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rolled in, the Naval Reserve Officers Training Corps, the Platoon Leaders Class, Women Officers' Training Class, or the Naval Reserve Officer Candidates program who are not on active duty, is authorized for the purpose of conducting special physical examination procedures which have been requested by the Bureau to determine their physical fitness for appointment to, or continuation in, such a program. Upon a request from the individual's commanding officer or the officer in charge of the cognizant Navy or Marine Corps recruiting station or officer selection officer, naval medical facilities are authorized to admit persons in this category, when in the cognizant officer's opinion, hospitalization is deemed necessary for special physical examinations. Hospitalization should be kept to a minimum. Treatment other than for humanitarian reasons, unless otherwise provided for in this part, is not authorized.

§ 728.28 Inactive reserve commissioned officers of the Public Health Service; physical examination.

U.S. naval hospitals in the United States are authorized to conduct physical examinations of and administer immunizations to inactive Reserve commissioned officers of the Public Health Service upon presentation of written authorization from the U.S. Public Health Service. The authorization shall indicate the scope of the examination and immunizations required and the complete mailing address to which the completed report thereof is to be submitted. The examination and immunizations shall be given on an outpatient basis and consist of:

(a) A general physical examination reported on Standard Forms 88 and 89, to include X-ray, urinalysis (routine and microscopic), serological test for syphilis, hematocrit or hemoglobin, and red blood count, and

(b) Immunizations as necessary.

Subpart D-Retired Members of the Uniformed Services

§ 728.31 Authority.

Medical care is authorized for retired members of the uniformed serv

ices by 10 U.S.C. 1074(b) and by § 70.8 of this title.

§ 728.32 Retired members of a uniformed service defined.

(a) Inclusion. A retired member of a uniformed service is defined to include:

(1) A member or former member of a uniformed service who is entitled to retired or retainer pay or equivalent pay as a result of active duty in a uniformed service.

(2) A retired member of a Reserve component of the uniformed services who is entitled to retired pay from a uniformed service on attaining 60

years of age and who has completed 20 or more years of creditable service as set forth in 10 U.S.C. 1332, provided that he has served 8 or more years in a uniformed service on active duty other than for training.

(3) A member of a Reserve component of the uniformed services who is entitled to disability retired pay regardless of the period of active duty served.

(b) Exclusion. A retired member of a Reserve component of a uniformed service, who is entitled to retired pay by reason of years of satisfactory Federal service and who has not served on active duty for 8 years other than for training duty, is not eligible for medical care in medical facilities of the uniformed services under the provisions of 10 U.S.C. 1074(b).

§ 728.33 Scope of medical care authorized.

Retired members of the uniformed services (as defined in § 728.32(a)) are entitled to required medical care and adjuncts thereto to the same extent as provided for activity duty members in medical facilities of the uniformed services, subject to mission requirements and the availability of space and facilities and the capabilities of the medical staff as determined by the cognizant medical authority in charge of the medical facility. Nothing in this section is intended to change or modify the provisions of Executive Order 10122 of April 14, 1950 (3 CFR 1949-53 Comp., p. 313), as amended by Executive Order 10400 of September 27, 1952 (3 CFR 1949-53 Comp. p. 900).

§ 728.34 Application for medical care.

Retired members of the uniformed services may, upon request and presentation of valid identification, receive medical care and adjuncts thereto at naval medical facilities subject to provisions of §§ 728.33 and 728.35.

§ 728.35 Members retired for physical disability.

(a) Chronic diseases. All duties, powers, and functions incident to the hospitalization of retired members placed on the temporary disability retired list, or permanently retired for physical disability, or receiving disability retirement pay, who require hospitalization for chronic diseases, are vested in the Administrator of Veterans' Affairs. Such members may not be hospitalized in naval medical facilities, except:

(1) When hospitalization is authorized by the Veterans' Administration;

or

(2) When such members have completed 20 or more years of active duty and elect not to receive hospitalization in Veterans' Administration facilities for chronic diseases other than blindness, neuropsychiatric or psychiatric disorders and tuberculosis, and are acceptable medically to the commanding officer of the naval medical facility.

