or telephonic requests may be made. Requests should contain the following information concerning the individual:

(a) Name, grade/rate, social security number.

(b) Duty station, duties if pertinent, whether on leave or liberty, if not on duty, exact period of leave or liberty.

(c) Character and extent of condition requiring treatment including diagnosis.

(d) Whether chronic condition.

(e) Origin or cause of disease or injury.

(f) Professional care needed and probable time required.

(g) Estimated cost.

(h) Probable length of tour at present location.

(i) Professional medical or dental opinion whether tansfer to federal facilities practicable.

(In requests for dental care, paragraphs (c) through (g) of this section should be detailed estimates provided by the dentist who will accomplish the work.)

§ 732.14 NAVMED 6320/10, Statement of Civilian Medical/Dental Care. (Formerly Form NAVMED-U.)

Form NAVMED 6320/10 is required in each case of sickness or injury of any person covered by this part who receives care from any source other than a federal facility. The report (report symbol 6320-2), in triplicate, shall be prepared by a naval medical officer or dental officer when practicable, or by the senior officer present where a naval medical or dental officer is not on duty, cr by the individual concerned when on detached duty where a senior officer is not present. Completed forms should be forwarded to the approving officer supplemented as appropriate by requirements of instructions issued by approving authorities. In all cases the diagnosis shall be included and if prior approval was not obtained for the use of non-federal facilities the circumstances which necessitated their use shall also be stated.

§ 732.15 Payment of claims.

(a) General. Bills, claims, or other documentary evidence of care received from non-federal sources should be processed for payment by approving authorities within 30 days of receipt. Advice on unusual or questionable cases may be requested of the Bureau of Medicine and Surgery (Code 73). When approving officers already have information available from messages, speedletters, or other correspondence which would support payment of the claim, the requirement for a NAVMED 6320/10 shall be waived and the claim approved for payment. The claimant shall be advised by the approving authority of any delay experienced in processing claims. Any person whose eligibility depends upon his being in a duty status at the time the care is provided is considered to be in a duty satus while on authorized leave or liberty. Persons are not eligible who are continuously absent without authority during a period of treatment. However, when the absence without authority is terminated by the member's actual or constructive return to military control prior to termination of the care, entitlement will be the same as though no unauthorized absence

existed. "Constructive return" to military control for medical and dental care is effected when a naval activity informs a civilian source providing medical or dental care to a naval member that the Navy will accept responsibility for the patient's care. The acknowledgmert may be oral or in writing. Return to military control may also be effected when a member has been arrested by civil authorities at the request of naval authorities, or when the arrest has been accomplished by civil authorities for a civil offense and such authorities have notified naval authorities that the member can be released to military custody.

(b) Approval of claims by geographical area. Claims for care from civilian sources shall be approved for payment by:

(1) District medical/dental officers of the district in which treatment was rendered.

(2) Executive Director, OCHAMPU SEUR, U.S. Army Medical Command, APO, New York 09403, for care rendered within the U.S. European Command, Africa, the Middle East, and the Malagasy Republic.

(3) Commanding Officer, U.S. Naval Hospital, FPO, San Francisco 96651, for care rendered in Southeast Asia, the Philippines, Hong Kong, Taiwan, Pakistan, Bangladesh, India, Nepal, Afghanistan, and Sri Lanka.

(4) Commander, U.S. Naval Forces, Japan, FPO Seattle 98762, for care rendered in Japan and Okinawa.

(5) Commander, U.S. Naval Forces, Marianas, FPO San Francisco 96630, for care rendered in New Zealand and Guam.

(6) Commanding Officer, US. Naval Communications Station, FPO San Francisco 96680, for care rendered in Australia.

(7) Commanding Officer, U.S. Naval Air Station, FPO New York 09560, for care rendered in Bermuda.

(8) Commandant, Fifteenth Naval District, FPO New York 09530, for care rendered in Central and South America.

(9) Commandant, Eighth Naval District, New Orleans, LA 70146, or Commandant, Eleventh Naval District, San Diego, CA 93132, for care rendered in Mexico to members stationed within

these districts. Claims for care rendered in Mexico to all other personnel, forward to Chief, Bureau of Medicine and Surgery (Code 73).

(10) Chief, Bureau of Medicine and Surgery (Code 73), for care rendered in Canada or to NATO personnel and in unusual circumstances which require Bureau level review prior to approval, adjudication, or payment.

(11) The commanding officer of operational units, outside the United States, instead of forwarding claims to the appropriate command contained in paragraphs (b)(1) through (9) of this section may approve and direct payment by the disbursing officer serving his command, when local policy and/ or the maintenance of good public relations warrant the expeditious payment of medical bills.

