Ch. I, Subchap. B) and Navy Civilian Personnel Instructions.

(e) Charges and collections. Beneficiaries of the BEC shall be billed for inpatient and outpatient care at the rates prescribed by BUMED Instruction 6320.4 series and collections made locally from the BEC office of jurisdiction by hospitals. Charges and collections shall be made by BUMED for the Naval Hospital, Guantanamo Bay, Cuba, only. All billings must be supported by a CA-16 or CA-17; in addition, outpatient services shall be supported by a DD Form 7. Charges and collections for naval medical facilities not under the management control of BUMED shall be made in accordance with the Navy Comptroller Manual (vol. 3, chap. 5, sec. 2, subsec. 5).

(f) Exception. The BEC will not be billed for outpatient services provided civilian employees under the Navy's Health Program for Civilian Employees (see § 728.73).

§ 728.63 Beneficiaries of the Public Health Service, not members of the uniformed services.

(a) Authority. The following persons, not members of the uniformed services, are entitled to medical, surgical, and dental treatment and hospitalization under the Public Health Service Act (42 U.S.C. 249 and 253) and many receive such care and treatment at the expense of the Public Health Service and from other Government medical or hospital facilities when authorized by officials of that agency.

(1) Noncommissioned ships' officers and members of crews of the U.S. Coast and Geodetic Survey on active duty.

(2) Seamen employed on vessels of United States Registry.

(3) Seamen employed on State school ships or on vessels of the U.S. Government of more than 5 tons' burden.

(4) Cadets of State maritime academies on State training ships.

(5) Seamen on vessels of the Mississippi River Commission and officers and crews of vessels of the Fish and Wildlife Service.

(6) Enrollees in the United States Maritime Service on active duty and

members of the Merchant Marine Corps.

(7) Employees and noncommissioned officers in the field service of the Public Health Service when injured or taken sick in line of duty.

(b) Authorization for admission. (1) Persons in the above categories may be admitted to naval medical facilities within the United States as beneficiaries of the Public Health Service upon presentation of the prescribed form. Treatment Authorization (Form PHS 894), prepared and signed by the medical officer of the nearest PHS medical facility.

(2) In the case of detached personnel, or those serving in a locality where a PHS medical officer is not available, who require emergency medical care, a written request for hospitalization signed by either the individual or the commanding officer (or ship's master) may be accepted. Nonemergency cases shall not ordinarily be admitted until eligibility for admission has been verified. There is no exception to the treatment that members of the American Merchant Marine may receive as long as they can show proof that they have been employed as a seaman for 60 days of continuous service, a part of which time must have been during the 90 days immediately preceding application for medical care. In emergency or nonemergency cases, the medical officer in charge of the nearest PHS hospital or inpatient clinic shall be immediately notified of the details, and requested to verify the propriety of such request for treatment. In cases involving Military Sea Transportation Service civil service seamen, the verification may be obtained by contacting the nearest MSTS facility. The method of notification (telephone, telegraph, etc.) shall be determined by the urgency of the situation at hand. The verifying officer shall forward one copy of the Treatment Authorization.

(c) Emergency status. In determining emergency and nonemergency classification, consideration should be given to the seaman's present status. For instance: A seaman may request treatment for what would normally be considered as a nonemergency ailment; however, it may be of such a nature

that, unless treated, the man would not be able to sail with his ship. Such cases should be treated as an emergency.

(d) Outpatient treatment. Outpatient care may be furnished persons in the above categories only in an emergency when immediate treatment is required. In such cases, the commanding officer of the naval medical facility shall obtain authorization as required by paragraph (b)(2) of this section.

(e) Outside the United States. Outside the United States, only persons in the following categories may be provided medical care as PHS beneficiaries:

(1) Noncommissioned ships' officers and members of the Coast and Geodetic Survey on active duty.

(2) Employees and noncommissioned officers in the field service of the PHS when injured or taken sick in line of duty.

(f) Charges and collections. Charges and collections for PHS beneficiaries shall be made at the management bureau level.

