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Privacy and Civil Liberties Data Sharing Agreement Program

Questions and answers about privacy and civil liberties at the Defense Health Agency Data Sharing Agreement (DSA) program.

Recommended Content:

Privacy Act at DHA | Privacy and Civil Liberties | Submit a Data Sharing Application | Submit a Data Sharing Application
Q1:

Why is a Data Sharing Agreement required?

A:

The DHA requires an approved DSA when requestors ask to use DHA data. The DHA, as a covered entity, uses the DSA process to:

  • Confirm that data will be used as allowed under the regulations
  • Promote privacy responsibility in the MHS
  • Maintain documentation in case of an investigation or audit
  • Share only the minimum data necessary for the purpose

Q2:

Who needs a Data Sharing Agreement?

A:

  • Business Associates who need DHA data to do work on behalf of the government
  • Government personnel who need DHA data for a research project or a survey
  • Researchers who need DHA data for a research project or survey
  • Students and professionals who need DHA data for an academic research project or for a dissertation

Q3:

How is the Data Sharing Agreement request process initiated?

A:

Requestors submit a Data Sharing Agreement Application (DSAA) endorsed by both the Applicant and Sponsor.

Q4:

How long will it take to obtain an approved Data Sharing Agreement?

A:

A DSA may be approved within 10 business days after a DSAA is approved.

Q5:

Who should be listed on the Data Sharing Agreement?

A:

The Applicant, Government Sponsor, and DHA Privacy and Civil Liberties Office (DHA Privacy Office) are listed on the DSA.

Q6:

Does the Data Sharing Agreement Sponsor need to be a member of the MHS?

A:

Yes, the DSA Sponsor needs to be a member of the MHS.

Q7:

How early should a Data Sharing Agreement Renewal Request be submitted?

A:

The DSA Renewal Request should not be submitted until the contract option year (as listed on the Renewal Request) has been granted.

Q8:

What is personally identifiable information, or PII?

A:

Under DoD 5400.11-R, "Department of Defense Privacy Program," May 14,2007, personally identifiable information (PII) is information about an individual that identifies, links, relates, or is unique to, or describes the individual. Examples are: a social security number; age; military rank; civilian grade; marital status; race; salary; home or office phone numbers; and other demographic, biometric, personnel, medical, and financial information.

Q9:

What is protected health information, or PHI?

A:

Under DoD 6025.18-R, "Department of Defense Health Information Privacy Regulation, protected health information (PHI) is a subset of PII. PHI is health information, including demographic information collected from an individual, created or received by a health care provider, health plan, employer, or health care clearinghouse, and relating to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and that identifies the individual; or with respect to which there is a reasonable basis to believe the information can be used to identify the individual.

Q10:

What is de-identified information?

A:

HIPAA defines de-identified data as:

  • Data that does not identify an individual
  • Data that has the 18 categories of direct identifiers removed
  • Data that allows no reason to believe it can be used, alone or in combination with other information to identify an individual

Q11:

What is a limited data set?

A:

DoD 6025.18-R defines a limited data set as PHI that excludes 16 of the 18 direct identifiers. A limited data set may still include the following (potentially identifying) information: admission dates, discharge dates, service dates, dates of birth, and, if applicable, age at time of death (including decedents age 90 or over). Also, five-digit zip code or any other geographic subdivision, such as state, county, city, precinct, and their equivalent geocodes (except street address) may also remain as part of a limited data set (LDS).

Project 112 SHAD

Questions and answers about Project 112 SHAD

Recommended Content:

Health Readiness | Environmental Exposures | Chemical and Biological Exposures | Project 112/SHAD
Q1:

Are there plans to notify those affected?

A:

Yes, the Veterans Affairs (VA) has taken the responsibility for outreach to veterans. In addition to personal notification by letter, the VA operates a toll free Helpline at (800) 479-8387 for veterans and maintains a Project 112/SHAD webpage. Please contact the VA Public Affairs office at (202) 273-5705 for more details about their program to contact veterans.

Q2:

Did the FDA and CDC approve these tests?

A:

The agencies that became the CDC and the Public Health Service were aware of the conduct of the tests and assisted in their planning to assure the safety of the U.S. population and those participating. The FDA would not normally exercise any regulatory authority over this type of test, so they were not involved.

Q3:

Have you provided names to the VA?

A:

Yes, for each fact sheet that we published we provided the VA lists of those known to be involved. Because crew lists and unit rosters are not classified, we provided them to the VA while the declassification effort was underway. This gave the VA an opportunity to begin converting Service numbers into social security numbers to find addresses for these veterans in advance of the announcement.

Q4:

How many of these tests were there and where are they listed?

A:

The Deseret Test Center planned 134 chemical and biological warfare tests to be conducted between 1962 and 1973. DoD's investigation has confirmed that 84 of these tests were not executed and 50 are known to have been conducted. 

Q5:

How many people died from these tests?

A:

Our investigation has not revealed any cases of illness related to exposures at the time of the tests. We have found no evidence in DoD records that anyone died as a result of exposures during any Deseret Test Center test.

Q6:

How much did the investigation cost?

A:

We have not calculated the costs, and that is not a factor in determining what work we do to protect the health of veterans and Service members. This work was fully integrated into all the other activities of our office, so its cost would be difficult to separate.

Q7:

Some Deseret Test Centers have names or numbers. What is the difference?

