Code of Federal Regulations: Containing a Codification of Documents of ...

5. Distribution. Except as provided under "Limitations," (subsection E.6., of this enclosure), and except where classified information is involved, environmental reviews will be made available to the Department of State, the Council on Environmental Quality, other interested federal agencies, and, on request, to the public in the United States. Interested foreign governments also may be informed of the reviews and, subject to the "Limitations" (subsection E.6., of this enclosure) and controls on classified information, will be furnished copies of the documents on request. This provision for document distribution is not a requirement that distribution be made prior to taking the action that is the subject of the review.

6. Limitations. The requirements with respect to the preparation, content, and distribution of environmental reviews in the international context must remain flexible. The specific procedures must be determined on a case-by-case basis and may be modified where necessary to:

a. Enable the component to act promptly. Considerations such as national security and foreign government involvement may require prompt action that must take precedence in the environmental review process;

b. Avoid adverse impacts on relations between the United States and foreign governments and international organizations;

c. Avoid infringement or the appearance of infringement on the sovereign responsibilities of another government. The collection of information and the preparation and distribution of environmental documentation for actions in which another nation is involved or with respect to the environment and resources of another nation, unless done with proper regard to the sovereign authority of that nation, may be viewed by that nation as an interference in its internal affairs and its prerogative to evaluate requirements with respect to the environment; and

d. Ensure consideration of:

(1) Requirements of governmental confidentiality. This refers to the need to protect sensitive foreign affairs information and information received from another government with the understanding that it will be protected from disclosure regardless of its classification;

(2) National security requirements. This refers to the protection of classified information;

(3) Availability of meaningful information. Information on the environment of foreign nations may be unavailable, incomplete, or not susceptable to meaningful evaluation, and this may reduce or change substantially the normal content of the environmental review;

(4) The extent of the participation of the DoD component concerned and its ability to affect the decision made. The utility of the

environmental analysis and the need for an in-depth review diminishes as the role of the Department of Defense and control over the decision lessens; and

(5) International commercial, commercial confidentiality, competitive, and export promotion factors. This refers to the requirements to protect domestic and foreign trade secrets and confidential business information from disclosure. Export promotion factors includes the concept of not unnecessarily hindering United States exports.

7. Classified Information. Classified information will be safeguarded from disclosure in accordance with the DoD procedures (32 CFR 159) established for such information under Executive Order 12065. The requirements of that Executive Order take precedence over any requirement of disclosure in this part.

Defense (Health Affairs). The Secretary of Defense, by DoD Directive 5136.1, "Assistant Secretary of Defense (Health and Environment)," (under revision) delegated authority to the Assitant Secretary of Defense (Health Affairs) to provide policy guidance, management control and coordination (including coordination with the Department of Health, Education, and Welfare) as required for CHAMPUS and to develop, issue and maintain Regulations with the coordination of the Military Departments as necessary and appropriate. Additional implementing authority is contained in DoD Directive 5105.46,' "Civilian Health and Medical Program of the Uniformed Services," December 4, 1974.

(ii) Department of Health, Education, and Welfare. The Secretary of Health, Education, and Welfare has delegated authority to the Assistant Secretary for Health, Department of Health, Education, and Welfare (DHEW), to consult with the Secretary of Defense or a designee and to approve and issue joint regulations implementing Chapter 55, Title 10, United States Code (Dependents' Medical Care Act, as amended). This delegation is effective April 19, 1976 (39 FR 18698, May 6, 1976).

(iii) Office of CHAMPUS (OCHAMPUS). By DoD Directive 5105.46, "Civilian Health and Medical Program of the Uniformed Services," December 4, 1974, OCHAMPUS was established as an Office, Secretary of Defense field activity under the policy guidance and direction of the Assistant Secretary of Defense (Health Affairs). The Director, OCHAMPUS, is directed to execute the following responsibilities and functions:

(a) Supervise and administer the programs and missions to: (1) Provide technical direction and guidance on organizational, administrative, and

operational matters.

(2) Conduct studies and research activities in the health care area to assist in formulating policy required to guide OCHAMPUS in carrying out its programs.

'See footnote 1 to § 199.4.

(3) Enter into agreements through the Department of Defense with respect to the Military Departments or other U.S. Government entities, as required, for the effective performance of CHAMPUS.

(4) Supervise and administer OCHAMPUS financial management activities to include:

(i) Formulating budget estimates and justifications to be submitted to the Deputy Assistant Secretary of Defense (Administration) for inclusion in the overall budget for the Office of the Secretary of Defense.

(ii) Assuring the establishment and maintenance of necessary accounting records and the submission of required financial reports to the Deputy Assistant Secretary of Defense (Administration).

(iii) Assuring the effective execution of approved budgets.

(5) Contract for claims processing services, studies and research, supplies, equipment, and services necessary to carry out the CHAMPUS programs.

