32 CFR 728.2 - Definitions.

§ 728.2 Definitions.

Unless otherwise qualified in this part, the following terms, when used throughout, are defined as follows:

(a)Active duty. Full-time duty in the active military service of the United States. This includes full-time training duty; annual training duty; and attendance, while in the active military service, at a school designated as a service school by law or by the Secretary of the military department concerned. It does not include full-time National Guard duty.

(b)Active duty for training. A tour of active duty for reserves for training under orders that provide for automatic reversion to non-active status when the specified period of active duty is completed. It includes annual training, special tours, and the initial tour performed by enlistees without prior military service.

(c)CHAMPUS. Civilian Health and Medical Program of the Uniformed Services.

(d)Catchment area. A specified geographic area surrounding each Uniformed Services Medical Treatment Facility (USMTF) or designated Uniformed Services Treatment Facility (USTF). In the United States, catchment areas are defined by zip codes and are based on an area of approximately 40 miles in radius for inpatient care and 20 miles in radius for ambulatory care. Zip codes designating such areas in the United States are specified in Volumes I and II of the Military Health Services System (MHSS) Catchment Area Directory. Catchment areas for facilities outside the United States are defined in Volume III of the MHSS Catchment Area Directory. These directories exclude certain areas because of geographic barriers.

(e)Chronic condition. Any medical or surgical condition marked by long duration or frequent recurrence - or likely to be so marked - which, in light of medical information available, will ordinarily resist efforts to eradicate it completely; a condition which needs health benefits to achieve or maintain stability that can be provided safely only by, or under the supervision of, physicians, nurses, or persons authorized by physicians.

(f)Civilian employee. Under 5 U.S.C. 2105, a nonmilitary individual (1) appointed in the civil service, (2) engaged in the performance of a Federal function, or (3) engaged in the performance of his or her duties while subject to the supervision of The President, a Member or Members of Congress, or the Congress, a member of a uniformed service, an individual who is an employee under 5 U.S.C. 2105, the head of a Government controlled corporation, or an adjutant general designated by the Secretary concerned under section 709c of title 32. Included are justices and judges of the United States, appointed and engaging in the performance of duties per 5 U.S.C. 2104.

(g)Cooperative care. Medical services and supplies for which CHAMPUS will share in the cost under circumstances specified in § 728.4(z), even though the patient remains under the primary control of a USMTF.

(h)Cooperative care coordinator. Designated individual in a CHAMPUS contractor's office who serves as the point of contact for health benefits advisors on all matters related to supplemental-cooperative care or services provided or ordered for CHAMPUS-eligible beneficiaries by USMTF providers.

(i)Dental care. Treatment which will prevent or remedy diseases, disabilities, and injuries to the teeth, jaws, and related structures and thereby contribute to maintenance or restoration of the dental health of an individual.

(j)Dependent. A spouse, an unremarried widow or widower, a child, or a parent who bears that legal relationship to his or her sponsor. For the purpose of rendering care under title 10, U.S.C., chapter 55, this category may also include an unremarried former spouse. However, each beneficiary must also meet the eligibility criteria in § 728.31(b) and § 728.31(c).

(k)Designated USTFs. The following former U.S. Public Health Service (USPHS) facilities operate as “designated USTFs” for the purpose of rendering medical and dental care to active duty members and to all CHAMPUS-eligible individuals.

(1)Sisters of Charity of the Incarnate Word Health Care System, 6400 Lawndale, Houston, TX 77058 (713) 928-2931 operates the following facilities:

(i) St. John Hospital, 2050 Space Park Drive, Nassau Bay, TX 77058, telephone (713) 333-5503. Inpatient and outpatient services.

(ii) St. Mary's Hospital Outpatient Clinic, 404 St. Mary's Boulevard, Galveston, TX 77550, telephone (409) 763-5301. Outpatient services only.

(iii) St. Joseph Hospital Ambulatory Care Center, 1919 La Branch, Houston, TX 77002, telephone (713) 757-1000. Outpatient services only.

(iv) St. Mary's Hospital Ambulatory Care Center, 3600 Gates Boulevard, Port Arthur, TX 77640 (409) 985-7431. Outpatient services only.

(2)Inpatient and outpatient services.