(b) Definition. For the purpose of this section "chronic diseases" shall include chronic arthritis, malignancy, poliomyelitis with disability residuals, tuberculosis, blindness and deafness requiring definitive rehabilitation, major amputees, psychiatric or neuropsychiatric disorders, neurological disabilities, degenerative diseases of the nervous system, and severe injuries to the nervous system including quadriplegics, hemiplegics, and paraplegics.

(c) Scope. This section shall not be considered to affect eligibility for hospitalization for conditions not defined as chronic diseases nor for outpatient treatment regardless of the nature of the illness for which treatment is required.

(d) Temporary disability retired list. Retired members placed on the temporary disability retired list who require hospitalization in connection with the conduct of periodic physical examina

tions may be admitted to naval medical facilities.

(e) Emergency officers' retired list. Persons placed upon the emergency officers' retired list who are receiving retired pay shall be eligible for hospitalization privileges provided by law or regulation for officers of the Regular Navy who have been retired for physical disability. Other persons placed upon the emergency officers' retired list without retired pay and entitled only to compensation pursuant to law or regulation of the Veterans' Administration may be admitted only as a beneficiary of that agency.

§ 728.36 Medications for retired members. The provisions of § 728.43 shall apply in furnishing medications to retired members.

§ 728.37 Charges and collections.

(a) Retired members. Retired officers, drawing retired or retainer pay or equivalent pay as a result of active duty in a uniformed service, shall be charged the value of a hospital ration or subsistence. Charges shall be collected locally from the officer. No local charges or collections shall be made for enlisted retired members.

(b) Reimbursement for cost of ration. Reimbursement to BUMED managed activities for the average cost of rations furnished enlisted naval members shall be accomplished in accordance with instructions contained in the Financial Management Handbook. For activities not under the management of BUMED, reimbursement shall be effected in accordance with instructions contained in NAVCOMPT Manual.

Subpart E-Dependents of Uniformed Services

8 728.41 General.

(a) Eligible dependents. The Dependents' Medical Care Act (10 U.S.C. 1071-1085) authorizes certain medical care to be provided eligible dependents of members and retired members of the uniformed services, and dependents of persons who died while a member or retired member of a uniformed service.

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(b) Joint uniformed services regulations. The medical service policies and procedures for administering the medical care program for dependents are promulgated by joint uniformed services regulations. Reference shall be made to these regulations (SECNAVINST 6320.8 series, see §§ 577.60 through 577.68 of this title) for information and guidance with respect to the following:

(1) Definition of terms peculiar to dependent medical care program.

(2) Determination of eligibility and authorization for admission of depend

ents.

(3) Determination of source from which dependents are to receive medical care.

(4) Administration of medical care for dependents at medical facilities of the uniformed services.

(5) Administration of medical care obtained from civilian sources for spouses and children of active duty members of the uniformed services.

(6) Administration of medical care not otherwise provided for.

(c) Fiscal aspects. The policies and procedures for guidance of naval activities with respect to fiscal aspects of medical care for dependents of the uniformed services are promulgated by SECNAVINST 6320.9 series (see §§ 577.80 through 577.84 of this title) and BUMEDINST 6322.6 series.

§ 728.42 Medical care at naval medical facilities.

(a) Care for eligible dependents. Upon request, and presentation of valid DD Form 1173 (Uniformed Services Identification and Privilege Card), authorized medical care shall be provided for eligible dependents of members and retired members of the uniformed services and dependents of eligible persons who died while a member or retired member of a uniformed service at U.S. naval fixed medical treatment facilities designated by the Bureau of Medicine and Surgery to provide inpatient and outpatient medical care for dependents. Normally, medical care shall be limited to those dependents residing in the areas which the facilities have been designated to serve.