§ 728.64 Selective Service registrants and applicants for enlistment or reenlistment.

(a) Selective Service registrants—(1) Authority. Selective Service registrants who suffer illness or injury while acting under orders issued under the Universal Military Service and Training Act are entitled to emergency medical care, including hospitalization, in accordance with rules and regulations prescribed by the Director of Selective Service (50 U.S.C. App. 461). Registrants shall be provided necessary medical care and treatment, including inpatient care, upon request of the local Selective Service official.

(2) Charges and collections. Charges and collections for Selective Service registrants shall be made at the management bureau level.

(b) Applicants for enlistment or reenlistment. (1) Applicants for enlistment or reenlistment while under military control who suffer acute illnesses and/ or injuries while awaiting or undergoing enlistment processing at recruiting stations or at Armed Forces examining stations may be furnished emergency medical care including emergency hos

pitalization at military medical facilities. Admissions shall be accomplished in accordance with § 728.61(d).

(2) Charges and collections. Charges and collections shall be accomplished in accordance with § 728.61(i).

§ 728.65 Beneficiaries of the U.S. Naval Home.

(a) Admission. A beneficiary of the U.S. Naval Home at Philadelphia, Pa., may be admitted to a naval hospital upon the request of the Governor of the Naval Home. If a beneficiary is admitted in an emergency, the Governor or the Naval Home shall be notified immediately.

(b) Charges and collections. No charges are to be made for hospitalization.

§ 728.66 FBI Agents and claimants against the United States.

(a) FBI Agents. Agents of the Federal Bureau of Investigation are authorized to receive physical examinations at naval medical facilities upon presentation of a letter of authorization from the Department of Justice. Hospitalization, not to exceed 3 days, is authorized for diagnostic purposes only if necessary to determine the individual's physical fitness and will not be for the purpose of correcting defects.

(b) Claimants against the United States. Claimants against the United States whose claims or suits are being handled by the Department of Justice or a U.S. attorney may be given physical examinations at naval medical facilities upon written authorization from the Department of Justice or U.S. attorney in the case. The purpose of such examinations will be to determine the extent and nature of the injuries or disabilities claimed, and the report of such examinations shall be furnished promptly to the Department of Justice or U.S. attorney. Hospitalization, not to exceed 3 days, is authorized if necessary for the proper conduct of the examination.

(c) Charges and collections. Charges shall be made at the rates as prescribed by BUMED Instruction 6320.4 series. Collections for physical examinations shall be made at the activity

level for BUMED-managed activities (except Naval Dispensary, Washington, D.C.), and in accordance with the Navy Comptroller Manual (vol. 3, chap. 5, sec. 2, subsec. 5) for nonBUMED-managed activities. Collections for hospitalization shall be made by the management bureau upon receipt of the letter of authorization.

§ 728.67 Beneficiaries of the Department of State; officers and employees of the Foreign Service and their dependents. (a) Authority. In the event an officer or employee of the Foreign Service who is a citizen of the United States, or his dependent, incurs an illness or injury while located abroad, which requires hospitalization or similar treatment, the Secretary of State is authorized to pay for the cost of treatment of the illness or injury under the Foreign Service Act of 1946, as amended (22 U.S.C. 1156).

(1) In case of a dependent, maternity care is not included.

(2) The term "dependent" includes wife who is not an employee of the Foreign Service; husband who is physically or mentally incapable of supporting himself; and unmarried children (including step and adopted children) under 21 years of age or, regardless of age, if physically or mentally incapable of supporting themselves.

(b) Authorization for care. (1) Foreign Service personnel and their dependents may be furnished inpatient and outpatient care at naval medical facilities for an illness or injury incurred abroad, upon written request from an appropriate Department of State official. In event that a Foreign Service employee or his dependent is admitted in an emergency without the required written request, the commanding officer of the naval medical facility shall obtain proper written authorization as soon as possible from the appropriate Department of State official. Outpatient care at the expense of the Department of State is authorized only when treatment is furnished for an illness or injury incurred abroad which requires hospitalization. Outpatient care before and following hospitalization is authorized.