A:

All Deseret Test Center tests were designated by test numbers. Initially the test center assigned cover names to the tests as well, but in the later years of the program this stopped. There is no difference between these later tests and the others in terms of the level of security or risk.

Q8:

Was the biological agent known as wheat rust sprayed in other states?

A:

The investigation into the work of the Deseret Test Center has found only one test that they conducted using Wheat Stem Rust, DTC Test 69-75 at Yeehaw Junction, Florida, in late 1968.

Q9:

How will veterans involved in these tests know it is safe to come forward?

A:

Some veterans have told us they are concerned about possibly releasing classified information about these tests when discussing their health concerns. We have discussed these concerns with staff at the (VA) and advised them that veterans may provide details that affect their health with their health care provider. In turn, the VA included our response in their notification letter:

"You may provide details that affect your health to your health care provider. For example, you may discuss what you believe your exposure was at the time, reactions, treatment you sought or received, and the general location and time of the tests. On the other hand, you should not discuss anything that relates to operation information that might reveal chemical or biological warfare vulnerabilities or capabilities."

Veterans are welcome to contact our staff at (800) 497-6261 for confirmation that they will not violate security requirements by stating that they were involved in Deseret Test Center tests.

Q10:

Was Deseret Test Center an Army Program?

A:

Deseret Test Center was a joint service program based at Army facilities with staff from all the Services. Army and Navy vessels were used, as well as Marine Corps and Air Force aircraft, and members of all four Services were involved.

Q11:

Were civilians included in these tests?

A:

Some government civilians were involved in the tests, all of whom were Department of Defense employees or contractors. For some of the land-based testing using simulants still believed to be harmless to humans, it appears people may have been exposed without their knowledge.

Q12:

What is the Deseret Test Center and how does it relate to Project SHAD?

A:

From 1962 to 1973, the Deseret Test Center, headquartered at Fort Douglas, Utah, conducted a series of operational chemical and biological warfare tests in support of Project 112. The purpose of the tests done under Project Shipboard Hazard and Defense (SHAD) was to identify U.S. warships' vulnerabilities to attacks with chemical or biological warfare agents and to develop procedures to respond to such attacks while maintaining a war-fighting capability. The purpose of the land-based tests was to learn more about how chemical or biological agents behave under a variety of climatic, environmental and use conditions. To date, DoD Investigators identified 5,842 Service members who were involved in one or more of these tests. The Deseret Test Center planned 134 tests; 50 were conducted and 84 were cancelled.

Q13:

What should a Veteran do if they believe they are affected by one of the Deseret Test Center tests?

A:

Veterans who have health concerns regarding their participation in a Deseret Test Center test are encouraged to contact the VA's Helpline toll free at (800) 749-8387.

Q14:

What was the testing and was the crew vulnerable to the test?

A:

The purpose of the tests done under Project Shipboard Hazard and Defense was to identify U.S. warships' vulnerabilities to attacks with chemical or biological warfare agents and to develop procedures to respond to such attacks while maintaining a war-fighting capability. The purpose of the land-based tests was to learn more about how chemical or biological agents behave under a variety of climatic, environmental and use conditions. To date, DoD Investigators identified 5,842 Service members who were involved in one or more of these tests.The information from these tests was used to enhance protection of our Service members, and to understand the behavior of chemical and biological warfare agents in varying climates and terrain. At no time were there any tests to determine the effect on people.

Q15:

What will the VA do for those who think they are ill from their work with Deseret Test Center?

A:

Veterans Affairs (VA) has offered a medical evaluation to all Deseret Test Center participants who so wish. The VA can best provide details of the benefits and assistance available to veterans. The VA operates a toll free Helpline at (800) 749-8387 for veterans and maintains a Project 112/SHAD webpage.

Q16:

When did DoD begin their investigation?

A:

At the request of the Department of Veterans Affairs, the DoD accepted the mission to provide data related to the SHAD tests in September 2000. A team was assembled to learn which ships and units were involved in the tests, when the tests took place, and what substances were used in testing and decontamination. The investigations was expanded to include all tests done by the Deseret Test Center under Project 112.

Q17:

When did the test series take place?

A:

 The test series began in 1962 and ended in 1973.

Q18:

Where were the tests conducted?

A:

Shipboard Hazard and Defense (SHAD) tests were conducted on the open sea in the North Atlantic, open water locations of the Pacific Ocean and near the Marshall Islands, Hawaii, Puerto Rico and the California coast. Land-based tests took place in Alaska, Hawaii, Maryland, Florida, Utah, Georgia, and in Panama, Canada and the United Kingdom.

Q19:

Why did it take so long for the information to be released?

A:

The purpose of the tests done under Project Shipboard Hazard and Defense was to identify U.S. warships' vulnerabilities to attacks with chemical or biological warfare agents and to develop procedures to respond to such attacks while maintaining a war-fighting capability. The purpose of the land-based tests was generally to learn more about how chemical or biological agents behave under a variety of climatic, environmental and use conditions. To reveal details of the effectiveness of our defenses and details of our defensive procedures and equipment could compromise the safety of our Service members. The DoD had no indication that this operational testing had any health effect on the personnel involved.

Q20:

Why did sailors receive nasal swabs or throat gargles during the tests?