(12) The commanding officer authorizing the care in other geographical areas not covered in subparagraphs (1) through (9) of this paragraph.

(13) The appropriate command contained in paragraphs (b)(1) through (9) of this section for care rendered aboard commercial vessels enroute to a country located within any of the foregoing geographical areas.

(c) Preparation of claims. Unpaid bills should be submitted in quadruplicate, itemized to show the dates on or between which the services were rendered or supplies furnished, and the nature of and the charges for each item. Receipt of the services or supplies should be acknowledged on the face of the bill, or by separate certificate, by the person receiving treatment, or by an officer having cognizance of the case. Separate bills should be submitted for services of special nurses, anesthetists, or other persons on a fee basis, unless the bill including such services is accompanied by receipts to show that the expenses have been defrayed by the physician, dentist or other source of care submitting the bill, or by a statement to the effect that the individual is a full-time employee of the payee. When the expenses have already been paid by an individual, including service member, NAVCOMPT Manual 046393-1 requires the signature of the individual on the face of the NAVCOMPT From 2160 (Public Voucher for Medical Ser

vices), the claim for reimbursement as well as the payment voucher. In lieu of using the NAVCOMPT Form 2160 for this type of payment, the Standard Form 1164 (Claim for Reimbursement for Expenditures on Official Business), prepared in accordance with NAVCOMPT Manual 046377-2 a and b, may be utilized to fill the requirement for a signed claim. The paid invoices supporting a claim for reimbursement on a Standard Form 1164 will not require certification. The approving authority will certify the Standard Form 1164 and insert the appropriate accounting classification thereon. The bills and proof of payment should be forwarded to the appropriate approving officer, along with the Form NAVMED 6320/10, indicating in item 12 the complete address to which the check is to be mailed and the amount.

(d) Approval/disapproval of claims. When the required documents have been received by the approving officer, he shall determine whether the bills are payable in whole or in part, or whether the claims should be disallowed. Where payment is to be disallowed, the claimant should receive a prompt and courteous letter stating the reason for the disallowance. If approvable, the approving officer will prepare a NAVCOMPT Form 2160 and forward the voucher, supported by itemized invoices, to the appropriate Naval Regional Finance Center (NRFC) or disbursing officer for payment in accordance with NAVCOMPT Manual 046393. In lieu of the NAV COMPT 2160, the approving authority may stamp the physician, dentist, or hospital invoice with a certification stamp (a sample of which is contained in paragraph 5(d) of BUMEDINST 6320.32B) to certify that the services were received and the amount is proper for payment. (Approving officers shall requisition stamp through normal channels.) All copies of the invoice must be certified. Approved invoices will be forwarded to the appropriate paying office. The paying office will forward a check to the appropriate payee and simultaneously furnish BUMED with copies of the invoice and the payment voucher. Approving authorities shall take precautions

against duplicate payments in accordance with NAVCOMPT Manual 046073.

(e) Amount payable. The amounts payable in any case shall be those considered reasonable by the approving officer after taking into consideration all of the facts in the case. Normally, payment should be approved at rates generally prevailing within the geographical area where the services or supplies were furnished. Rates specially established by the Veterans Administration or those used in Medicare should not be considered controlling, though they may be considered along with other facts. If, after careful review, any charge is considered excessive, the claimant should be apprised of the conclusion reashed and provided an opportunity to voluntarily reduce the amount of the claim. If this does not result in a proper reduction of the bill and the claim is that of a physician or dentist, the difference in opinion should be referred to the grievance committee of the Claimant's professional group for an opinion of the reasonableness of the charge. If satisfactory settlement of any claim cannot be made, it should be forwarded to BUMED (Code 73) for decision. Payment shall not be withheld to seek payment from health benefit plans or insurance policies for which premiums are paid privately.

(f) Recovery of medical care payments. Evidence of payments shall be submitted to the action JAG designee in accordance with Part 757 of this chapter, in all cases of payment where a third party may be legally liable for causing the injury or disease treated, or when a Government claim is possible under workmen's compensation or under medical payments insurance (in all automobile accident cases).

§ 732.16 Collection for subsistense.

The accounts of officers (Navy and Marine Corps) receiving treatment in Veterans Administration hospitals, the Canal Zone Hospital, or in civilian hospitals at the Department of the Navy's expense will be checked by subsistence. This checkage shall be made by DD 139, Pay Admustment Authorization, which shall be submitted by the officer's commanding officer having

custody of the member's pay record. It is the responsibility of the originating activity to insure that checkage has been accomplished in accordance with MPPM 30137. When officers are hospitalized in an Army, Air Force, or U.S. Public Health Service medical facility, the charge for subsistence will be collected by the facility.

