For TRICARE providers
Federal Law (5 U.S.C. 5536) prohibits medical personnel, who are Active Duty Service Members (ADSM) or civilian employees of the
government, compensation above their normal pay and allowances for medical care rendered. This prohibition applies to TRICARE
benefits whether the claim for reimbursement is filed by the individual who provided the care, the facility in which the care was
rendered, or by the sponsor/beneficiary. Claims for TRICARE benefits will be denied in any situation where either a uniform member
or civilian employee of the uniform services has the opportunity to exert, directly or indirectly, any influence on the referral of TRICARE
beneficiaries to one or more providers on a selective basis.
Please continue to notify us of any changes related to your provider file information (name, address, specialty, tax number, group
affiliations, etc.).
TRICARE policy(32 CFR 199.6) states that individual health care professionals who are allowed to render health care services only under direct and ongoing supervision as training to be credited towards earning a clinical academic degree or other clinical credential required for the individual to practice independently are excluded from TRICARE participation for the duration of such training.
Providers employed or under a contract which provides for payment to the individual professional provider by an institutional provider cannot be considered. Employees reimbursed by the hospital/institution are not eligible for separate reimbursement outside the realm of the hospital.
