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Others authorized the e * Dependents authoro Active duty and re- same benefits as active | . Other beneAdjuncts *::::::::: ãome." | *ed the ame bene | j bers(8)
Wheel chairs(?) ........................... Yes ............................ Yes .................................. Yes ............................ Yes
* When considered medically appropriate by the attending physician.
.*Outside the United States and at designated remote stations when considered medically appropriate by the attending physi
Clas!. * Contact or goes are not to be issued solely for cosmetic reasons. Further guidelines are contained in
*In addition to the hearing aid, include in initial issue one spare receiver cord, *:::::..o. o supply of batteries,
and a statement indicating make, model, “A” and “B” batteries, as app
of receiver, serial number, code, part numbers, ropriate. Provide replacement of o aids upon the same basis as initial issue and, except in unoa circumstances, will not be replaced within 2 years of the initi
ttery voltage, and type of
furnishing of the last replacement of the appliance.
ectacles, contact lenses, or intraocular lenses .# be provided dependents with eye conditions which require these items
for § medical or surgical management of a c NAVMEDCOMINST 6810.1.
ition other than ordinary refractive error. For further information, consult
7 May be loaned on a custody basis at the discretion of the attending physician.
*See subpart of this part relating to specific beneficiary.
9When considered by the attending s: and dentist to be an adjunct to a medical or surgical condition other than dental ng
and when in consonance with existi 10For further guidelines, consult BUMEDINST 6320.41B.
islation and directives.
Subport l—Reservists–Continued Trediment, Return to Limited Duty, Sepdrotion, or Retirement for Physical Disobility
§ 728.101 General.
(a) Notice of eligibility (NOE). While the NOE is basically a document that substantiates entitlement to a disability benefit equal to pay and allowances, it may be accepted when required to substantiate eligibility for benefits other than pay and allowances, i.e., treatment in USMTFS under the provisions of title 10, United States Code.
(b) Physical disability benefits. The following, excerpted and paraphrased from SECNAVINST 1770.3, paragraph 10, is applicable when a reservist may be entitled to physical disability benefits.
(1) When a notice of eligibility (NOE) has been issued to a member hospitalized in a naval MTF and the attending physician is of the opinion that recovery is not anticipated or that the reservist is not expected to be fit for return to full duty within a reasonable period, a medical board will be convened and the case managed the same as that of a Regular member. Assure that a copy of the NOE accompanies the medical board report forwarded to the Central Physical Evaluation Board. Disability benefits, equal to pay and allowances, will continue in Such instances until final disposition.
(2) There is no limited duty status, per se, for inactive reservists. However, if the attending physician determines that a reservist is temporarily unfit for full duty, but will be fit for full duty following a period of convalescence or following duty with physical limitations, not to exceed 6 months, the phySician may return the reservist to duty With a summary of the hospitalization or treatment. The summary will set forth the limitations posed by the member’s disability and the period of Such limitations. Followup hospitalization, treatment, and evaluation for the Same condition may be provided at USMTFS during the period of restricted duty, if required. If, during the period of the restricted duty, it appears that the reservist will be permanently unfit for full duty, promptly authorize the reservist to report for evaluation, treatment if required, and appearance before a medical board at the nearest naval MTF Capable of accomplishing same. Admission to the sicklist is authorized, when required. Should the medical board recommend appearance before a physical evaluation board, disability benefits equal to pay and allowances should continue until final disposition is effected.
§ 728.102 Care from other than Federal SOURCES,
The provisions of this subpart do not authorize care for reservists at other than Federal facilities nor Out of funds available for operation of USMTFs (supplemental care) after a period of active duty or a period of training duty ends, including travel to and from such training. Such care may be rendered under the provisions of part 732 of this chapter.
Subport J–Initioting Collection Action on Poy Potients
§ 728.111 General.
The Comptroller of the Navy has approved a system of transactions that generates reports to COMNAV MEDCOM on unfunded reimbursable transactions. The purpose of the final report is to provide data on Services furnished by naval health Care facilities for which central Collection from other Government agencies and private parties is required.