PART 733-DECORATIONS AND AWARDS

NOTE: Information and regulations concerning all current awards available to individuals and units in the naval service are published in SECNAVINST 1650.1D, Navy and Marine Corps Awards Manual. This manual is available for examination and individual copies of provisions thereof may be purchased in accordance with § 701.1.

[37 FR 10500, May 24, 1972]

PART 734-PAYMENT OF CERTAIN ALLOWANCES AND DIFFERENTIALS TO CIVILIAN EMPLOYEES OF NONAPPROPRIATED FUND INSTRUMENTALITIES OF THE DEPARTMENT OF THE NAVY

Sec.
734.1 Purpose.
734.2 Scope.

734.3 Implementation.

AUTHORITY: Sec. 10, 65 Stat. 712, sec. 912, 68A Stat. 290, sec. 5031, 70A Stat. 278, as amended, sec. 133, 76 Stat. 517, secs. 301, 5921-5925, 80 Stat. 379, 510-512; 3 U.S.C. 301, 5 U.S.C. 301, 5921-5925, 10 U.S.C. 133, 5031, 26 U.S.C. 912; E.O. 11137, 29 FR 223, 3 CFR 1964 Supp. p. 112, except as otherwise noted.

fense, governing payments of allowances and differentials in foreign areas and cost-of-living allowances in nonforeign areas to civilian employees of nonappropriated fund activities of the United States under the jurisdiction of the Armed Forces covered by 5 U.S.C. 2105c.

[29 FR 10512, July 29, 1964, as amended at 41 FR 26Ɛ64, June 30, 1976]

§ 734.3 Implementation.

With approval of the Department of Defense, the Commandant of the Marine Corps, the Chief of Naval Personnel, the Commander, Naval Supply System Command and the Director of the Office of Civilian Manpower Management have been directed to take action insuring that "allowances and differentials" and "cost-of-living allowances" which may be prescribed for civilian employees under Executive Order 11137 comply with the following:

(a) Foreign areas “Overseas Differentials and Allowances". (1) Foreign areas are defined as any areas (including the Trust Territory of the Pacific Islands) situated outside the United States, the Commonwealth of Puerto Rico, the Canal Zone, and the possessions of the United States.

(2) The rates of payments authorized for the allowances and differentials which may be prescribed shall not, with respect to any locality, exceed those prescribed by the Department of State Standardized Regulations (Government Civilians, Foreign Areas) under Exec. Order No. 10903, 3 CFR 433 (1961) for other employees of the United States in the same locality.

(3) The types of allowances and differentials which may be prescribed shall be within the range of those provided in Department of Defense Directive 1418.1 of April 17, 1961, except that an education allowance may be paid as authorized in section 270 of the Department of State Standardized Regulations (Government Civilians, Foreign Areas) under Executive Order 10903.

(4) Allowances and differentials will be prescribed only for those employees who meet the eligibility requirements contained in section 030 of the Depart

ment of State Standardized Regulations (Government Civilians, Foreign Areas), including the requirement of United States citizenship, and whose rates of basic compensation are fixed in conformity with rates paid for work of a comparable level of difficulty and responsibility to employees stationed in the United States, exclusive of Alaska and Hawaii.

(b) Nonforeign areas “Cost of Living Allowances". (1) Nonforeign areas are defined as Alaska, Hawaii, the Commonwealth of Puerto Rico, Virgin Islands, Guam, and other areas listed in section 591 of the Federal Personnel Manual.

(2) The rates of payments authorized for the cost-of-living allowances which may be prescribed shall not, with respect to any locality, exceed those prescribed by the Civil Service Commission in regulations published in the Federal Personnel Manual, under Executive Order 10000, 3 CFR 792 (1948), as amended, for other employees of the United States in the same locality.

(3) The cost-of-living allowances prescribed shall not apply to employees who are stationed in either the Canal Zone or in any "foreign area" as defined in paragraph (a)(1) of this section.

(4) Cost-of-living allowances will be prescribed only for those employees whose rates of basic compensation are fixed in conformity with rates paid, for work of a comparable level of difficulty and responsibility, to employees stationed in the United States, exclusive of Alaska and Hawaii.

[29 FR 10512, July 29, 1964, as amended at 37 FR 6472, Mar. 30, 1972; 41 FR 26864, June 30, 1976]

PART 735-REPORTING BIRTHS AND DEATHS IN COOPERATION WITH OTHER AGENCIES

Sec. 735.1 Purpose. 735.2 Births. 735.3 Deaths. 735.4 Policy.

AUTHORITY: Sec. 5031, 70A Stat. 278, as amended, secs. 301, 552, 80 Stat. 379, 383; 5 U.S.C. 301, 552, 10 U.S.C. 5031.