32 CFR Part 199 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS / TRICARE)

Scope

32 CFR Part 199 prescribes guidelines and policies for the administration of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), now operating under the TRICARE brand. The regulation covers eligibility, benefits, claims, appeals, dental program, provider reimbursement, and program-specific extensions such as the Extended Care Health Option and Continued Health Care Benefit Program.

Audience

Marines, family members, and survivors using TRICARE health coverage. S-1 personnel processing DEERS enrollment and TRICARE eligibility actions. Tricare beneficiary representatives at command level. Casualty Assistance Calls Officers (CACOs) advising surviving family on TRICARE continuation.

Authority

The regulation is issued under 5 U.S.C. 301 and 10 U.S.C. Chapter 55. Source. 51 FR 24008, July 1, 1986. Applies geographically within the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, US possessions and territories, and all foreign countries unless specific exemptions are granted in writing by the Director, OCHAMPUS, or a designee. Applies throughout DoD, the Coast Guard, the Public Health Service, and NOAA Commissioned Corps.

Section map

• 199.1. General provisions.
• 199.2. Definitions.
• 199.3. Eligibility.
• 199.4. Basic program benefits.
• 199.5. TRICARE Extended Care Health Option (ECHO).
• 199.6. TRICARE-authorized providers.
• 199.7. Claims submission, review, and payment.
• 199.8. Double coverage.
• 199.9. Administrative remedies for fraud, abuse, and conflict of interest.
• 199.10. Appeal and hearing procedures.
• 199.11. Overpayments recovery.
• 199.12. Third party recoveries.
• 199.13. TRICARE Dental Program.
• 199.14. Provider reimbursement methods.
• 199.15. Quality and utilization review peer review organization program.
• 199.16. Supplemental Health Care Program for active duty members.
• 199.17. TRICARE program.
• 199.20. Continued Health Care Benefit Program (CHCBP).
• 199.21. TRICARE Pharmacy program.
• Appendix A. Acronyms.

Status

Active. The eCFR maintains the current text at the external URL above. Defense Health Agency administers the program. Confirm the current text before relying on a specific section.