(i) Wyman Park Health System, Inc., 3100 Wyman Park Drive, Baltimore, MD 21211, telephone (301) 338-3693.

(ii) Alston-Brighton Aid and Health Group, Inc., Brighton Marine Public Health Center, 77 Warren Street, Boston, MA 02135, telephone (617) 782-3400.

(iii) Bayley Seton Hospital, Bay Street and Vanderbilt Avenue, Staten Island, NY 10304, telephone (718) 390-5547 or 6007.

(iv) Pacific Medical Center, 1200 12th Avenue South, Seattle, WA 98144, telephone (206) 326-4100.

(3)Outpatient services only.

(i) Coastal Health Service, 331 Veranda Street, Portland, ME 04103, telephone (207) 774-5805.

(ii) Lutheran Medical Center, Downtown Health Care Services, 1313 Superior Avenue, Cleveland, OH 44113, telephone (216) 363-2065.

(l)Disability retirement or separation. Temporary or permanent retirement or separation for physical disability as provided in title 10, U.S.C., 1201-1221.

(m)Elective care. Medical, surgical, or dental care desired or requested by the individual or recommended by the physician or dentist which, in the opinion of other cognizant professional authority, can be performed at another place or time without jeopardizing life, limb, health, or well-being of the patient, e.g., surgery for cosmetic purposes and nonessential dental prosthetic appliances.

(n)Emergency care. Medical treatment of patients with severe, life-threatening, or potentially disabling conditions that require immediate intervention to prevent undue suffering or loss of life or limb and dental treatment of painful or acute conditions.

(o)Health benefits advisors (HBA). Designated individuals at naval facilities who are responsible for advising and assisting beneficiaries covered in this part concerning medica1 and dental benefits in uniformed services facilities and under CHAMPUS. They also provide information regarding Veterans' Administration, Medicare, MEDICAID, and such other local health programs known to be available to beneficiaries (see § 728.4(n)).

(p)Hospitalization. Inpatient care in a medical treatment facility.

(q)Inactive duty training. Duty prescribed for Reserves by the Secretary concerned under section 206 of title 37, U.S.C. or any other provision of law. Also includes special additional duties authorized for Reserves by an authority designated by the Secretary concerned and performed on a voluntary basis in connection with the prescribed training or maintenance activities of the units to which they are assigned. It includes those duties when performed by Reserves in their status as members of the National Guard.

(r)Legitimate care. Those medical and dental services under the cooperative/supplemental care program of CHAMPUS that are legally performed and not contrary to governing statutes.

(s)Maximum hospital benefit. That point during inpatient treatment when the patient's progress appears to have stabilized and it can be anticipated that additional hospitalization will not directly contribute to any further substantial recovery. A patient who will continue to improve slowly over a long period without specific therapy or medical supervision, or with only a moderate amount of treatment on an outpatient basis, may be considered as having attained maximum hospital benefit.

(t)Medical care. Treatment required to maintain or restore the health of an individual. Medical care may include, but is not limited to, the furnishing of inpatient treatment, outpatient treatment, nursing service, medical examinations, immunizations, drugs, subsistence, transportation, and other adjuncts such as prosthetic devices, spectacles, hearing aids, orthopedic footwear, and other medically indicated appliances or services.

(u)Medically inappropriate. A situation arising when denial of a Nonavailability Statement could result in significant risk to the health of a patient or significant limitation to the patient's reasonable access to needed health care.

(v)Medically necessary. The level of services and supplies (i.e., frequency, extent, and kinds) adequate for the diagnosis and treatment of illness or injury, including maternity care. Medically necessary, includes the concept of appropriate medical care.

(w)Medical treatment facility (MTF). Any duly authorized medical department center, hospital, clinic, or other facility that provides medical, surgical, or dental care.

(x)Member or former member. Includes:

(1) Members of the uniformed services ordered to active duty for more than 30 days.

(2) Retired members as defined in § 728.2(bb).

(3) Members of a uniformed service ordered to active duty for more than 30 days who died while on that duty.

(4) Deceased retired members.

(y)Military patient. A member of a United States uniformed service on active duty, active duty for training, or inactive duty training, or an active duty member of the armed forces of a foreign government who is receiving inpatient or outpatient care.

