32 CFR 728.77 - Secretarial designees.

§ 728.77 Secretarial designees.

Subject to the capabilities of the professional staff and the availability of space and facilities, naval MTFs and DTFs will provide treatment to individuals that have been granted Secretarial designee status by any of the three service Secretaries (Navy, Army, or Air Force), the Secretary of Commerce for NOAA personnel, the Secretary of Health and Human Services for USPHS personnel, or the Secretary of Transportation for Coast Guard personnel.

(a)Potential designees. Upon a showing of sufficient cause, the Secretary of the Navy may authorize individuals, not otherwise authorized by law, to receive such care as is available in naval MTFs in the United States. Designation may be extended on a worldwide basis for preadoptive children and wards of active duty members, and for abused dependents delineated in paragraph (a)(6) of this section. Temporary in loco parents or foster parent status of the member with regard to a minor is insufficient for approval. Also, civilian health care under the CHAMPUS program cannot be authorized for other than abused dependents. The Secretary's discretionary authority is exercised most conservatively, however, favorable action is usually taken on requests involving the following situations:

(1) Preadoption proceedings wherein an active duty member or a retired member has taken affirmative legal action to adopt a child.

(2) Custodianships and guardianships authorized by a court order wherein the member is designated by the court as the custodian or guardian and the child is fully dependent upon the active duty or retired member sponsor.

(3) Evaluation and selection of nonbeneficiaries who are donor candidates for an organ or tissue transplant procedure in behalf of a military service beneficiary.

(4) Nonbeneficiary participants in officially approved clinical research studies.

(5) Unremarried former spouses who: Require care for a condition incurred during or caused/aggravated by conditions associated with the member's or former member's creditable service; do not qualify under the former spouses act; and do not have medical coverage under an employer-sponsored health plan which will provide for the care required.

(6) Abused dependents of discharged or dismissed former uniformed services members in need of medical or dental care resulting from knowledge of the abuse or for an injury or illness resulting from abuse by the former member. Eligibility will terminate the earliest of 1 year after the date on which the member is discharged or dismissed from a uniformed service, or when care is no longer needed.

(7) In other instances wherein the circumstances clearly merit the providing of treatment in naval MTFs, and in which the best interest of the patient, the Navy, and the Government will be served, favorable Secretarial action may result. The mere need of medical care by a former beneficiary or other person, alone, will not support approval of such a request.

(b)Requests for consideration. Requests for consideration will be submitted to the Commander, Naval Medical Command (MEDCOM-33) by applicants via their command, when applicable, or by the Medical Department command concerned. Requests should include any pertinent information which will support resolution and a return address. Requests involving:

(1) Preadoption must include a legible reproducible copy of an interim court order or adoption agency placement agreement which names the sponsor and identifies the other participating parties. A petition for a court order is insufficient to support a recommendation for approval.

(2) Custodianships and guardianships must include a legible reproducible copy of the court order, identification of the parties, and also identify any amounts of income to which the ward is entitled.

(3) Participants in clinical research studies must include:

(i) Sufficient clinical information concerning the nature of the study.

(ii) Benefits which may accrue to the individual.

(iii) The extent, if any, to which access by other authorized beneficiaries will be impaired.

(iv) Benefits which will accrue to the command, e.g., enhancement of training, maximum use of specialized facilities, etc.

(v) Recommended duration of designation.

(vi) Whether the consenting individual has been informed concerning the nature of the study, its personal implications, and freely consents.

(4) Unremarried former spouses must include:

(i) A notarized copy of the marriage license.

(ii) A statement attesting to the fact that the sponsoring former spouse achieved 20 or more years of creditable military service.

(iii) Copy of divorce decree with official date.

(5) Abused depdendents must include:

(i) Full name, social security number, grade or rate, branch or service, and date and type of discharge or dismissal of the former member. Such a member must have received a dishonorable or bad-conduct discharge or dismissal from a uniformed service as a result of court-martial conviction for an offense involving abuse of a dependent of the member.

(ii) Full names, social security numbers (if assigned), and relationship to the former member of any dependent in need of medical or dental care to treat adverse health conditions resulting from such dependent's knowledge of the abuse or any injury or illness suffered by the abused person as a result of such abuse.

(c)Blanket designation.

(1) The Secretary of Defense has granted Secretarial designee status to full-time Schedule “A” faculty members of the Uniformed Services University of Health Sciences (USUHS). They have been provided documentation substantiating their eligibility and, where necessary, an eligibility termination date. These personnel are authorized routine care at the Naval Hospital, Bethesda, MD. At other naval MTFs, only emergency treatment is authorized while they are traveling on official university business. The letter of authorization excludes routine dental care, prosthetic appliances, and spectacles.

(2) The following officials within the Government, the Department of Defense, and military departments have been granted blanket Secretarial designation for medical and emergency dental care in naval MTFs in the United States:

(i) The President.

(ii) The Vice President.

(iii) Members of the Cabinet.

(iv) Article III Federal Judges.

(v) U.S. Court of Military Appeals Judges.

(vi) Members of Congress.

(vii) The Secretary, Deputy Secretary, and the Assistant Secretaries of Defense.

(viii) The Under Secretary of Defense for Policy.

(ix) The Under Secretary of Defense for Research and Engineering.

(x) The Secretaries, Under Secretaries, and the Assistant Secretaries of the Military Departments.

(d)Authorization. Designees will present a signed letter bearing the letterhead of the designating service. Secretarial designees are not included in the DEERS data base and may not possess Government identification cards. Therefore, the only proof of their eligibility for treatment may be the letter of authorization. When a Secretarial designee presents for treatment:

(1) Ask for identification of the individual presenting the letter of authorization to assure that the person seeking care is the individual to whom the letter was issued.

(2) Check the expiration date on the letter of authorization. Many authorizations are issued for only a specified period of time, e.g., abused dependents - no longer than 1 year.

(3) Check to assure that the individual is applying for care authorized by the letter of authorization. Designation is often granted for a specific diagnosis or specific mode of treatment.

(4) Check to assure that the individual has not been designated for care only as specific facility. Many authorizations are granted for conditions or for care that can be rendered only by a specified physician or under a specific program.

(5) Place a copy of the letter of authorization in the individual's Health Record or outpatient treatment record on the left side at the first visit or admission.

(e)Charges and collection.

(1) Interagency rates are applicable for inpatient and outpatient care provided outside the National Capital Region to all individuals listed in paragraph (c)(2) of this section with the exception of Members of Congress. Charges are at full reimbursement rates for Members of Congress provided inpatient or outpatient care outside the National Capital Region.

(2) In the National Capital Region:

(i) Charges are waived for outpatient care provided to all categories listed in paragraph (c)(2) of this section.

(ii) Charge interagency rates for inpatient care of all individual in paragraph (c)(2) of this section except Members of Congress. Charge Members of Congress at full reimbursement rates.

(3) Complete and submit, per subpart J, a DD 7 (Report of Treatment Furnished Pay Patients, Hospitalization Furnished, part A) or DD 7A (Report of Treatment Furnished Pay Patients, Outpatient Treatment, part B) when outpatient or inpatient care is rendered to Secretarial designees whose charges for care have not been waived.

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