[Federal Register Volume 76, Number 43 (Friday, March 4, 2011)]
[Notices]
[Pages 12081-12082]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-4865]
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DEPARTMENT OF DEFENSE
Office of the Secretary
Notice of Two-Year Continuation of Disease Management
Demonstration Project for TRICARE Standard Beneficiaries
AGENCY: Department of Defense.
ACTION: Notice of Two-Year Continuation of Disease Management
Demonstration Project for TRICARE Standard Beneficiaries.
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SUMMARY: This notice is to advise interested parties of the
continuation of a Military Health System (MHS) demonstration project
entitled ``Disease Management Demonstration Project for TRICARE
Standard Beneficiaries''. The original demonstration notice was
published on June 13, 2007 (72 FR 32628-32629) and described a
demonstration project to provide disease management (DM) services to
TRICARE Standard beneficiaries in addition to the TRICARE Prime
beneficiaries who were already entitled to such services. TRICARE began
the demonstration project in March 2007 for Standard beneficiaries and
this demonstration project has enabled the MHS to provide uniform
policies and practices on disease and chronic care management
throughout the TRICARE network. Additionally, the demonstration has
helped determine the effectiveness of DM programs in improving the
health status of beneficiaries with targeted chronic diseases or
conditions, and any associated cost savings. The TRICARE Management
Activity (TMA) chose a phased approach to determine the efficacy and
cost effectiveness of its disease management demonstration, beginning
with beneficiaries identified with the disease states of asthma, heart
failure, and diabetes. TMA now intends to continue the disease
management services to TRICARE Standard beneficiaries until a permanent
TRICARE disease management benefit (per the John Warner National
Defense Authorization Act of 2007, section 734) is implemented. This
continuation of the disease management demonstration project will be
conducted under the authority provided in 10 U.S.C. 1092.
DATES: Effective date: The extension of the demonstration will be
effective April 1, 2011 and will continue for a period of two years
until March 31, 2013.
ADDRESSES: TRICARE Management Activity (TMA), 5111 Leesburg Pike, Suite
810, Falls Church, VA 22041-3206.
FOR FURTHER INFORMATION CONTACT: Robin Marzullo, Disease Management
Nurse Consultant, Population Health and Medical Management--TRICARE
Management Activity, telephone (703) 681-6717 x 1214.
SUPPLEMENTARY INFORMATION:
A. Background
For additional information on the TRICARE demonstration project for
disease management, please see 72 FR 32628-32629 and 74 FR 11089-11090.
The original demonstration notice focused on explaining the differences
between the disease management benefits available to TRICARE Standard
and TRICARE Prime beneficiaries and the manner in which disease
management services had been provided prior to the demonstration. The
prior notice explained that for purposes of the demonstration, the
Department of Defense (DoD) would waive, for these disease management
services provided to Standard beneficiaries, the provisions of 10
U.S.C. 1079(a)(13) and 32 CFR 199.4(g)(39) that expressly exclude
clinical preventive services for TRICARE Standard beneficiaries. The
prior notice also explained the enrollment process and cap on disease
management costs.
B. Description of Extension of Demonstration Project
Under this demonstration, DoD has waived, for disease management
services provided to TRICARE Standard beneficiaries, the provisions of
10 U.S.C. 1079(a)(13) and 32 CFR 199.4(g)(39) that expressly exclude
clinical preventive services for TRICARE Standard beneficiaries in the
current benefit. The Military Health System (MHS) has enrolled TRICARE
Standard beneficiaries in its disease management programs. Disease
management services provided to Standard beneficiaries have included,
but have not been limited to: Clinical preventive examinations, patient
education and counseling services, and periodic screening exams. MHS
disease management program costs have been capped not to exceed the
amount approved by the contracting officer. The disease management
program costs are total costs of disease management services provided
to both Prime and Standard beneficiaries. Only those beneficiaries
identified by the TRICARE Management Activity (TMA) for disease
management of asthma, heart failure, diabetes, COPD, depression,
anxiety, and cancer, have been included in the current program.
Beneficiaries identified by TMA are included in the disease management
program unless they choose to opt out. This action directly reduces
variation across the system and results in improved consistency and
quality for beneficiaries with targeted chronic illness, regardless of
TRICARE classification. Furthermore, including TRICARE Standard
beneficiaries in current disease management efforts informs the MHS
about total potential savings and return on investment (ROI) associated
with disease management, a stated requirement of the John Warner
National Defense Authorization Act for Fiscal Year 2007. Continuing to
provide disease management services to all TRICARE beneficiaries will
continue to maintain our overall quality of care throughout the MHS
program. By educating patients about their disease and helping them
manage their symptoms, many of the complications of these diseases can
be avoided, possibly slowing the progression of their chronic disease,
thus resulting in significant cost savings.
[[Page 12082]]
C. Implementation
The extension of the demonstration will be effective on April 1,
2011. The terms and conditions of the original demonstration as
provided in the Notice published at 72 FR 32368-32369 will continue on
that date.
D. Evaluation
An independent evaluation of the demonstration will continue to be
conducted. The evaluation is designed to use a combination of
administrative and survey measures of health care outcomes (clinical,
utilization, financial, and humanistic measures) to provide analyses
and comment on meeting its goal of providing uniform disease management
policies and practices across the MHS.
Dated: March 1, 2011.
Morgan F. Park,
Alternate OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. 2011-4865 Filed 3-3-11; 8:45 am]
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