(a) Patient administration departments. The initiation of the Collection process begins with patient administration departments. Collection action cannot be accomplished unless patient administration departments take the initial step to complete: (1) DD 7, Report of Treatment Furmished Pay Patients, Hospitalization Furmished (part A). Prepare a Separate Substantiating DD 7, in triplicate, for each Category Of pay patient receiving inpatient care. At the end of each day that any pay patient is admitted, Submit DD 7’s to the Collection agent. (2) DD 7A, Report of Treatment Furnished Pay Patients, Outpatient Treatment Furmished (part B). Prepare a separate Substantiating DD 7A, in triplicate, for each category of pay patient receiving outpatient care. At the end of each day that any pay patient is treated on an outpatient basis, Submit DD 7A’s to the Collection agent. (b) Collection agents. Upon receipt of a completed DD 7 or DD 7A, collection agents will take the action indicated in paragraph 24304 of the Resource Management Handbook, NAVMED P-5020, to effect central collection action.
$728.113 Categories of pay patients.
The categories of patients for whom collection action must be initiated are:
(a) Coast Guard. (1) Active Officers; (2) Retired Officers; (3) Active Enlisted; (4) Retired Enlisted; (5) Dependents; (6) Cadets.
(b) Public Health Service. (1) Active Officers; (2) Retired Officers; (3) Dependents of Officers.
(c) National Oceanic and Atmospheric Administration (NOAA). (1) Active Officers; (2) Retired Officers; (3) Dependents of Officers.
(d) Foreign. (1) NATO Officers (Except Canadians provided care under the comparable care agreement.); (2) NATO Enlisted (Except Canadians provided Care under the comparable care agreement.); (3) NATO Dependents; (4) Civilians Accompanying NATO Members; (5) Foreign Military Sales (FMS) Officers; (6) FMS Enlisted; (7) FMS Dependents; (8) FMS Civilians; (9) Military Grant Aid Officers; (10) Military Grant Aid Enlisted; (11) Military Grant Aid Dependents; (12) Military Grant Aid Civilians; (13) Military Officers From Other Than NATO Nations; (14) Military Enlisted From Other Than NATO Nations; (15) Dependents of Officers and Enlisted From Other Than NATO Nations; (16) Civilians Accompanying Military Members of Other Than NATO Nations; (17) Nationals and Their Dependents.
(e) Secretarial designees not eacempted from paying.
(f) Others. (1) Merchant Marines; (2) Military Sealift Command (MSC) PerSonnel; (3) Public Health Service beneficiaries (Other than Commissioned Corps); (4) Veterans Administration beneficiaries; (5) Peace Corps beneficiaries; (6) Job Corps beneficiaries; (7) Volunteers In Service to America, (VISTA) beneficiaries; (8) Office of Workers Compensation Program (OWCP) beneficiaries; (9) Bureau of Employees Compensation (BEC) beneficiaries; (10) Department of State and Other Federal Agencies beneficiaries (prepare a separate form for each Federal agency); (11) Civilian Humanitarian Nonindigents (CHNI); (12) Trust Territory beneficiaries; (13) Others not Specified above who are not entitled to health benefits at the expense of the Government.
When a U.S. Navy or Marine Corps member or a Canadian Navy Or Marine Corps member receives authorized care from other than a Navy treatment facility, care is under the cognizance of the uniformed Service medical treatment facility (USMTF) providing care, the USMTF referring the member to another treatment Source, or under the provisions of this part. If Such a member is not receiving care at or under the auspices of a Federal source, responsibility for health and welfare, and the adjudication of claims in Connection with their care, remains within the Navy Medical Department. Part 728 of this chapter and NAVMEDCOMINST
6320.18 contain guidelines concerning Care for Other eligible beneficiaries, not authorized care by this part.
Ensure that personnel under your Cognizance are made aware of the Contents of this part. Failure to comply with contents may result in delayed adjudication and payment or may reSult in denial of Navy financial responSibility for expenses of maternity, medical, or dental care obtained.
