HT0011-20-R-0043 HFAS PWS Attachment 2a - Implementation Guidance Memo for DHA PM CQM in the MHS - Vols 1-7.pdf

DEFENSE HEALTH AGENCY

7700 ARLINGTON BOULEVARD, SUITE 5101

FALLS CHURCH, VIRGINIA 22042-5101

MEMORANDUM FOR ASSISTANT SECRETARY OF THE ARMY (MANPOWER AND

RESERVE AFFAIRS)

ASSISTANT SECRETARY OF THE NAVY (MANPOWER AND

RESERVE AFFAIRS)

ASSISTANT SECRETARY OF THE AIR FORCE (MANPOWER

AND RESERVE AFFAIRS)

SUBJECT: Implementation Guidance for Defense Health Agency Procedures Manual, “Clinical Quality Management in the Military Health System,” Volumes 1-7

In accordance with the Office of the Under Secretary of Defense, Personnel and Readiness (USD(P&R)) Memorandum, “Strengthening Clinical Quality Management in the Military Health System,” dated April 1, 2019 (attached), which directed “actions to strengthen accountability, transparency, and standardization,” this Defense Health Agency Procedures Manual (DHA-PM) establishes clinical quality management procedures that are applicable across the entire Military Health System (MHS).

Pursuant to the Department of Defense (DoD) guidance, the transition of the administration and management of military medical treatment facilities (MTFs) from the Military Departments to the DHA will be done in a phased approach, with full transition occurring no later than September 30, 2021. DHA-PM 6025.13, Volumes 1-7, are written to accommodate when all MTFs are under the authority, direction and control of the DHA, but transition practicalities, particularly with regard to responsibilities, may be reflected within this manual as well, as authorized by the April 1, 2019 USD(P&R) memo cited above. During the phased transition, memoranda of agreement or understanding and other guidance will direct how the Military Departments will implement and support execution of the guidance in this DHA-

PM.

To effectively implement this DHA-PM during the course of the broader transition effort underway, the following guidance is provided:

• The effective date of this DHA-PM is October 1, 2019. All CQM activities initiated prior to October 1, 2019 shall be processed in accordance with the Military Department policy in effect at the time the action was initiated. All CQM activities initiated on or after October 1, 2019 will be processed in accordance with this DHA-PM. For medical tort claims, active duty disability cases, and active duty death cases, the date of payment shall be used as the date upon which to determine when the CQM activity was initiated. A clinical adverse action will be considered to be initiated when one of the following occurs: the provider is limited in or removed from patient care, notice has been given of a summary suspension, or similar initiation of an action.

• This DHA-PM applies to clinical quality management in the MHS. To the extent the

Military Departments retain authority for provision of care, the procedures contained in this DHA-PM apply.

• During this transition period, the Military Departments will be responsible for the implementation, application, and execution of this DHA-PM in MTFs that are under their authority, direction, and control. This includes, but is not limited to, CQM activities such as credentialing and privileging, and reporting providers to the National Practitioner Data Bank, states of licensure, and other applicable certifying or regulatory agencies in accordance with this DHA-PM. For example, if an MTF has not transitioned to the authority, direction, and control of the DHA, the Military Departments, vice the Director, DHA, would be responsible for reporting a final clinical adverse action after following the procedures contained in this DHA-PM.

• To the extent this DHA-PM refers to an MTF Director undertaking a certain activity, that reference includes MTF Commanders or Directors during the transition period. To the extent this DHA-PM refers to processes and procedures not explicitly outlined in this DHA-PM, the Military Departments shall utilize applicable or referenced DHA Publications or, in the absence of applicable DHA Publications, continue to utilize existing Military Department policies until such time as they are superseded by an applicable DHA Publication. For example, references in this DHA-PM to Off-Duty Employment (ODE) should be interpreted and applied in accordance with existing Military Department guidance on ODE until such time as the DHA issues a publication on ODE that would supersede existing Military Department guidance. Published DHA Publications can be found at: http://www.health.mil/dhapublications.

• For any matters related to implementation and execution of this DHA-PM during the transition period, the Military Departments may request a waiver from a specific requirement if necessary for operational readiness or due to transition practicalities. As provided for in Volume 1, such waivers will be evaluated by the Director on a case-by-case basis.

The intent of this guidance is to ensure an orderly and seamless transition of the administration and management of MTFs from the Military Departments to the DHA in a way that will ensure no lapses in quality of care or patient safety.

http://www.health.mil/dhapublications

Attachments:

As stated cc:

Assistant Secretary of Defense for Health Affairs Surgeon General of the Army Surgeon General of the Navy Surgeon General of the Air Force Joint Staff Surgeon