Patient Administration - Army Publishing Directorate - U.S. Army

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offered in the medical treatment facilities. Patients will not be assigned duties outside the limits of their physical profile (see AR 40-501). Chapter 9 Administration of Patients in Non-Army MTFs 9–1. Care in Navy and Air Force MTFs Army military personnel may be provided medical care subject to access as determined by the Navy and Air Force MTF commander. Patients are eligible for care as defined in chapter 2 subject to the rules of the Navy or Air Force MTF commander. 9–2. General policies applying to care in Navy and Air Force MTFs Army military personnel hospitalized in Navy and Air Force facilities are not also admitted to Army MTFs. Personnel accountability is managed as specified in paragraph 8-3b. Collection of subsistence charges from Army officer patients, hospitalization charges from Army Family members, and charges for other categories of patients is made locally by the Navy or Air Force MTF. 9–3. Army administrative units at Navy and Air Force MTFs When the Service concerned concurs, an MTF commander may establish, from available resources, Army administrative units in Navy and Air Force MTFs. Army administrative units coordinate directly with Navy and Air Force MTF staff. An Army administrative unit stationed at a Navy or Air Force MTF is assigned to the Army MTF having geographical area responsibility for Army patients located at the Navy or Air Force MTF. a. Command authority. (1) Army administrative staff comply with station orders or regulations of the Navy or Air Force MTF. (2) The Army administrative unit performs WTU functions. (See chap 8.) (3) Army personnel at a Navy or Air Force MTF will be subject to the military authority of the Navy or Air Force commander, but may be assigned or attached to the Army administrative unit for administration. Military control of such personnel normally will be exercised by the Navy or Air Force commander through the commander of the Army administrative unit. b. Supervision and support. Army MTF commanders supervise and provide required logistical and administrative support to Army administrative units. c. Navy or Air Force MEBs. Such MEBs are used in lieu of an Army MEB. (See paras 7-14 through 7-16.) d. Military discipline. (1) The commander of an Army administrative unit may have authority under the UCMJ, Article 15 to impose nonjudicial punishment upon those Army members assigned or attached subject to the provisions of the UCMJ, Article 32. (2) With the consent of the Navy or Air Force commander, Army prisoner patients may be transferred into and out of Navy or Air Force MTFs under either Army guard or the guard of the Service concerned. Local Navy or Air Force confinement facilities may be used with permission of the Navy or Air Force commander for temporary confinement of Army personnel. e. Autopsies and professional inspections. (1) Navy or Air Force medical officers may make professional inspection of deceased Army personnel as required. (2) The Navy or Air Force commander may direct that autopsies be performed on the remains of Army military personnel when such procedures are necessary to find the true cause of death and to acquire information to complete military records. Such autopsies, including microscopic examination of tissues, may be performed by Navy or Air Force medical officers per TM 8-300/NAVMED P-5065/AFM 160-19. Copies of autopsy protocols will be filed with the permanent records of the Army administrative unit. f. Funds. The Navy or Air Force MTF procedures to safeguard patient funds and valuables will be used. 9–4. Care in Federal MTFs other than those of the Uniformed Services Personnel listed in this paragraph may be provided medical care subject to access as determined by directors of Federal facilities. Patients are subject to the same limitations identified in chapter 2 and any additional rules of the Federal facility concerned. a. Members of the Army, RC, and applicants identified in paragraphs 3-1 through 3-8. b. Retired Army members. Retired Army members (see paras 3-9 and 3-10) placed on the TDRL may be furnished required medical examinations at VA treatment facilities upon DA request. Inpatient and outpatient medical and dental care for nonservice-connected disabilities may be provided in VA treatment facilities on a space-available basis as Army beneficiaries. 66 AR 40–400 27 January 2010
c. Civilians interned by the Army. Such individuals will be provided hospitalization in Armed Forces MTFs only in the absence of adequate civilian facilities. (See para 3-38.) d. Other categories of beneficiaries. Other categories of beneficiaries may be treated in other Federal facilities. However, the patient administrator will coordinate with the receiving facility prior to referral to ensure care is authorized according to that Federal facility’s rules of care and that reimbursement methodologies are acceptable to the Army MTF commander. 9–5. Authorization DA Form 4159 (Request for Medical Care in a Federal Medical Treatment Facility Outside Department of Defense) is used to authorize care in Federal MTFs for Army beneficiaries. A commander may authorize care for a Soldier under his or her command when required in a Federal MTF. DA Form 4159 is prepared in triplicate and is addressed to the officer in charge of the Federal MTF in which care is desired. The patient presents the original and one copy of the form to the MTF when applying for treatment. In an emergency, care may be furnished without such a request; however, DA Form 4159 should be forwarded after the event. DA Form 4159 is not required for active and retired Army members. Identification will be made by DD Form 2 (ACT) (Armed Forces of the United States—Geneva Conventions Identification Card (Active)) or DD Form 2 (RET) (United States Uniformed Service Identification Care (Retired)). DA Form 4159 is available on the APD Web site (www.apd.army.mil). 9–6. Use of Federal medical treatment facilities for supplementation When it is necessary to use the services of other Federal MTFs to supplement Army MTFs or MEPS, commanders may obtain such services upon their written request direct to the officer in charge of the Federal MTF concerned. Vouchers for these services will be sent to the facility requesting the services and paid from local operating funds. 9–7. Reimbursement to other Federal facilities Vouchers for care furnished by Federal MTFs will be prepared by the agencies concerned. They will be sent (supported by copies of DA Form 4159, when appropriate) to Commander, USAMEDCOM, ATTN: MCRM-F, 2050 Worth Road, Fort Sam Houston, TX 78234-6000 for settlement with the following exceptions. a. Vouchers for services incurred by applicants identified in paragraphs 3-4 through 3-8 will be settled by the MEPS requesting services. Emergency medical care for acute illnesses and injuries identified in paragraph 3-8 are forwarded to Commander, USAMEDCOM, ATTN: MCRM-F, 2050 Worth Road, Fort Sam Houston, TX 78234-6000. b. Vouchers for quadrennial medical examinations of USAR personnel will be forwarded to the appropriate MCS contractor. c. Vouchers for medical examinations performed for members and prospective members of the RC will be paid by the State concerned. d. Vouchers for services obtained for DA Federal civilian employees addressed in paragraph 3-14 will be settled locally by the organization arranging for the occupational health services. 