Subport B-Medical dnd Dentol Core From Nonnoivol Sources
Unless otherwise qualified in this part the following terms when used throughout are defined as follows: (a) Active duty. Full-time duty in the active military service of the United States. Includes full-time training duty; annual training duty; and attendance, while in the active military Service, at a School designated as a Service school by law or by the Secretary of the military department concerned. (b) Active duty for training. A specified tour of active duty for Reserves for training under orders that provides for automatic reversion to non-active duty status when the specified period of a Ctive duty is completed. It includes annual training, Special tours, and the initial tour performed by enlistees without prior military service. The period of duty includes travel to and from training duty, not in excess of the allowable constructive travel time prescribed by SECNAVINST 1770.3 and paragraphs 10242 and 10243 of DOD Military Pay and Allowances Entitlements Manual. (c) Constructive return. For purposes of medical and dental Care, an unathorized absentee’s return to military control may be accomplished through notification of appropriate military authorities as outlined below. (1) For members in an unauthorized absentee (UA) status, constructive return to military control for the purpose of providing medical or dental care at Navy expense is effected when one of the following has occurred: (i) A naval activity informs a civilian provider of medical or dental care that the Navy accepts responsibility for a naval member’s care. The naval activity providing this information must also provide documentation of such notification to the appropriate adjudication authority in §732.20. (ii) A member has been apprehended by civil authorities at the specific request of naval authorities and naval authorities have been notified that the member can be released to military Custody. (iii) A naval member has been arrested, while in a UA status, by civil authorities for a civil offense and a naval authority has been notified that the member can be released to military control. (2) When a naval member has been arrested by civil authorities for a civil Offense while in a UA status and the Offense does not allow release to military control, constructive return is not accomplished. The individual is responsible for medical and dental care received prior to arrest and the incarcerating jurisdiction is responsible for care required after arrest. (d) Designated Uniformed Services Treatment Facilities (Designated USTFs). Under Pub. L. 97–99, the following facilities are “designated USTFs” for the purpose of rendering medical and dental care to all categories of individuals entitled to Care under this part. (1) Sisters of Charity of the Incarnate Word Health Care System, 6400 Lawndale, Houston, TX 77.058 (713) 928– 2931 operates the following facilities: (i) St. John Hospital, 2050 Space Park Drive, Nassau Bay, TX 77058, telephone (713) 333–5503. Inpatient and outpatient Services. (ii) St. Mary’s Hospital Outpatient Clinic, 404 St Mary’s Boulevard, Galveston, TX 77550, telephone (409) 763– 5301. Outpatient services only. (iii) St. Joseph Hospital Ambulatory Care Center, 1919 La Branch, Houston, TX 77002, telephone (713) 757–1000. Outpatient Services only. (iv) St Mary’s Hospital Ambulatory Care Center, 3600 Gates Boulevard, Port Arthur, TX 77640 (409) 985–7431. Outpatient Services only. (2) Impatient and outpatient Services. (i) Wyman Park Health System, Inc., 3100 Wyman Park Drive, Baltimore, MD 21211, telephone (301) 338–3693.
