[Code of Federal Regulations]
[Title 22, Volume 1]
[Revised as of April 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 22CFR191.22]

[Page 739-740]
 
                       TITLE 22--FOREIGN RELATIONS
 
                     CHAPTER I--DEPARTMENT OF STATE
 
PART 191_HOSTAGE RELIEF ASSISTANCE--Table of Contents
 
                       Subpart C_Medical Benefits
 
Sec. 191.22  Administration of benefits.

    (a) An eligible person, who desires medical or health care under 
this subpart or any person acting on behalf thereof, shall submit an 
application to the Office of Medical Services, Department of State, 
Washington, DC 20520 (hereafter referred to as the ``Office''). The 
applicant shall supply all relevant information, including insurance 
information, requested by the Director of the Office. An eligible person 
may also submit claims to the Office for payment for emergency care when 
there is not time to obtain prior authorization as prescribed by this 
paragraph, and for payment for care received prior to or ongoing on the 
effective date of these regulations.
    (b) The Office shall evaluate all requests for care and claims for 
reimbursement and determine, on behalf of the Secretary of State, 
whether the care in question is authorized under Sec. 191.21 of this 
subpart. The Office will authorize care, or payment for care when it 
determines the criteria of such section are met. Authorization shall 
include a determination as to the necessity and reasonableness of 
medical or health care.
    (c) The Office will refer applicants eligible for benefits under 
other Government health programs to the Government agency administering 
those programs. Any portion of authorized care not provided or paid for 
under another Government program will be reimbursed under this subpart.
    (d) Eligible persons may obtain authorized care from any licensed 
facility or health care provider of their choice approved by the Office. 
To the extent possible, the Office will attempt to arrange for 
authorized care to be provided in a Government facility at no cost to 
the patient.
    (e) Authorized care provided by a private facility or health care 
provider will be paid or reimbursed under this subpart to the extent 
that the Office determines that costs do not exceed

[[Page 740]]

reasonable and customary charges for similar care in the locality.
    (f) All bills for authorized medical or health care covered by 
insurance shall be submitted to the patient's insurance carrier for 
payment prior to submission to the Office for payment of the balance 
authorized by this part. The Office will request the health care 
providers to bill the insurance carrier and the Department of State for 
authorized care, rather than the patient.
    (g) Eligible persons will be reimbursed by the Office for authorized 
travel to obtain an evaluation of their claim under paragraph (b) of 
this section and for other authorized travel to obtain medical or health 
care authorized by this subpart.