(2) The written request for admission shall include complete identifica

tion of the Foreign Service employee or his dependent, and statements that the treatment is authorized under Foreign Service Act of 1946 and that reimbursement will be made by the Department of State.

(c) Admission to naval medical facilities overseas. (1) In event of an illness or injury of a Foreign Service employee or his dependent which, in the opinion of the principal or administrative officer of the Department of State, meets the conditions of eligibility for hospitalization, such officer will furnish the commanding officer of the overseas naval medical facility a letter, in duplicate, requesting admission of the employee or dependent at expense of the Department of State.

(2) In event that the Department of State principal or administrative officer believes that the illness or injury does not meet the conditions of eligibility for hospitalization, that officer may request admission of the Foreign Service employee or dependent at the patient's own expense. If admission is authorized by the commanding officer of the overseas naval medical facility, all hospitalization expenses incurred shall be the responsibility of the employee and shall be collected locally. If payment is not made within the prescribed period, the commanding officer shall notify the administrative officer of the nearest Foreign Service post. The principal officer at the employee's post will take immediate steps to insure that the naval medical facility is reimbursed by the Foreign Service employee.

(d) Evacuation to the United States. If it is determined that a Foreign Service employee or his dependent requires prolonged hospitalization, the commanding officer of the naval medical facility shall report the case to the nearest Department of State officer and request authority to return the patient to the United States. Aeromedical evacuation may be utilized in accordance with OPNAV Instruction 4630 series. Dependent patients requiring prolonged hospitalization who decline evacuation shall be released to custody of their sponsor.

(e) Admission to U.S. naval hospital in United States. The Medical Director, Department of State, will arrange

with the commanding officer of naval hospitals in the United States for admission of Foreign Service personnel and their dependents. Written authorization for admission, in duplicate, will be furnished by the medical director. In event an officer, employee, or dependent is admitted without prior authorization to a naval hospital in the United States in an emergency for treatment of an illness or injury incurred abroad, the commanding officer shall request authorization from the Medical Director, Department of State. Admission is not authorized for an illness or injury incurred in the United States.

(f) Physical examinations and immunizations. (1) The Foreign Service Act of 1946, as amended, authorizes the Secretary of State to provide for physical examinations for applicants for employment and for officers and employees of the Foreign Service who are United States citizens, and their dependents, including examinations necessary to establish disability or incapacity for retirement purposes. In addition, the Act authorizes the Secretary of State to provide for administration of inoculations and vaccinations for such officers and employees (22 U.S.C. 1158).

(2) Physical examinations may be conducted, whenever practicable, by medical officers at naval medical facilities, and immunizations may be furnished upon presentation of written authorization from an appropriate Department of State official. The authorization, in duplicate, will include the type of examination or immunization required and state that the individual is entitled to services at the expense of the Department of State. Reports of physical examinations shall be submitted as requested by the letter of authorization.

(g) Charges and collections. All charges and collections for beneficiaries of the State Department shall be made at the activity level for BUMEDmanaged activities, and in accordance with the Navy Comptroller Manual (vol. 3, chap. 5, sec. 2, subsec. 5) for non-BUMED-managed activities.

Charges for inpatient and outpatient care shall be in accordance with the

rates prescribed in BUMED Instruction 6320.4 series.

§ 728.68 Peace Corps.

(a) Authority. The Secretary of Defense has authorized medical care for Peace Corps volunteers and volunteer leaders to the same extent now authorized for officers and employees of the Foreign Service. Such care will be afforded when the availability of space and facilities and the capabilities of the professional staff permit.

(b) Authorization for physical examination, treatment, and/or admission. Peace Corps Volunteers, volunteer leaders, and dependents of volunteer leaders may be furnished inpatient and outpatient care in naval medical facilities upon written request from an appropriate Peace Corps official. The written authorization shall include complete identification of the volunteer, volunteer leader, or his dependent; nature of the authorization and/ or a statement that the illness or injury was incurred abroad; and that reimbursement will be made.