A:

Deployment Health Support Directorate (DHSD) investigators questioned the Deseret Test Center personnel they interviewed on the reason for taking gargle samples and nasal swabs from vessel crew members. The practice was an informal, and largely undocumented, supplement to the mechanical samplers positioned throughout the test ships to measure organism penetration and dispersion. It appears that the data gathered may have been used to help validate mechanical samplers in the early tests where Bacillus globigii was the biological simulant being used, allowing the practice to be discontinued once samplers were optimally positioned. One known exception is that during the Autumn Gold test, gargle samples and nasal swabs were taken of crewmembers wearing protective masks to determine the effectiveness of the masks. These sample readings are documented in the Autumn Gold test report, but unfortunately are not linked to the crew members whom provided the samples.

Q21:

Why did this investigation take so long?

A:

The information Veterans Affairs (VA) needed was classified and was not centralized. The Deseret Test Center, the organization that ran the original tests, was closed in 1973. The investigation required a search for 40-year-old documents and records kept by different military services in different locations. It also required declassification of medically relevant information, without releasing military information that remains classified for valid operational security reasons.

Reserve Health Readiness Program: General

View general questions and answers about the Reserve Health Readiness Program (RHRP):

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Q1:

What is RHRP?

A:

RHRP is the Reserve Health Readiness Program which has been developed by the Department of Defense (DoD) to deliver medical and dental readiness services to the United States military.

Q2:

To what branches does the RHRP provide services?

A:

  • U.S. Army Reserve (USAR)
  • Army National Guard (ARNG)
  • U.S. Navy Reserve (USNR)
  • U.S. Marine Forces Reserve (MARFORRES)
  • U.S. Air Force Reserve (USAFR)
  • U.S. Coast Guard Reserve (USCGR)
  • Air National Guard (ANG)

Q3:

Does the RHRP also serve active duty service members?

A:

RHRP provides Post-deployment Health Reassessment (PDHRA), Periodic Health Assessment (PHA), and Individual Medical Readiness (IMR) services to active duty members in selected Service branches who are geographically remote from military medical facilities.

Q4:

Does the RHRP also serve DoD civilians?

A:

RHRP conducts PDHRA assessments for Army Corps of Engineers and Materiel Command civilians who have returned from deployment.

Q5:

What services are available through RHRP?

A:

  • Medical
  • Dental (including treatment)
  • PHA
  • Optometry
  • Audiology
  • Immunization
  • Phlebotomy
  • Laboratory analysis
  • Women's readiness
  • PDHRA

Please contact your command for branch specific information. Most services are available individually or at group events.

Q6:

Is there a call center for the RHRP?

A:

Yes, the phone number for the call center is 1-800-666-2833, ext. 3555. The call center is open Monday-Friday 0700-2200 and Saturday 0700-1500 CST. In addition, RHRP offers an MHA and PDHRA call center (1-888-734-7299) which is available 24 hours a day, 7 days a week.

Q7:

What is PHA?

A:

PHA is a Periodic Health Assessment. The PHA is required on an annual basis; it replaced the five year retention physical.

Q8:

What is PDHRA?

A:

PDHRA is the Post Deployment Health Reassessment (required 90-180 days post-return from deployment). 

Q9:

How do I get records updated if dental or immunization services were not performed by RHRP?

A:

For these services (ARNG and USAR only), send the appropriate documentation via email or fax it to 1-888-628-0099. RHRP will update MEDPROS or let you know if the document is not acceptable.

Q10:

Which immunizations are routine and which are for deployment?

A:

  • Routine: Hepatitis A, Hepatitis B, TDAP and influenza (in season).
  • Deployment: These are theater specific; check with your command for further guidance.

Q11:

What services are annual?

A:

Annual services include the flu vaccine, dental exam and the PHA, to include vision screening. Audio screening may be annual depending on your branch of the military (please contact your command).

Q12:

What's the difference between a vision screening and an eyewear exam?

A:

Vision screening will determine if you need prescription eyewear. An eyewear exam is to determine the needed prescription and fill the prescription (two pair and mask inserts).

Q13:

Why are vouchers sometimes automatically entered by RHRP?

A:

For certain services, USAR and ARNG have requested automatic further evaluation based on results from a previous appointment.

Q14:

What constitutes a no-show?

A:

A no-show is when a Service member misses an appointment or does not call RHRP at least 24 hours prior to the appointment to cancel or reschedule the appointment.

Q15:

What should I do if I have a concern about RHRP services?

A:

Let RHRP know. The best ways to do so are by expressing the concern on a customer satisfaction survey or going through your command structure. Alternatively, you can also send us an email message.

Q16:

Is there a cost for RHRP services?

A:

There is no cost to you for authorized services. RHRP services are paid for by your Service Component. If you have specific questions about costs or charges, please contact your medical readiness coordinator.

Reserve Health Readiness Program: Unit POC

View questions and answers about the Reserve Health Readiness Program (RHRP) targeted to Unit POCs:

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Q1:

How far in advance do I schedule an event?

A:

All finalized information should be submitted to RHRP a minimum of 14 days prior to the date of the event.

Q2:

How do I schedule and submit an event?

A:

USAR and ARNG have the option of entering an event voucher in the Army’s Automated Voucher System (AVS). All other branches should contact the IMR Department at RHRP at 1-800-666-2833, ext 3508 for assistance.

Q3:

What are the minimums required to schedule a group event?

A:

The per day group number minimums are as follows: 

  • Immunizations = 80
  • PHAs = 40
  • Vision screening = 40
  • EKG = 25
  • Dental = 50
  • Panos = 20
  • Blood Draws = 30
  • Audio = 50
  • Eyewear = 50
  • PDHRA = 40

Q4:

What if I do not meet the minimums for a group event?

