Patient Administration - Army Publishing Directorate - U.S. Army
Patient Administration - Army Publishing Directorate - U.S. Army Patient Administration - Army Publishing Directorate - U.S. Army
(14) Column (n). Enter any pertinent remarks to this column. b. The joint statement in figure 11-3 will be prepared in quadruplicate and all copies signed by the retiring custodian. c. Records, keys, cash, valuables, etc., will be turned over to the succeeding custodian who will sign all copies of the above statement after satisfaction that no discrepancy exists. d. When actual transfer of the PTF has been accomplished, the original of the above statement, accompanied by a signature card bearing the signature of the new custodian, will be forwarded to the hospital commander. The MTF commander will give written notice of the change to the local bank and will enclose the signature card of the new custodian. The three remaining copies of the above custodian’s statement will be distributed to the outgoing custodian, the new custodian, and the files of the PTF. e. Where a safe has been provided for use by the custodian, the combination will be changed as prescribed in AR 37-103. Use of the MSA safe should be avoided when possible. PTF activities should be separated from ongoing MSA collections, disbursing, and billing operations. 12–5. Operating principles a. Items other than funds and valuables will not be accepted for deposit in the PTF. b. Firearms or other weapons or objects which could be considered a menace to safety or health, other than Government property, will be receipted for and turned over to the WTU commander or other responsible activity for safekeeping and disposition. c. The PTF will not be used for the safeguarding of funds and valuables belonging to individuals not in a patient status. d. No investments or loans may be made with the funds on deposit. e. No donations or contributions may be made or received by the PTF. f. Money deposited in the PTF will not be used for purposes of cashing checks. Checks will not be accepted for deposit as cash. g. Disbursements will be made by check whenever practicable. Disbursements will be made only to a patient who is a depositor (whether or not he or she is physically able to sign the necessary forms) except as follows: (1) A disbursement may be made to an intermediate individual upon written authorization of the patient depositor. (2) A check may be drawn payable to the individual assuming custody of a mentally incompetent patient upon discharge. (3) A check may be drawn payable to the custodian of a PTF for a cash on hand reimbursement. (4) A check may be drawn payable to the Treasurer of the United States for the transfer of unclaimed monies or overages. h. In MTFs where various elements are located separately or at considerable distance from one another, the commander may authorize the operation of a separate subfund. This subfund will operate as prescribed in this chapter, with the custodian of the PTF retaining responsibility for its operation. The custodian will authorize the transfer of the applicable deposit records and establish a change fund. Daily or weekly, as appropriate, a summary of all receipts and disbursements and cash on hand will be prepared in duplicate, and the original submitted together with a deposit or request for reimbursement of change fund, as applicable, to the (main) PTF. Totals from the summary of the subfund transactions will be posted separately to the DA Form 4128. i. The custody and accountability for the funds and property of hospitalized prisoners is the responsibility of the commander of the installation confinement facility. The custodian of the PTF will not be designated the custodian of the prisoners’ personal deposit fund; however, the PTF may be used for the safekeeping of those belongings of hospitalized prisoners which prisoners are permitted to retain. Other items must be placed in the prisoners’s personal deposit fund. 12–6. Safeguarding of funds and valuables The custodian will maintain positive internal control processes over all funds and valuables to ensure accountability to a designated individual at all times. a. Deposits. All funds deposited in a Federal depository will be placed in a suspense account. Under exceptional circumstances, an account may be established in a commercial bank. This exception is generally applicable for activities operating OCONUS. Permission to establish such an account must be obtained from DFAS-Indianapolis Center, 8899 East 56th Street, Indianapolis, IN 46249. (1) When a patient arrives with cash in any amount, the PTF custodian will offer to secure the cash in excess of $20.00 and other valuables for the patient. Cash will be deposited with the supporting DAO, Federal depository, or held at risk in the hospital safe. At the time of the deposit to the DAO or Federal depository, the PTF custodian will request that a check equal to the cash deposited be drafted on the Treasury of the United States payable to the patient. Copies of the collection, deposit, and disbursing document will be kept separately by the MSA, custodian, and a copy provided to the patient. The check will be logged in and maintained by the PTF custodian. A nominal amount of cash may be kept by the patient or in trust by the custodian at the patient’s request. 80 AR 40–400 27 January 2010