(b) Outpatient. Except in cases of emergency, or as otherwise indicated by distance traveled or other extenuating circumstances, outpatient medical care for dependents is to be routinely available only during the regular working hours of the facility.

§ 728.43 Medical services not otherwise provided.

(a) Prescriptions. Prescriptions written by civilian physicians (non-Navyemployed) for dependents who present a valid DD Form 1173 (Uniformed Services Identification and Privilege Card) may be filled if:

(1) The commanding officer determines that pharmacy personnel and funds are available.

(2) The items are routinely stocked. (3) The amounts are reasonable and correct as to dosage.

(4) Narcotics are not included. (Articles 3-31 and 3-33, Manual of the Medical Department, deal with prescribing and dispensing drugs.)

(b) Medications. Medications shall not be furnished by mail to retired personnel or dependents unless they are directly under the care of a naval physician. Such medications shall be limited to those regularly stocked, in reasonable amounts, correct as to dosage, and shall not include narcotics.

(c) Therapeutic measures. X-ray, laboratory, physical therapy, and other ambulatory diagnostic or therapeutic measures for eligible dependents requested by non-Navy-employed civilian physicians may be provided upon approval of the commanding officer or department heads designated by him, if the rendering of such services is subordinated to and does not unduly interfere with providing adequate inpatient and outpatient care to active duty personnel and other persons eligible to receive care at naval medical facilities.

(d) Guard against excessive demands. All activities shall guard

against excessive demands for the privileges extended by paragraphs (a) through (c) of this section.

§ 728.44 Maternity cases.

The per diem charge for a maternity-case dependent shall include the mother and the newborn infant until the mother is allowed to leave the medical facility. If further hospitalization of the infant is required, the per diem charge shall continue for the infant. For purposes of computing per diem charge, a multiple birth shall be considered as one birth. The same per diem charge shall apply whenever an infant under 1 year of age is hospitalized, such charge to include the mother if she is required by the activity to remain with the infant. If the mother is hospitalized, and of necessity an infant under 1 year of age accompanies or remains with her, the per diem charge for the mother shall also include such infant. For a child 1 year of age or over, the per diem charge shall be in addition to the charge for the mother. A Standard Form 535, Newborn Record, shall be prepared. The infant shall be taken up in the Register of Patients as indicated in article 23-222, Manual of the Medical Department.

§ 728.45 Charges and collections.

Eligible dependents of active duty and retired members of the uniformed services, and dependents of persons who died while on active duty or in a retired status of the uniformed services shall be charged the dependent's rate. Charges shall be collected locally.

Subpart F-Members of Foreign Military Services and Their Dependents

§ 728.51 Medical care authorized in the United States.

(a) Furnishing of medical care. Members of foreign military services on active duty in the United States may be furnished medical care at naval medical facilities as authorized in this subpart and subject to the provisions of Subpart A of this part. In general, the policies of this subpart shall govern the furnishing of medical care to members of foreign military services on duty in the United States.

(b) Inpatient care. Inpatient care shall be limited to those cases which will benefit from definitive hospital

care within a reasonable period of time. When a patient is found to require hospitalization in excess of 90 days, or his condition indicates that he should be transferred to a hospital within his own nation, or to a private institution, a notification shall be submitted promptly to the Bureau of Medicine and Surgery, giving full identification of patient, diagnosis, prognosis, estimated period of hospitalization, and recommended disposition. The Bureau will arrange appropriate disposition. Hospitalization generally shall not be granted to members of foreign military services who require prolonged hospitalization for chronic conditions, hospitalization for nervous or mental disorders, or domiciliary care, except in an emergency to preserve life or prevent suffering.

(c) Adjuncts. Prosthetic devices, hearing aids, orthopedic footwear and similar adjuncts are not authorized for members of foreign military services. Spectacles may be furnished when required to enable the member to perform his assigned duties and the spectacles are not available through civilian sources.