A:

If you do not meet the minimum for a service, contact RHRP at 1-800-666-2833, ext. 3508. USAR and ARNG may also submit individual vouchers in AVS.

Q5:

Can units combine for a group event?

A:

Yes, but units must be within the same branch of service.

Q6:

How do I submit/cancel an individual voucher?

A:

Individual vouchers must be submitted through AVS for USAR and ARNG. All other branches should contact their command for further guidance on how to submit a voucher. To cancel a voucher, contact RHRP Customer Service at 1-800-666-2833 ext. 3555.

Q7:

How do I submit/cancel a group event?

A:

Group events must be submitted through AVS for USAR and ARNG. All other branches should contact their command for further guidance on how to request a group event. To cancel a group event, contact your event coordinator or contact IMR at 1-800-666-2833, ext 3508.

Q8:

What can cause a delay in completing a PHA?

A:

Additional services may be needed, such as follow-up audio (Comprehensive Audiology Exam - CAE), blood draws or EKG.

Q9:

What happens if a Service member gets a bill for RHRP services?

A:

Please contact the RHRP office at 1-800-666-2833, ext. 3555.

Q10:

Where do I find the pricing for RHRP services?

A:

Please contact the program manager for your branch of service. 

Q11:

How do I get a copy of my Service members' PHA or dental exams?

A:

Please refer to your Service Component module (e.g., MRRS, PIMR, MEDPROS, PHA or DenClass) or medical readiness coordinator. 

  • For PHA, contact Medical Operations at 1-800-666-2833, ext. 1207. 
  • For Dental, call Customer Service at 1-800-666-2833, ext. 3555.

Q12:

How do I update my contact information (e.g., phone, address, etc.)?

A:

Please contact the RHRP IMR Department at 1-800-666-2833, ext. 3508. Also, do not forget to update other military databases such as DEERS.

Q13:

How do I get a service expedited?

A:

In very rare instances (e.g. very short notice deployment to a disaster site) you can get services expedited. 

  • For an individual appointment, the command’s IMR representative should call Customer Service at 1-800-666-2833. 
  • For a group event, the command’s IMR representative should call their event coordinator or 1-800-666-2833, ext. 3555.

Q14:

I'm in the Army. How do I get write access for MEDPROS?

A:

Contact your command for this access. The MEDPROS Help desk is at 1-703-681-4976.

Q15:

What actions should I take if I encounter any issues during a group event?

A:

Please contact the RHRP office at 1-800-666-2833, ext. 3555.

Q16:

What are the cancellation and no show policies?

A:

  • Decreasing services requested within 14 and 6 calendar days of the event date will result in a Cancellation Fee. 
  • Decreasing services requested within 5 calendar days of the event date will result in a No-Show Fee. 
  • Failure to meet GE minimums will also result in a No-Show Fee.

Reserve Health Readiness Program: Service Member

View questions and answers about the Reserve Health Readiness Program (RHRP) for service members:

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Q1:

I was told by my Commander that I need a PDHRA. What do I do?

A:

First, complete the Service member portion of the PDHRA on your Service-specific website. Then, call the toll free PDHRA call center, which is available 24 hours a day / 7 days a week at 1-888-734-7299, option 3.

Q2:

How do I schedule my individual medical or dental services?

A:

Call Customer Service at 1-800-666-2833, ext. 3555. The call center is open Monday-Friday 0700-2200 or Saturday 0700-1500 CST.

Q3:

How do I start my PHA?

A:

For USAR only, and only for an in-clinic appointment: you need to start the process on your AKO site. Complete the Service member portion and call Customer Service at 1-888-697-4299 to schedule the face-to-face appointment. If you are having problems accessing your AKO site, call the number above and complete the Service member portion over the phone.

If you are getting your PHA at a group event, you should not complete the AKO portion of the PHA as this information will be obtained at the event.

All other branches contact your command.

Q4:

What is a CAE?

A:

A Comprehensive Audio Evaluation (CAE) is more than just an audiogram and is used to determine the hearing portion of the PULHES when a possible loss of hearing has been identified. The CAE includes a bone-density screening and can also include a SPeech Recognition In Noise Test (SPRINT) if needed.

Q5:

How do I get a copy of a service that I completed through the Reserve Health Readiness Program?

A:

Please contact your Command’s IMR representative and have them follow up with RHRP.

Q6:

I have a profiled PHA. How do I get my PULHES changed?

A:

If you are in the USAR, your unit administrator needs to call your RSC. If you are in the ARNG, your unit administrator should contact the DSS for your state.

Q7:

What do I need to bring to my clinic appointment?

A:

RHRP will send (by Federal Express) a package of paperwork and/or supplies to you prior to your appointment. Please review and complete all necessary paperwork before the scheduled appointment and bring all materials with you. Also bring any relevant medical documentation (i.e., MRB, profiles, etc.) and your prescription eyeglasses if attending a PHA.

Q8:

Do I have to wear my military uniform to an appointment?

A:

You do not need to wear your uniform to an in-clinic appointment; however, contact your Command’s IMR representative for direction during a battle assembly.

Q9:

Where will my appointment be scheduled?

A:

It will be scheduled within 50 miles of your preferred zip code (i.e., home of record, work, unit etc.).

Q10:

How do I get records updated if services were not performed by RHRP?

A:

For USAR only, send appropriate documentation via email and RHRP will update MEDPROS, or let you know if the document is not acceptable.

For all other Components, contact your unit for guidance on how to update your records.