(6) Monitor claims adjudication and processing contracts to ensure that CHAMPUS Contractors are fulfilling their obligations.

(7) Convey appropriate CHAMPUS information to providers of care, practitioners, professional societies, health industry organizations, fiscal agents, hospital contractors, and others who have need of such information.

(8) Collect, maintain, and analyze Program cost and utilization data appropriate for preparation of budgets, fiscal planning, and as otherwise needed to carry out CHAMPUS programs and missions.

(9) Arrange for the facilities, logistical and administrative support to be provided by the Military Departments.

(10) Execute such other functions as appropriate to administer the programs and missions assigned.

(b) Direct and control the office, activities and functions of OCHAMPUSEUR.

NOTE: The Director, OCHAMPUS may also establish similar offices for OCHAMPUSSO and OCHAMPUSPAC.

Defense (Health Affairs), such policies or regulations as required to effectively administer and manage the CHAMPUS Program.

(d) The Uniformed Services Health Benefits Committee. (1) The Uniformed Services Health Benefits Committee, established by DoD Directive 5105.46, advises the Assistant Secretary of Defense (Health Affairs) and considers questions of policy with respect to CHAMPUS, facilitates exchanges of information among the Assistant Secretary of Defense (Health Affairs), the Director, OCHAMPUS, and the Uniformed Services, and provides advice and recommends policy to the Assistant Secretary of Defense (Health Affairs) on CHAMPUS operations.

(2) The Uniformed Services Health Benefits Committee consists of:

(i) A chairman, who is also the Deputy Assistant Secretary of Defense (Health Resources and Programs);

(ii) One representative from each of the Uniformed Services; and

(iii) The Director, OCHAMPUS, who serves as the Executive Secretary of the Committee.

(e) Issuance of identification cards: Uniformed Services. Each of the Uniformed Services is responsible for the issuance of identification cards to dependents of members of the Uniformed Services on active duty, to retired members of the Uniformed Services and their dependents, and dependents of deceased active duty and deceased retired members of the Uniformed Services as appropriate. (Refer to Chapter III of this regulation, "Eligibility".)

D. Medical Benefits Program. The CHAMPUS is a program of medical benefits provided by the Federal Government under public law to specified categories of individuals who are qualified for these benefits by virtue of their relationship to one of the seven Uniformed Services. Although similar in structure in many of its aspects, CHAMPUS is not an insurance program in that it does not involve a contract guaranteeing the indemnification of an insured party against a specified loss in return for a premium paid. Further, CHAMPUS is not subject to those state regulatory bodies or agencies which control the insurance business generally.

(e-1) Program funds. The funds used by the CHAMPUS Program are appropriated funds furnished by the Congress through the annual Appropriations Act for the Department of Defense and the Department of Health, Education, and Welfare. These funds are further disbursed by agents of the Government under contracts negotiated by the Director, OCHAMPUS (or a designee), under the provisions of the Armed Services Procurement Regulation (ASPR). These agents (referred to in this Regulation as "CHAMPUS Contractors") receive claims against the Program and adjudicate the claims under the provisions of this Regulation and in accordance with administrative procedures and instructions set forth in their contracts. The funds expended for CHAMPUS benefits are Federal funds provided CHAMPUS Contractors solely to pay CHAMPUS claims and are not a part of or obtained from the CHAMPUS Contractor's funds related to other programs or insurance coverage. CHAMPUS Contractors are reimbursed for the adjudication and payment of CHAMPUS claims at a fixed rate set forth in their contracts.

NOTE: Where a CHAMPUS contract has not yet been competitively procured, or where award was made on an emergency basis, administrative expenses are or may be on a cost-reimbursement rather than fixedprice basis. In such instances, reimbursement is limited to those administrative expenses incurred and directly related to the administration of the CHAMPUS Program.

(f) Claims adjudication and processing. The Director, OCHAMPUS is responsible for making such arrangements as are necessary to adjudicate and process CHAMPUS claims worldwide.

(1) The United States-(i) Contracting out. The primary method of processing CHAMPUS claims in the United States is through competitively procured, fixed-price contracts. The Director, OCHAMPUS (or a designee) is responsible for the issuance of appropriate Requests for Proposals (REP's) and the evaluation and award of such contracts for the purpose of adjudicating and processing CHAMPUS claims (and related supporting activities). Such contracts may be negotiated for

Defense (Health Affairs). The Secretary of Defense, by DoD Directive 5136.1, "Assistant Secretary of Defense (Health and Environment)," (under revision) delegated authority to the Assitant Secretary of Defense (Health Affairs) to provide policy guidance, management control and coordination (including coordination with the Department of Health, Education, and Welfare) as required for CHAMPUS and to develop, issue and maintain Regulations with the coordination of the Military Departments as necessary and appropriate. Additional implementing authority is contained in DoD Directive 5105.46,1 "Civilian Health and Medical Program of the Uniformed Services," December 4, 1974.