(2) Deposits and requests for checks will be made through the MSA. A separate deposit slip and collection voucher will be used for each patient. (3) The chief of PAD will ensure the security of the PTF by periodically reviewing internal controls and SOPs. On a random monthly basis, the chief of PAD will assign a disinterested third party to audit the PTF. b. Valuables. Valuables will be placed in a safe or other container or room which provides the same degree of protection. c. Loss of funds or valuables. When a shortage in the funds or a loss of property is discovered, the matter will be investigated and disposed of according to AR 15-6. When losses of funds are not recoverable and it has been determined that there was no fraud, dishonesty, or willful misconduct and no one is held pecuniarily liable, the fund should be liquidated and a claim initiated against the Government according to AR 27-20. 12–7. Forms DA Form 3696, DA Form 3983 (Patients’ Trust Fund Authorization for Deposit or Withdrawal of Funds and Valuables), DA Form 4128, and DA Form 4665 (Patients’ Trust Fund—Daily Summary Record) will be used to record deposit and withdrawal of funds and valuables and central PTF accountability. DA Form 3983 and DA Form 4665 are available on the APD Web site (www.apd.army.mil). 12–8. Procedures upon admission When admitted to the hospital, the patient will be informed that the hospital assumes no liability or responsibility for the loss of funds or valuables not placed in deposit. If the patient desires not to make a deposit, DA Form 3696 will be prepared and the statement block indicating that no deposit is desired will be signed by the patient or witnessed, if the patient is unable to sign, the form will be forwarded to the custodian. This procedure need not be utilized by those facilities that have established other means of recording the patients’ desire to not use the PTF. 12–9. Audit The PTF will be audited annually and at any other time deemed appropriate by the MTF commander. Chapter 13 Injury and Illness Cases-Medical Affirmative Claims 13–1. General a. Purpose. (1) The Federal Medical Care Recovery Act, 42 USC 2651-2653, established the U.S. Government’s independent right to recover the reasonable value of health care services provided at Government expense to an individual as a result of an injury or illness incurred under circumstances creating a tort liability upon some third person. (2) 10 USC 1095 provides authority for military health care facilities to collect the reasonable costs of health care from health insurance and Medicare supplemental policies. 10 USC 1095 also authorizes the United States to recover from automobile liability, medical payments, and personal injury protection or no-fault insurance. This chapter establishes procedures in support of medical affirmative claims. b. Applicability. The provisions of this chapter do not apply to battle casualties or to claims between Federal agencies. c. Recovery judge advocate (RJA). The term “RJA” as used in this chapter means the legal advisor in the Office of the SJA assigned responsibility for asserting a medical affirmative claim. The RJA normally will work in the designated judge advocate office that furnishes legal services to the Army hospital that provided the initial treatment or hospitalization of an injured person entitled to medical care at Army expense. This is generally the judge advocate or legal advisor of the command or installation supporting the Army MTF. Geographic areas assigned to an RJA generally coincide with the geographic areas assigned to MEDDAC/MEDCEN commanders. The designated RJA is responsible for asserting, pursuing, and settling claims arising from an injury or illness as a result of a recoverable accident or incident. In cases where more than one treatment facility provides medical care to a beneficiary, the responsibility for recovery may be transferred to another claims office, depending on which office has the most significant interest in a particular claim (AR 27-20 and DA Pam 27-162). d. Medical affirmative claim. A medical affirmative claim is a claim-other than a health insurance claim-asserted in favor of the United States, for the reasonable value of health care services furnished at Government expense. These claims include, but are not limited to, claims asserted against automobile and motorcycle insurance, including personal injury protection and medical payment coverage, or uninsured/underinsured provisions; homeowner’s or renter’s policies; products, premises, or general liability policies; and worker’s compensation (on-the-job injury) funds. These claims were previously referred to as third party liability (TPL) claims and are commonly referred to as Federal Medical Care Recovery Act claims. e. Health care services. The term “health care services” includes all medical care furnished by or at the expense of AR 40–400 27 January 2010 81
- Page 39 and 40: . Each Uniformed Service secretary
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- 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
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(14) Column (n). Enter any pertinent remarks to this column.<br />
b. The joint statement in figure 11-3 will be prepared in quadruplicate and all copies signed by the retiring<br />