Q11:

How do I find out what immunizations I am due for?

A:

Contact your Command’s IMR representative for a MEDPROS lookup.

Q12:

Is RHRP an insurance program?

A:

No, RHRP is a DoD program designed to deliver medical and dental readiness services for the U.S. military.

Q13:

What happens if I refuse services at an appointment or a group event?

A:

If you have documentation to show you’ve had the service, you should make a copy and give it to the provider. If you just don’t want the service or are unsure if you need the service, you should contact your Command’s IMR representative for guidance before refusing the service, as there may be repercussions with your command for doing so.

Reserve Health Readiness Program: DoD Civilian

View questions and answsers about the Reserve Health Readiness Program (RHRP) for DoD Civilians:

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Q1:

What services do you provide for civilians?

A:

As this point, RHRP conducts PDHRAs for Army Corps of Engineers and Army Installations Command civilian employees who have returned from deployment.

Q2:

How do I get my PDHRA completed?

A:

You can find the PDHRA on AKO. Complete your portion there and then call the PDHRA Call Center, which is available 24 hours a day/ 7 days a week at 1-888-734-7299, option 3. 

Separation Health Assessment

Questions and answers about the Separation Health Assessment

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Separation Health Assessment
Q1:

Why are all Service members required to get the SHPE before leaving active duty?

A:

The DoD requires a separation history and physical examination to capture the complete medical history of Service Members and evaluate members filing a disability claim.

Results are accessible by both the DoD and VA so even if you’re not filing a VA claim now, the results are available if you decide to file a disability claim later.

Q2:

How do I schedule the exam?

A:

You can schedule the exam at any military hospital or clinic or VA facility. Find one near you:

Q3:

If there’s any information missing from my record, how do I get it added?

A:

You can view your health record on the TOL Patient Portal through the Blue Button feature. If something’s missing, contact the provider that conducted the exam or ordered the lab work to ensure it gets added. All your health records are shared with the VA.

Q4:

How do I file a VA disability claim?

A:

You can file a VA disability claim through eBenefits, in person with a Veterans Service Organization, or with a VA representative at a military installation. Submit a copy of your Service Treatment Record (STR) from your current period of military service and any copies of private treatment records not associated with TRICARE referrals. For more information on VA disability benefits, call 1-800-827-1000 or visit the VA’s website.

Small Business Programs

View questions and answers about the Defense Health Agency Small Business Program.

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Q1:

How is a small business defined or categorized?

A:

Visit the Small Business Administration (SBA) website to learn how they define a small business.

Q5:

How do I do business with the DHA? What does the DHA buy?

A:

Visit the Doing Business with the DHA Office of Small Business Programs (OSBP) webpage to find out what DHA buys and for information on doing business with the DHA.

Q6:

What entity established the size standards within a certain industry?

A:

The SBA is responsible for establishing size standards. Visit the SBA’s Size Standard Office for more information.

TEAM UP

Questions and answers about TEAM UP

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TEAM UP
Q1:

How can I use TEAM UP in my facility?

A:

Facilities that have used TEAM UP have first gathered support from the internal staff team around asking patients to engage in their care, and specifically around the concepts highlighted within the TEAM UP brochure. Once you have secured the support from your colleagues, begin to share the brochures with your patients – to officially welcome them onto the care team!

Third Party Collection Program

Questions and answers about third party collections and using other health insurance.

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Third Party Collection Program
Q1:

What is other health insurance (OHI)?

A:

Other health insurance (OHI) is any health insurance policy covering medical, dental, or pharmacy that you may have through your employer or private insurance company. TRICARE, TRICARE Supplemental plans, Medicare, Medicaid, and certain government-sponsored programs are not OHI. If you have OHI and are covered by TRICARE, federal law requires military treatment facilities (MTFs) to collect reasonable payments from third party payers (unless you are active duty). The money collected (commonly referred to as “reimbursement” or “remittance”) supports the operation and maintenance budget of the MTF where you receive your care. OHI reimbursements help your MTF improve the quality of health care.

Q2:

What is the DD Form 2569, and why do I need to complete it?

A:

The DD Form 2569 is the way you tell DoD about your OHI. The information provided on the DD Form 2569 is used to properly route a health care claim to your OHI provider.

Q3:

Who has to complete this form?

A:

All DoD beneficiaries, except active duty, are required to complete the DD Form 2569. This includes active duty family members, retirees, and family members of retirees.

Q4:

How often do I have to complete the DD Form 2569?

A:

At every visit, you are required to inform DoD about any OHI you have or any changes since your last appointment. A DD Form 2569 must be completed annually and when your insurance coverage or information changes. Health plan information (see below) can change between appointments and from year to year. Please verify that you have the most up-to-date health insurance information from your insurance provider and report it on the DD Form 2569. Some MTFs utilize DD Form 2569 Compliance Cards that allow beneficiaries to certify the form has been completed. Beneficiaries must still update the DD Form 2569 with any changes and renew their OHI registration card, generally upon the anniversary of the issue date noted on the card or when OHI status or information is updated.

Q5:

What are my responsibilities?

A:

Provide information about your OHI coverage. This information includes:

  • Policy name and number
  • Coverage type
  • Patient relationship to insured
  • Policy effective dates

OHI will not limit your access to care. But if you intentionally fail to provide information about your OHI, you could be disqualified for health care services from MTFs.

Q6:

Will I get a bill if OHI does not pay or pays only a portion of the MTF bill?

