[Code of Federal Regulations]
[Title 32, Volume 5]
[Revised as of July 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 32CFR728.12]

[Page 312-313]
 
                       TITLE 32--NATIONAL DEFENSE
 
                   CHAPTER VI--DEPARTMENT OF THE NAVY
 
PART 728_MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL 
DEPARTMENT FACILITIES--Table of Contents
 
       Subpart B_Members of the Uniformed Services on Active Duty
 
Sec. 728.12  Extent of care.

    Members who are away from their duty stations or are on duty where 
there is no MTF of their own service may receive care at the nearest 
available Federal MTF (including designated USTFs) with the capability 
to provide required care. Care will be provided without regard to 
whether the condition for which treatment is required was incurred or 
contracted in line of duty.
    (a) All uniformed services active duty members. (1) All eligible 
beneficiaries covered in this subpart are entitled to and will be 
rendered the following treatment and services upon application to a 
naval MTF whose mission includes the rendering of the care required. 
This entitlement provides that when required care and services are 
beyond the capabilities of the facility to which the member applies, the 
commanding officer of that facility will arrange for care from another 
USMTF, designated USTF, or other Federal source or will authorize and 
arrange for direct use of supplemental services and supplies from 
civilian non-Federal sources out of operation and maintenance funds.
    (i) Necessary hospitalization and other medical care.
    (ii) Occupational health services as defined in Sec. 728.2(z).
    (iii) Necessary prosthetic devices, prosthetic dental appliances, 
hearing aids, spectacles, orthopedic footwear, and other orthopedic 
appliances (see subpart H). When these items need repair or replacement 
and the items were not damaged or lost through negligence, repair or 
replacement is authorized at Goverment expense.
    (iv) Routine dental care.
    (2) When a USMTF, with a mission of providing the care required, 
releases the medical management of an active duty member of the Navy, 
Marine Corps, Army, Air Force, or a commissioned corps member of USPHS 
or NOAA, the resulting civilian health care costs will be paid by the 
referring facility.
    (3) The member's uniformed service will be billed for care provided 
by the civilian facility only when the referring MTF is not organized 
nor authorized to provide needed health care (see part 732 of this 
chapter for naval members). Saturation of service or facilities does not 
fall within this exception. When a naval MTF retains medical management, 
the costs of supplemental care obtained from civilian sources is paid 
from funds available to operate the MTF which manages care of the 
patient. When it becomes necessary to refer a USPHS or NOAA commissioned 
corps member to a non-Federal source of care, place a call to the 
Department of Health and Human Services (DHHS), Chief, Patient Care 
Services on (301) 443-1943 or FTS 443-1943 if DHHS is to

[[Page 313]]

assume financial responsibility. Patient Care Services is the sole 
source for providing authorization for non-Federal care at DHHS expense.
    (b) Maternity episode for active duty female members. A pregnant 
active duty member who lives outside the MHSS inpatient catchment area 
of all USMTFs is permitted to choose whether she wishes to deliver in a 
closer civilian hospital or travel to the USMTF for delivery. If such a 
member chooses to deliver in a naval MTF, makes application, and 
presents at that facility at the time for delivery, the provisions of 
paragraph (a) of this section apply with respect to the furnishing of 
needed care, including routine newborn care (i.e., nursery, newborn 
examination, PKU test, etc.); arrangements for care beyond the 
facility's capabilities; or the expenditure of funds for supplemental 
care or services. Pay expenses incurred for the infant in USMTFs or 
civilian facilities (once the mother has been admitted to the USMTF) 
from funds available for care of active duty members, unless the infant 
becomes a patient in his or her own right either through an extension of 
the birthing hospital stay because of complications, subsequent transfer 
to another facility, or subsequent admission. If the Government is to 
assume financial responsibility for:
    (1) Care of pregnant members residing within the MHSS inpatient 
catchment area of a uniformed services hospital or in the inpatient 
catchment area of a designated USTF, such members are required to:
    (i) Make application to that facility for care, or
    (ii) Obtain authorization, per part 732 of this chapter, for 
delivery in a civilian facility.
    (2) Non-Federal care of pregnant members residing outside inpatient 
catchment areas of USMTFs and USTFs, the member must request and receive 
authorization per part 732 of this chapter. Part 732 of this chapter 
also provides for cases of precipitious labor necessitating emergency 
care. OPNAVINST 6000.1, Management of Pregnant Servicewomen, contains 
medical-administrative guidelines on management prior to admission and 
after discharge from admission for delivery.
    (c) Reserve and National Guard personnel. In addition to those 
services covered in paragraphs (a) and (b) of this section, Reserve and 
National Guard personnel are authorized the following under conditions 
set forth. (See Sec. 728.25 for additional benefits for National Guard 
personnel.)
    (1) Personnel whose units have an active Army mission of manning 
missile sites are authorized spectacle inserts for protective field 
masks.
    (2) Personnel assigned to units designated for control of civil 
disturbances are authorized spectacle inserts for protective field masks 
M17.