custodian.<br />
c. Records, keys, cash, valuables, etc., will be turned over to the succeeding custodian who will sign all copies of<br />
the above statement after satisfaction that no discrepancy exists.<br />
d. When actual transfer of the PTF has been accomplished, the original of the above statement, accompanied by a<br />
signature card bearing the signature of the new custodian, will be forwarded to the hospital commander. The MTF<br />
commander will give written notice of the change to the local bank and will enclose the signature card of the new<br />
custodian. The three remaining copies of the above custodian’s statement will be distributed to the outgoing custodian,<br />
the new custodian, and the files of the PTF.<br />
e. Where a safe has been provided for use by the custodian, the combination will be changed as prescribed in AR<br />
37-103. Use of the MSA safe should be avoided when possible. PTF activities should be separated from ongoing MSA<br />
collections, disbursing, and billing operations.<br />
12–5. Operating principles<br />
a. Items other than funds and valuables will not be accepted for deposit in the PTF.<br />
b. Firearms or other weapons or objects which could be considered a menace to safety or health, other than<br />
Government property, will be receipted for and turned over to the WTU commander or other responsible activity for<br />
safekeeping and disposition.<br />
c. The PTF will not be used for the safeguarding of funds and valuables belonging to individuals not in a patient<br />
status.<br />
d. No investments or loans may be made with the funds on deposit.<br />
e. No donations or contributions may be made or received by the PTF.<br />
f. Money deposited in the PTF will not be used for purposes of cashing checks. Checks will not be accepted for<br />
deposit as cash.<br />
g. Disbursements will be made by check whenever practicable. Disbursements will be made only to a patient who is<br />
a depositor (whether or not he or she is physically able to sign the necessary forms) except as follows:<br />
(1) A disbursement may be made to an intermediate individual upon written authorization of the patient depositor.<br />
(2) A check may be drawn payable to the individual assuming custody of a mentally incompetent patient upon<br />
discharge.<br />
(3) A check may be drawn payable to the custodian of a PTF for a cash on hand reimbursement.<br />
(4) A check may be drawn payable to the Treasurer of the United States for the transfer of unclaimed monies or<br />
overages.<br />
h. In MTFs where various elements are located separately or at considerable distance from one another, the<br />
commander may authorize the operation of a separate subfund. This subfund will operate as prescribed in this chapter,<br />
with the custodian of the PTF retaining responsibility for its operation. The custodian will authorize the transfer of the<br />
applicable deposit records and establish a change fund. Daily or weekly, as appropriate, a summary of all receipts and<br />
disbursements and cash on hand will be prepared in duplicate, and the original submitted together with a deposit or<br />
request for reimbursement of change fund, as applicable, to the (main) PTF. Totals from the summary of the subfund<br />
transactions will be posted separately to the DA Form 4128.<br />
i. The custody and accountability for the funds and property of hospitalized prisoners is the responsibility of the<br />
commander of the installation confinement facility. The custodian of the PTF will not be designated the custodian of<br />
the prisoners’ personal deposit fund; however, the PTF may be used for the safekeeping of those belongings of<br />
hospitalized prisoners which prisoners are permitted to retain. Other items must be placed in the prisoners’s personal<br />
deposit fund.<br />
12–6. Safeguarding of funds and valuables<br />
The custodian will maintain positive internal control processes over all funds and valuables to ensure accountability to<br />
a designated individual at all times.<br />
a. Deposits. All funds deposited in a Federal depository will be placed in a suspense account. Under exceptional<br />
circumstances, an account may be established in a commercial bank. This exception is generally applicable for<br />
activities operating OCONUS. Permission to establish such an account must be obtained from DFAS-Indianapolis<br />
Center, 8899 East 56th Street, Indianapolis, IN 46249.<br />
(1) When a patient arrives with cash in any amount, the PTF custodian will offer to secure the cash in excess of<br />
$20.00 and other valuables for the patient. Cash will be deposited with the supporting DAO, Federal depository, or<br />
held at risk in the hospital safe. At the time of the deposit to the DAO or Federal depository, the PTF custodian will<br />
request that a check equal to the cash deposited be drafted on the Treasury of the United States payable to the patient.<br />
Copies of the collection, deposit, and disbursing document will be kept separately by the MSA, custodian, and a copy<br />
provided to the patient. The check will be logged in and maintained by the PTF custodian. A nominal amount of cash<br />
may be kept by the patient or in trust by the custodian at the patient’s request.<br />
80 AR 40–400 27 January 2010