A:

No. You will not be billed for care at an MTF (except for subsistence costs related to inpatient care or co-pays for TRICARE services provided downtown). In every case in which payment from a third party payer is received, it will be considered as satisfying the normal medical services or subsistence charges, and you will not have to make any further payment.

TRICARE Formulary

View questions and answers about the TRICARE Formulary.

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TRICARE Formulary
Q1:

Is my medication covered by TRICARE?

A:

You can find out if your medication is covered by looking it up on the Formulary Search Tool.

Q2:

What can I do if my medication isn't covered?

A:

Your provider can call the Express-Scripts Prior Authorization line @ 1-866-684-4488 to request a medical necessity override. 

NOTE: In some cases your medication (injections and vaccines) may be covered as a medical benefit so you can call your TRICARE Regional Contractor.

Q3:

What can I do if my medical necessity override for a non-covered medication is not approved?

A:

You can contact Express-Scripts Customer Service @ 1-877-363-1303 for information regarding the appeals process.

Q4:

How do I know if generic is required for my medication?

A:

You can find out if generic is required by looking it up on the Formulary Search Tool.

Q5:

How do I get a brand name instead of generic?

A:

Your provider can either call the Express-Scripts prior authorization line @ 1-866-684-4488 to establish medical necessity or he/she can fill out the Brand over Generic Prior Authorization Request Form and fax it to Express-Scripts.

Q6:

What can I do if the request for brand name was denied?

A:

You can contact Express-Scripts Customer Service @ 1-877-363-1303 for information regarding the appeals process.

Q7:

How do I know if my medication requires prior authorization?

A:

You can find out if your medication requires prior authorization by looking it up on the Formulary Search Tool.

Q8:

What if my medication requires prior authorization?

A:

Your provider can either call the Express-Scripts prior authorization line @ 1-866-684-4488 or he/she can fill out the prior auth form that is linked to that medication on the Formulary Search Tool and fax it to Express-Scripts.

Q9:

What can I do if my prior authorization was denied?

A:

You can contact Express-Scripts Customer Service @ 1-877-363-1303 for information regarding the appeals process.

Q10:

How do I know if my medication requires medical necessity?

A:

You can find out if your medication requires medical necessity by looking it up on the Formulary Search Tool.

Q11:

What if my medication requires medical necessity?

A:

Your provider can either call the Express-Scripts prior authorization line @ 1-866-684-4488 to establish medical necessity or he/she can fill out the medical necessity form that is linked to that medication on the Formulary Search Tool and fax it to Express-Scripts.

Q12:

What can I do if my medical necessity was denied?

A:

You can contact Express-Scripts Customer Service @ 1-877-363-1303 for information regarding the appeals process.

Q13:

Is there an age restriction on my medication?

A:

You can look up your medication on the Formulary Search Tool. These will be listed under the "Notes" section.

Q14:

How do I get my medication if there is an age restriction?

A:

Your provider will need to call the Express-Scripts Prior Authorization line @ 1-866-684-4488 to establish medical necessity.

Q15:

What can I do if the request for a medical necessity override was denied?

A:

You can contact Express-Scripts Customer Service @ 1-877-363-1303 for information regarding the appeals process.

Q16:

Are there quantity limits on my medication?

A:

You can find out if there are quantity limits on your medication is covered by looking it up on the Formulary Search Tool. These will be listed under the "Notes" section.

Q17:

What can I do if my doctor wants me to take more than the allowed amount

A:

Your provider can call the Express-Scripts PA line @ 1-866-684-4488 to establish medical necessity for a quantity limit override.

Q18:

What can I do if the request for a quantity limit override was denied?

A:

You can contact Express-Scripts Customer Service @ 1-877-363-1303 for information regarding the appeals process.

Q19:

How can I get reimbursement for a prescription if I paid full price or my other health insurance (OHI) cost share?

A:

You can contact Express-Scripts Customer Service @ 1-877-363-1303 for assistance.

Q20:

How can access more information about my medication like indications and side effects?

A:

The following websites have medication information like indications and side effects: 

TRICARE Patient Transfer Pilot

Questions and answers about the TRICARE Patient Transfer Pilot

Q1:

Why is TRICARE launching the TRICARE Patient Transfer Pilot?

A:

We want to evaluate the collaboration between our MTFs, the regional contractors and civilian emergency departments. The outcome may enable us to consider operational and financial changes needed to:

  • Optimize the capabilities of the direct care system
  • Support medical readiness
  • Enhance MTF provider efficiency and graduate medical education programs
  • Steward taxpayer dollars
  • Reduce beneficiary costs
  • Enhance beneficiary satisfaction

Q2:

Why would beneficiaries want to transfer to a MTF?

A:

Beneficiaries will need to decide based on their individual scenario. They may already have a doctor at the MTF they prefer to see or maybe moving to an MTF will save them money.

Q3:

Is there any scenario when transferring to an MTF may not be the best option for beneficiaries?

A:

A transfer won’t be recommended unless the patient is clinically stable and doctors at both facilities agree to the transfer. Ultimately, it’s a personal decision, and beneficiaries should consider:

  • The rules for their health plan (i.e. TRICARE Prime, TRICARE Select, TRICARE For Life)
  • The type of care they need and how long they may be admitted
  • Which facility is more convenient for them (closer to home, etc.)
  • Costs for the care at a civilian facility compared to the MTF

Q4:

What is the process for transferring from a civilian facility to an MTF?