(z)Occupational health services. Includes medical examinations and tests related to preemployment, preplacement, periodic, and pretermination; tests required for protecting the health and safety of naval personnel; job-related immunizations and chemoprophylaxis; education and training related to occupational health; and other services provided to avoid lost time or to improve effectiveness of employees. The latter will include the furnishing of emergency treatment of illnesses or injuries occurring at work. Furnish such health services to both active duty military personnel and naval civilian employees per current directives.

(aa)Retired member. A member or former member of a uniformed service who is entitled to retired or retainer pay, or equivalent pay, as a result of service in a uniformed service. This includes a member or former member who is: (1) Retired for length of service; (2) permanently or temporarily retired for physical disability; (3) on the emergency officers' retired list and is entitled to retired pay for physical disability; or (4) otherwise in receipt of retired pay under chapter 67 of title 10.

(bb)Routine care. Medica1 and dental care necessary to maintain health or dental functions other than care of an emergency or elective nature.

(cc)Supplemental care or services. When medical or dental management is retained by a naval MTF and required care is not available at the facility retaining management, any additional material, professional diagnostic or consultative services, or other personal services ordered by qualified uniformed service providers, and obtained for the care of that patient are supplemental. See § 728.12 concerning the management of active duty member patients.

(dd)Uniformed services. The Navy, Marine Corps, Air Force, Army, Coast Guard, Commissioned Corps of the Public Health Service, and the Commissioned Corps of the National Oceanic and Atmospheric Administration.

(ee)USMTF. Uniformed services medical treatment facility.

(ff)Visit, outpatient. Appearance by an eligible beneficiary at a separate, organized clinic or specialty service for: Examination, diagnosis, treatment, evaluation, consultation, counseling, or medical advice; or treatment of an eligible beneficiary in quarters; and a signed and dated entry is made in the patient's health record. Specifically excluded are personnel in an inpatient status at the time of such a visit.

This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.

United States Code
U.S. Code: Title 10 - ARMED FORCES

§ 1071 - Purpose of this chapter

§ 1072 - Definitions

§ 1073 - Administration of this chapter

§ 1073a - Contracts for health care: best value contracting

§ 1073b - Recurring reports and publication of certain data

§ 1074 - Medical and dental care for members and certain former members

§ 1074a - Medical and dental care: members on duty other than active duty for a period of more than 30 days

§ 1074b - Medical and dental care: Academy cadets and midshipmen; members of, and designated applicants for membership in, Senior ROTC

§ 1074c - Medical care: authority to provide a wig

§ 1074d - Certain primary and preventive health care services

§ 1074e - Medical care: certain Reserves who served in Southwest Asia during the Persian Gulf Conflict

§ 1074f - Medical tracking system for members deployed overseas

§ 1074g - Pharmacy benefits program

§ 1074h - Medical and dental care: medal of honor recipients; dependents

§ 1074i - Reimbursement for certain travel expenses

§ 1074j - Sub-acute care program

§ 1074k - Long-term care insurance

§ 1074l - Notification to Congress of hospitalization of combat wounded members

§ 1074m - Mental health assessments for members of the armed forces deployed in support of a contingency operation

§ 1075 - TRICARE Select

§ 1076 - Medical and dental care for dependents: general rule

§ 1076a - TRICARE dental program

§ 1076b - Repealed. Pub. L. 109–364, div. A, title VII, § 706(d), Oct. 17, 2006, 120 Stat. 2282]

§ 1076c - Dental insurance plan: certain retirees and their surviving spouses and other dependents

§ 1076d - TRICARE program: TRICARE Reserve Select coverage for members of the Selected Reserve

§ 1076e - TRICARE program: TRICARE Retired Reserve coverage for certain members of the Retired Reserve who are qualified for a non-regular retirement but are not yet age 60

§ 1077 - Medical care for dependents: authorized care in facilities of uniformed services

§ 1078 - Medical and dental care for dependents: charges

§ 1078a - Continued health benefits coverage

§ 1078b - Provision of food to certain members and dependents not receiving inpatient care in military medical treatment facilities

§ 1079 - Contracts for medical care for spouses and children: plans

§ 1079a - TRICARE program: treatment of refunds and other amounts collected

§ 1079b - Procedures for charging fees for care provided to civilians; retention and use of fees collected