(ii) Alston-Brighton Aid and Health Group, Inc., Brighton Marine Public Health Center, 77 Warren Street, Boston, MA 02135, telephone (617) 782–3400. (iii) Bayley Seton Hospital, Bay Street and Vanderbilt Avenue, Staten Island, NY 10304, telephone (718) 390– 5547 or 6007. (iv) Pacific Medical Center, 1200 12th Avenue South, Seattle, WA 98144, telephone (206) 326–4100. (3) Outpatient services only. (i) Coastal Health Service, 331 Veranda Street, Portland, ME 04103 (207) 774–5805. (ii) Lutheran Medical Center, Downtown Health Care Services, 1313 Superior Avenue, Cleveland, OH 44113, telephone (216) 363–2065. (e) Duty Status. The situation of the claimant when maternity, medical, or dental care is received. Members, including reservists, on leave or liberty are considered in a duty status. Reservists, performing active duty for training Or inactive duty training, are also Considered in a duty status during their allowable constructive travel time to and from training. (f) Emergency care. Medical treatment of Severe life threatening or potentially disabling conditions which result from accident or illness of Sudden onset and necessitates innediate intervention to prevent undue pain and suffering or loss of life, limb, or eyesight and dental treatment of painful or acute conditions. (g) Federal facilities. Navy, Army, Air Force, Coast Guard, Veterans Administration, and USTFS (former U.S. Public Health Service facilities listed in § 732.11(d). (h) Inactive duty training. Duty prescribed for Reserves by the Secretary of the Navy under Section 206 of Title 37, United States Code, or any other provision of law. Also includes special additional duties authorized for ReServes by an authority designated by the Secretary of the Navy and performed by Reserves on a voluntary basis in Connection with the prescribed training Or maintenance activities of units to which they are assigned. (i) Matermity emergency. A condition Commencing or exacerbating during pregnancy when delay caused by referral to a uniformed services medical treatment facility (USMTF) or designated USTF would jeopardize the welfare of the mother or unborn child. (j) Member. United States Navy and Marine Corps personnel, Department of National Defence of Canada. Navy and Marine Corps personnel, and Navy and Marine Corps personnel of other NATO Nations meeting the requirements for care under this part. (k) Non-federal care. Maternity, medical, or dental care furnished by Civilian sources (includes State, local, and foreign MTFs). (1) Nonnaval care. Maternity, medical, or dental care provided by Other than Navy MTFs. Includes care in other USMTFs, designated USTFs, VA facilities, as well as from civilian Sources. (m) Office of Medical Affairs (OMA) or Office of Dental Affairs (ODA). Designated offices, under program management control of COMNAVMEDCOM and direct control of regional medical commands, responsible for administrative requirements delineated in this part. Responsibilities and functional tasks of OMAs and ODAs are outlined in NAVMEDCOMINST 6010.3. (n) Prior approval. Permission granted for a specific episode of necessary but nonemergent maternity, medical, or dental care. (o) Reservist. A member of the Naval or Marine Corps Reserve. (p) Supplemental care—(1) Operation and maintenance funds, Navy. Supplemental care of all uniformed Services members, at Navy expense, encompasses only inpatient or Outpatient care augmenting the capability of a naval MTF treating a member. Such care is usually obtained from Civilian Sources through referral by the treating naval MTF. If a member, authorized care under this part, is admitted to or is being treated On an Outpatient basis at any USMTF, all supplemental Care is the financial responsibility of that facility regardless of whether the facility is organized or authorized to provide needed health Care. The cost of such care is chargeable to Operation and maintenance funds (OM&N) available for operation of the USMTF requesting the care regardless of Service affiliation of the member (See part, 728 of this chapter for such care under Navy Medical Department facilities).
(2) Nonnaval medical and dental care program funds. Adjudication authorities will pay claims, under this part, for care received as a result of a referral when: (i) A United States Navy or Marine Corps member or a Canadian Navy or Marine Corps member requires care beyond the capability of the referring USMTF and Care is obtained for Such a member not admitted to or not being treated on an Outpatient basis by a USMTF, and (ii) The referring USMTF is not organized nor authorized to provide the needed health Care. (3) Other uniformed Services Supplemental care programs. In addition to services that augment other USMTF's capabilities, supplemental care programs of the other uniformed Services include care and services comparable to those authorized by this part, e.g., emergency care and pre-approved nonemergency Care. (q) Umauthorized absence. Absence Or departure without authority from a member’s command or assigned place of duty. (r) Uniformed Services Medical Treatment Facilities (USMTF). Health care facilities of the Navy, Army, Air Force, Coast Guard, and the former U.S. Public Health Service facilities listed in paragraph (d) of this section designated as USTFs per DOD and Department of Health and Human Services directives.
(a) Regular members. To be eligible for non-Federal medical, dental, or emergency maternity care at Government expense, Regular active duty United States naval members and Canadian Navy and Marine Corps members must be in a duty status when Care is provided.
(b) Reservists. (1) Reservists on active duty for training and inactive duty training, including leave and liberty therefrom, are considered to be in a duty status while participating in training. Accordingly, they are entitled to care for illnesses and injuries occurring while in that Status.
(2) Reservists are entitled to care for injuries and illnesses occurring during