A:

Each MTF will establish its own process, but basically:

  • The civilian facility will contact the MTF Patient Transfer Hotline
  • The MTF decides if they will accept the transfer within 30 minutes
  • Patient transport is arranged within 30 minutes

MTFs and regional contractors will work with neighboring civilian facilities to inform them about the process and provide educational materials about the pilot.

Q5:

How can I learn more about the TRICARE Patient Transfer Pilot?

A:

For more information, contact a participating MTF using the links listed in the chart above.

Q6:

If a non-active duty beneficiary accepts transfer from the civilian hospital to an MTF, who pays for the ambulance ride?

A:

For the pilot, if either the civilian facility or the MTF makes the request, it is considered an "order" and allows TRICARE to cost share for the ambulance transport to the MTF. >>View Health Plan Costs

In some locations, the MTF may arrange for a contracted ambulance service at no cost to the beneficiary.

Uniform Business Office

This FAQ section is updated with questions the UBO gets about the Military Health System's (MHS’s) three health care cost recovery programs and overall revenue cycle direction.

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Uniform Business Office
Q1:

What should I do if a claim is denied?

A:

You should contact the payer and ask for the reason(s) that the claim was denied and what information is necessary to correct the claim (make sure you document the conversation). In addition to reviewing on a claim by claim basis, review denials for trends for certain submissions. Talk with your utilization review team to get a sense as to what is impacting covered vs. non-covered claims, identify trends, and seek to proactively reduce and correct common mistakes.

For additional questions or comments, please email the UBO Help Desk, or leave a message for the Help Desk staff at 202-741-1532.

Q2:

Can Army MEDCOM military treatment facilities (MTFs) bill for acupuncture and chiropractic services rendered to TRICARE beneficiaries?

A:

Yes, MTFs can bill for acupuncture and chiropractic services, provided there are UBO approved rates for the services (CPT or HCPCS codes). However, the payer may not cover acupuncture and chiropractic services if the payer determines those services are not covered, unless they are deemed medically appropriate by the provider.

Virtual Lifetime Electronic Record Health Information Exchange

Questions and answers about the Virtual Lifetime Electronic Record Health Information Exchange

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Virtual Lifetime Electronic Record Health Information Exchange Initiative
Q1:

What is electronic Health Information Exchange (HIE)?

A:

Electronic Health Information Exchange (HIE) allows your participating health care providers from different health care delivery organizations to appropriately access and securely share your health care information. Using HIE, health care information can follow you whenever and wherever it is needed. HIE makes it possible for the various providers involved in your care to gain access to the same information.

Q2:

What is VLER HIE?

A:

Virtual Lifetime Electronic Record (VLER) Health Information Exchange (HIE) is an initiative to share parts of the Department of Defense (DoD) medical record electronically, safely, and securely.

Q3:

What is the eHealth Exchange?

A:

The eHealth Exchange is a rapidly growing health information exchange network for securely sharing clinical information over the Internet nationwide. It is the largest health information exchange infrastructure in the United States (U.S.). Current eHealth Exchange participants include large provider networks, hospitals, pharmacies, regional health information exchanges and many federal agencies, representing 40% of all U.S. hospitals, tens of thousands of medical groups, more than 8,000 pharmacies and 100 million patients.

Q4:

How secure is HIE?

A:

HIE protects the privacy and security of your health care information by following the rules set in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The HIPAA Privacy Rule provides federal protections for individually identifiable health information and gives patients’ rights about that information. The Privacy Rule permits the sharing of health information for patient care and other important purposes. The Security Rule lists administrative, physical, and technical safeguards that must be used to protect the privacy and security of your health care information.

Q5:

What are the benefits of VLER HIE and the eHealth Exchange?

A:

Access to your medical history is very important to the health care providers caring for you. Using eHealth Exchange, your health care providers have a more complete view of your health record. This allows you and your health care team to make informed decisions about your health. Through the eHealth Exchange, your health care providers can share information on your prescriptions and medications, allergies, illnesses, laboratory and radiology results, immunizations, procedures, and clinical notes*.

*To improve your care experience, health information may be shared as permitted by the Health Insurance Portability and Accountability Act (HIPAA) with other authorized organizations who partner with the MHS. To enhance coordination among care teams, this includes notes written by your clinicians, which could contain information about sexual assault, domestic violence, child/elder abuse, substance abuse, mental health, and sexually transmitted diseases.

Q6:

What does it mean to Opt Out?

A:

If you choose to opt out, the Military Health System (MHS) will not be allowed to electronically share your health care information through the eHealth Exchange for any reason, even in case of emergency where you may be unconscious. Your provider may not have the necessary information to save your life.

Q7:

What does it mean to Opt Back In?

A:

A patient can request to opt back in at any time by submitting a VLER HIE Opt Back In Letter. When you opt back in, you allow your health care providers access to important health care information about you when you visit a medical facility connected with the eHealth Exchange and participating with the MHS.

Q8:

What is the downside of choosing not to participate Opting Out of VLER HIE and eHealth Exchange?

A:

If you have opted out, in the case of an emergency where you may be unconscious, your health care providers may not have immediate and complete access to important health care information necessary to save your life.

Q9:

Are active duty service members able to opt out?

A:

No, due to medical readiness and DoDI 6040.45 Active Duty are not able to opt out of VLER HIE.