§ 1080 - Contracts for medical care for spouses and children: election of facilities

§ 1081 - Contracts for medical care for spouses and children: review and adjustment of payments

§ 1082 - Contracts for health care: advisory committees

§ 1083 - Contracts for medical care for spouses and children: additional hospitalization

§ 1084 - Determinations of dependency

§ 1085 - Medical and dental care from another executive department: reimbursement

§ 1086 - Contracts for health benefits for certain members, former members, and their dependents

§ 1086a - Certain former spouses: extension of period of eligibility for health benefits

§ 1086b - Prohibition against requiring retired members to receive health care solely through the Department of Defense

§ 1087 - Programing facilities for certain members, former members, and their dependents in construction projects of the uniformed services

§ 1088 - Air evacuation patients: furnished subsistence

§ 1089 - Defense of certain suits arising out of medical malpractice

§ 1090 - Identifying and treating drug and alcohol dependence

§ 1090a - Commanding officer and supervisor referrals of members for mental health evaluations

§ 1091 - Personal services contracts

§ 1092 - Studies and demonstration projects relating to delivery of health and medical care

§ 1092a - Persons entering the armed forces: baseline health data

§ 1093 - Performance of abortions: restrictions

§ 1094 - Licensure requirement for health-care professionals

§ 1094a - Continuing medical education requirements: system for monitoring physician compliance

§ 1095 - Health care services incurred on behalf of covered beneficiaries: collection from third-party payers

§ 1201 - Regulars and members on active duty for more than 30 days: retirement

§ 1202 - Regulars and members on active duty for more than 30 days: temporary disability retired list

§ 1203 - Regulars and members on active duty for more than 30 days: separation

§ 1204 - Members on active duty for 30 days or less or on inactive-duty training: retirement

§ 1205 - Members on active duty for 30 days or less: temporary disability retired list

§ 1206 - Members on active duty for 30 days or less or on inactive-duty training: separation

§ 1206a - Reserve component members unable to perform duties when ordered to active duty: disability system processing

§ 1207 - Disability from intentional misconduct or willful neglect: separation

§ 1207a - Members with over eight years of active service: eligibility for disability retirement for pre-existing conditions

§ 1208 - Computation of service

§ 1209 - Transfer to inactive status list instead of separation

§ 1210 - Members on temporary disability retired list: periodic physical examination; final determination of status

§ 1211 - Members on temporary disability retired list: return to active duty; promotion

§ 1212 - Disability severance pay

§ 1213 - Effect of separation on benefits and claims

§ 1214 - Right to full and fair hearing

§ 1214a - Members determined fit for duty in Physical Evaluation Board: prohibition on involuntary administrative separation or denial of reenlistment due to unsuitability based on medical conditions considered in evaluation

§ 1215 - Members other than Regulars: applicability of laws

§ 1216 - Secretaries: powers, functions, and duties

§ 1216a - Determinations of disability: requirements and limitations on determinations

§ 1217 - Academy cadets and midshipmen: applicability of chapter

§ 1218 - Discharge or release from active duty: claims for compensation, pension, or hospitalization

§ 1218a - Discharge or release from active duty: transition assistance for reserve component members injured while on active duty

§ 1219 - Statement of origin of disease or injury: limitations

§ 1220 - Repealed. Pub. L. 87–651, title I, § 107(d), Sept. 7, 1962, 76 Stat. 509]

§ 1221 - Effective date of retirement or placement of name on temporary disability retired list

§ 2104 - Advanced training; eligibility for

§ 2107 - Financial assistance program for specially selected members

§ 2109 - Practical military training

§ 2110 - Logistical support

§ 5031 - Office of the Chief of Naval Operations: function; composition

§ 5537 to 5539 - Repealed. Pub. L. 90–235, § 2(a)(3), Jan. 2, 1968, 81 Stat. 756]

§ 6011 - Navy Regulations

§ 6201 - Members of the naval service in other United States hospitals

§ 6202 - Insane members of the naval service

§ 6203 - Emergency medical treatment: reimbursement for expense

U.S. Code: Title 31 - MONEY AND FINANCE