(c) Medical care authorized. (1) Peace Corps volunteers, volunteer leaders, and dependents of volunteer leaders may be furnished inpatient and outpatient care in naval medical facilities for an illness or injury incurred abroad upon written request from an appropriate Peace Corps official and subject to the availability of space and facilities and the capabilities of the medical staff. The medical care of Peace Corps volunteers, volunteer leaders, and dependents of volunteer leaders shall not interfere with the primary mission of the naval medical facility. In the event that a Peace Corps volunteer, volunteer leader, or his dependent is admitted in an emergency without the required written request, the commanding officer of the naval medical facility shall obtain proper written authorization as soon as possible from the appropriate Peace Corps official. Dental care shall be limited to the relief of pain or other emergency measures.

(2) If it is determined that a Peace Corps volunteer, volunteer leader, or his dependent requires prolonged hospitalization, the commanding officer

of the naval medical facility shall report the case to the appropriate Peace Corps official and request authority to return the patient to the United States. Dependent patients requiring prolonged hospitalization who decline evacuation shall be released to the custody of their sponsor.

(3) Complete physical examinations or any part thereof may be conducted. Reports of physical examinations shall be submitted as requested by the letter of authorization. The authorization, in duplicate, shall include the type of examination required.

(4) Immunizations may be furnished upon written authorization from an appropriate Peace Corps official. The authorization, in duplicate, shall include the type of immunization required.

(d) Charges and collections. At BUMED-managed activities, charges and collections for outpatient visits, examinations, or immunizations shall be made at the activity level; charges and collections for inpatient service shall be made at BUMED level. For non-BUMED-managed activities, all charges and collections shall be made in accordance with the Navy Comptroller Manual (vol. 3, chap. 5, sec. 2, subsec. 5).

Subpart H-Other Persons

§ 728.71 Former women members of the Armed Forces-maternity care.

(a) Eligibility. Former women members of the Armed Forces separated from active duty or from the service because of pregnancy, or separated from the service for reasons other than pregnancy who are found to have been pregnant at the time of separation may be provided maternity care at naval medical facilities, subject to the provisions of Subpart A of this part.

(b) Authorized care. Authorized maternity care includes medical and surgical care incident to the pregnancy, including prenatal care, hospitalization, confinement, and postnatal care in the hospital or as an outpatient not to exceed 6 weeks following delivery.

(c) Application. In making application for maternity care, a former enlisted woman should present her dis

charge certificate or a photostat thereof. An officer should present a certified copy of her request for resignation (if she was separated through acceptance of resignation) and her separation orders. A physician's certification will be accepted in any case where a woman has been separated for reasons other than because of pregnancy and it can be reasonably determined that the condition of pregnancy existed at the time of separation. At the time of separation, such pregnant women personnel shall be advised to register at a military medical activity, where suitable facilities are available, at least 30 days prior to anticipated date of delivery. In areas where there is more than one military facility providing maternity care, personnel must apply to the medical facility of the service from which they were separated if one is available in that community. Referral to other medical facilities may be made only when bed space is not available in a medical facility of the service from which the individual was separated.

(d) The child. The military departments assume responsibility for care of the child only during the mother's hospitalization, and further arrangements for the child must be made by the mother. If the mother contemplates release of the child for adoption, all arrangements must be made by the mother with local civil authorities in advance of hospitalization. In such cases, discharge of the mother shall not be made until she personally releases the child to appropriate local authorities. Local Red Cross and public welfare activities are in a position to advise in such matters.

(e) Charges and collections. Charges shall be made for the value of a hospital ration or subsistence only and shall be collected locally. No charge shall be made for the newborn infant while the mother is an inpatient.

(f) Overseas. Women members of the Navy and Marine Corps who become pregnant will ordinarily be returned to the United States by the first suitable means of transportation for separation from the service. If, however, the health of the woman would be endangered by such transportation, she shall be retained overseas until deliv