§ 728.52 Members of foreign military services assigned to NATO and their dependents.

(a) General. This section applies to medical care and treatment authorized for foreign personnel assigned to fulltime duty with the North Atlantic Treaty Organization in the United States.

(b) Authority. By agreement signed in London June 19, 1951, regarding the status of their forces (TIAS 2846, 4 UST 1792), the parties to the North Atlantic Treaty of 1949 have pledged among other things that members of a force or a civilian component (and their dependents) may receive medical and dental care, including hospitalization, under the same conditions as comparable personnel of the receiving state.

(c) Member countries. Belgium, Canada, Denmark, Federal Republic of Germany, France, Greece, Iceland, Italy, Luxembourg, Netherlands, Norway, Portugal, Turkey, United Kingdom, and the United States.

(d) Medical care—(1) Members of foreign military services (NATO). These personnel will be provided medical and surgical treatment and hospitalization at naval medical facilities, comparable to that provided members of the naval service.

(2) Dependents of members of foreign military service (NATO). These dependents are eligible to receive outpatient and inpatient care at naval medical facilities comparable to that authorized for dependents of the uniformed services. Medical care for dependents will be subject to the provisions of Subpart A of this part. Dependents shall not be furnished hospitalization for chronic diseases, nervous or mental disorders, elective medical or surgical care, or domiciliary care.

(3) Civilian components (employees of foreign military services). These persons may be provided immediate and ambulatory outpatient care for injuries and illness incurred in the performance of and proximately caused by the employment and for nonoccupational illness and injuries where facilities permit, to the extent that it will aid the individual to remain on the job.

(e) Dental care-(1) Members of foreign military services (NATO). Eligible personnel may receive dental care at any naval activity having a dental facility. Orthodontic treatment is not authorized nor is prosthetic treatment unless it is required to restore an extensive loss of masticatory function or to restore anterior teeth when lost incident to active service.

(2) Dependents of members of foreign military services-within United States, not in a designated remote area. These dependents may be provided dental care at designated naval medical activities only as an adjunct to inpatient care. This care is limited to injuries such as fractures of the jaw and treatment of acute infections. Routine operative care, fixed or removable prosthodontic restorations, or orthodontic treatment are not to be construed as adjunctive to medical or surgical treatment. At other naval activities, dependents may receive only such emergency dental treatment as demanded by the laws of humanity.

(3) Dependents of members of foreign military services-at designated remote areas within United States. At designated remote areas within the United States where adequate civilian dental facilities are not available, routine dental care is authorized. Routine dental care includes general operative, surgical, and prosthodontic treatment which active duty members of the uniformed services are furnished. Determinations made by the senior dental officer of the uniformed service dental facility, or his designee, as to the professional aspects of providing necessary dental care within the availability and capability of the dental staff shall be conclusive. Determinations as to the availability of space and facilities, or lack of them, for dependent dental care, shall be made by the senior dental officer of the dental facility with the approval of the installation commander whose personnel are served by the dental facility concerned.

(4) Civilian components (employees). These persons may be provided emergency dental care for injuries incurred in the performance of duties, when such treatment is necessary and demanded by the laws of humanity, and when such treatment is available and practicable.

(f) Disposition. When it is found necessary to return individuals to their home country for medical reasons, immediate notification shall be made to the NATO unit sponsoring the patient. The notification is to include pertinent information regarding the physical condition of the individual concerned.

(g) Charges and collections. Charges for subsistence shall be collected locally from officer personnel at the established hospital ration rate. No reimbursement shall be required for periods when such officers are authorized to "subsist out" or while in an authorized "leave" status. No collections shall be made locally from enlisted personnel. Charges for inpatient medical care provided dependents of military personnel shall be collected locally at the established dependent rate. No charges shall be made locally for care provided civilian components (employees) covered by this part. Charges

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