Warfare Exposure

The Department of Defense (DoD) and the Department of Veterans Affairs (VA) play distinct roles dealing with chemical and biological (CB) exposures. DoD identifies and validates veteran’s exposure to CB agents and provides the names of individuals along with their exposure information to the VA. The VA then notifies individuals of their potential exposure, provides treatment, if necessary, for these individuals and adjudicates any claim for compensation.

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Chemical and Biological Exposures | Chemical and Biological Exposures
Q1:

How much information can I divulge about my exposure, since I signed a "secrecy oath"?

A:

In 1993, Deputy Secretary of Defense William Perry issued a memorandum on "Chemical Weapons Research Programs Using Human Test Subjects." The memorandum released "any individuals who participated in testing, production, transportation or storage associated with any chemical weapons research conducted prior to 1968 from any non-disclosure restrictions or written or oral prohibitions (e.g., oaths of secrecy) that may have been placed on them concerning their possible exposure to any chemical weapons agents."

Secretary Perry also directed the Services to initiate procedures to release individuals who participated in testing, production, transportation or storage associated with any chemical weapons research after 1968 from any non-disclosure restrictions that may have been placed on them. Since most information relating to this research has been declassified, at least in part, Force Health Protection and Readiness has determined that participants in chemical-related research after 1968 may talk about their individual experiences to the Department of Defense (DoD) or the Department of Veterans Affairs without violating their oath of secrecy.

In January 2011, another memo, "Release from Secrecy Oaths Under Chem-Bio Research Programs", was released. This new memo clarifies and expands the 1993 directive to include biological weapons test subjects.

Q2:

What databases does the Department of Defense (DoD) maintain on veterans exposed to chemical and biological agents?

A:

DoD maintains a Project 112/SHAD (Shipboard Hazard and Defense) database. This database contains the names of veterans who participated in Project 112/SHAD testing in the 1960s and 1970s. It contains 6,400 names and is updated as needed when we discover additional veterans who were part of this testing. DoD also maintains a database containing the names of veterans who participated in mustard agent tests during World War II. The total numbers to date are 6,730. DoD is also currently in the process of populating our third exposure database, the Cold War Exposure database, which numbers 30,726. This database contains the names of veterans not included in other databases who participated in chemical and biological testing since World War II.

The total number for all of the databases currently is 43,856.

Q3:

Who maintains the database for veterans exposed to radiation?

A:

The Defense Threat Reduction Agency maintains information on veterans exposed to radiation during the Nuclear Test Personnel Review (NTPR) Program.

Q4:

In addition to names and service numbers, what other information does the DoD database contain?

A:

For each individual, the database will contain the following if available:

  • Type of test (i.e., performance, equipment, etc.)
  • Type of exposure (i.e., injection, intravenous (IV), etc.)
  • Date of exposure
  • Agent/simulant name
  • Agent/simulant amount if recorded
  • Treatments required as a result of the exposure
  • Documents describing the test procedures, if available.

Q5:

I think that I may have been involved in a test. How can I confirm it or get more information?

A:

If you need help verifying your possible participation in any of the tests or have information about the testing, please call the Department of Defense's contact managers at (800) 497-6261, Monday through Friday, 7:30 a.m. to 4 p.m. EST.

Alternatively, you may write to us at:

Health Readiness Policy & Oversight
ATTN: CB Exposures Manager
7700 Arlington Blvd.
Falls Church, VA 22042

If you'd like to speak with a Veterans Affairs (VA) representative, call the Special Issues Helpline at 1-800-749-8387. Many states offer services and benefits to veterans. To find out more about a particular state, please visit the VA State Veterans Affairs page.

Q6:

What substances were used during testing?

A:

The Department of Defense (DoD) has identified over 400 substances used during testing. Not all the substances were harmful as DoD tested many medicines and antidotes. These substances may be broken down as follows:

  • Chemical Agents (e.g., nerve agents, irritants)
  • Biological Agents (e.g., tularemia)
  • Vaccines (e.g., tularemia vaccines)
  • Hallucinogenic drugs (e.g., LSD)
  • Antidotes (e.g., atropine)
  • Medicines (e.g., Benadryl)
  • Other (e.g., alcohol, saline solution)
  • Tracers
  • Placebos

Q7:

Does the Department of Defense still conduct human experimentation with chemical and biological warfare agents?

A:

No. Current medical chemical & biological defense programs involving human subjects do not involve the exposure of these subjects to chemical or biological warfare agents.

There are medical chemical & biological defense programs that involve the use of human subjects in controlled clinical trials to test and evaluate the safety and effectiveness, of medical products (drugs, therapies, etc.) to protect against chemical agents. The use of human subjects in these trials involves volunteers who have provided informed consent. All use of human subjects in these trials is in full compliance with the "Common Rule," Federal Policy for the Protection of Human Subjects, Food and Drug Administration (FDA) regulations, Federal Acquisition Regulations (FAR), DoD Directives and Instructions, and all other applicable laws, regulations, issuances, and requirements.

Q8:

Does the Department of Defense (DoD) know where all the documents relating to chemical/biological agent testing are stored?

A:

The contractor doing the research for DoD on potential exposures has over 10 years of experience working with potential exposures. This experience enabled them to quickly identify major document storage locations and to prioritize their search efforts. More important is whether or not a storage site catalogued its documents. If a storage site did not catalogue its collection, researchers must comb through all material to locate the small subset that contains exposure information. This slows down the search effort.

Before terminating our efforts to locate potential chemical and biological exposures, DoD will work with its contractor to insure that the contractor did not miss any storage site that potentially contained a significant number of exposures.

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