9–8. Special consideration of Uniformed Services Family Health Plan beneficiaries Uniformed Services beneficiaries enrolled in the Uniformed Services Family Health Plan (USFHP) (see fig 9-1) managed care plan are not eligible beneficiaries at Army MTFs except for emergencies or until disenrolled. AD Army personnel are not eligible for the USFHP. 9–9. Administration of patients treated at Federal MTFs other than the Uniformed Services and civilian facilities Army MTF commanders are responsible for coordinating the care of AD Army patients treated at Federal MTFs other than the Uniformed Services and at civilian facilities. Major Army medical commanders are assigned GARs. The listing of GARs can be found at the Army Medicine Web site (www.armymedicine.army.mil). When AD Army general officers are admitted to or released from Navy, Air Force, or other Federal or civilian MTFs, the MTF assigned administrative responsibility will follow procedures specified in paragraph 6-3. When an AD Army member is admitted to a non-Army MTF or placed in quarters by a nonmilitary physician, the appropriate Army MTF commander will— a. Provide necessary professional medical evaluation and assistance. If the patient is receiving care from a civilian agency, a physician at the responsible Army MTF will promptly contact the attending civilian physician to determine the patient’s condition and the feasibility of evacuation to an MTF. b. Notify the patient’s parent unit except when notification has already been accomplished. c. Provide strength accounting, pay and allowances, and other personnel functions for patients assigned to an WTU and needed personnel functions except pay and allowances for patients attached to an WTU. (See chap 8.) These functions will be accomplished even though the patient is not physically located within the Army MTF having administrative responsibility. Army members hospitalized in Navy or Air Force MTFs are accounted for and substantiated by Navy or Air Force AAD reports or other similar documents. AR 40–400 27 January 2010 67
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Army Regulation 40-400 Medical Serv
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Headquarters Department of the Army
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Contents—Continued Department of
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Contents—Continued Autopsy author
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Contents—Continued Chapter 13 Inj
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Chapter 1 Introduction 1-1. Purpose
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nonemergent specialty care. The Pri
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(1) If not prohibited under the law
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Table 2-3 Supplemental care payment
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a. Treatment during and after duty.
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the camp commander or the MTF comma
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e provided an employee paid from ap
Page 25 and 26: (2) The Health Insurance Portabilit
Page 27 and 28: (n) Section 13. Signature of the MT
Page 29 and 30: discharged or transferred. When an
Page 31 and 32: encompasses the geographic area whe
Page 33 and 34: (3) Peace Corps applicants. (a) Exc
Page 35 and 36: the emergency. The patient or respo
Page 37 and 38: physicians, dentists, nurses (pract
Page 39 and 40: . Each Uniformed Service secretary
Page 41 and 42: 3-61. Treatment of former military
Page 43 and 44: Figure 3-2. Sample format memorandu
Page 45 and 46: 4-3. Comfort items for patients a.
Page 47 and 48: Kingdom, and the United States The
Page 49 and 50: f. The MTF commander who starts act
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Page 53 and 54: (3) Patients who are being or have
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Page 57 and 58: authorities, to the sponsor or NOK.
Page 59 and 60: (2) Enabling care (EC). AD patients
Page 61 and 62: patients in absent sick status, cha
Page 63 and 64: date the packet is mailed to the PE
Page 65 and 66: (4) A complete, current report of m
Page 67 and 68: Table 7-1 Distribution of medical b
Page 69 and 70: d. Instructions for the preparation
Page 71 and 72: . After approval by the Service rev
Page 73 and 74: . Soldiers who are in initial entry
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Page 79 and 80: a. Members of the Army, RC, and app
Page 81 and 82: medical documents by submitting DD
Page 83 and 84: 11-10. Audit and review The MSA is
Page 85 and 86: lost. The MSA must have the interna
Page 87 and 88: Figure 11-2. Sample memorandum form
Page 89 and 90: Chapter 12 Patients’ Trust Fund 1
Page 91 and 92: (2) Deposits and requests for check
Page 93 and 94: whom administrative responsibility
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Page 97 and 98: (4) Establish a process whereby all
Page 99 and 100: (1) Receive and open mail including
Page 101 and 102: d. Patient administrators of deploy
Page 103 and 104: AR 215-1 (not cited) Military Moral
Page 105 and 106: AR 36-2 Audit Services in the Depar
Page 107 and 108: VASRD Veteran’s Administration Sc
Page 109 and 110: DA Form 5009 Medical Record-Release
Page 111 and 112: Appendix B Persons authorized care
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(3) Is there a procedure in place t
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Glossary Section I Abbreviations AA
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EIN employee identification number
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MPRJ military personnel records jac
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REP 63 Reserve Enlistment Program o
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VA Veterans Affairs VARO Veterans A
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Disability separation Temporary or
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Maximum hospital benefit That point
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standard CHAMPUS cost shares apply.
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Convalescent leave, 5-1 Cosmetic su
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Civilian participants in Army-spons
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For assignment to WTU, 8-3 Outside
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Special consideration of USFHP bene
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Social Security, table 2-1, 3-21, 3
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Patient Administration - Army Publishing Directorate - U.S. Army

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