Attachment_J-8,_Special_Payment_Conditions.docx

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Attached to
TRICARE Overseas Program (TOP) 2021 Solicitation - HT940219R0001 Federal contract opportunity
Solicitation number
HT9402-19-R-0001
Issued by
Defense Health Agency

About this file

This solicitation requests proposals for the TRICARE Overseas Program (TOP) 2021 contract. The Defense Health Agency seeks an indefinite delivery/indefinite quantity contract to provide a range of administrative health care support services to TRICARE-eligible beneficiaries residing outside the United States and District of Columbia. Required services include developing provider networks, referral management, eligibility verification, medical evacuations, records translation, customer service/call center support, beneficiary/provider education, marketing, and claims processing. The period of performance comprises a one-year transition period followed by seven one-year option periods, with a potential six-month extension, for a total allowable term of eight years and six months. Proposals are due by October 31, 2019. Interested parties should monitor the Federal Business Opportunities website for solicitation updates and amendments.

Section J, Attachment J-8, Special Payment Conditions

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Section J Attachment J-8 Special Payment Conditions – Administrative Charges that are Attendant to the Delivery of Healthcare

Due to cultural differences in the delivery of health care overseas, health care providers and facilities in certain overseas locations may request reimbursement of administrative charges billed separately on claims. In accordance with TPM Chapter 12, Section 1.1, paragraph 3.3, such charges may be payable under TRICARE if they are attendant to the delivery of health care and they are determined to be reasonable and customary for a particular overseas location. This attachment identifies those countries where administrative charges billed separately on claims may be payable (subject to the conditions of TPM Chapter 12, Section 1.1). The TOP Contractor shall notify the Government if separately-billed administrative charges are claimed by providers or facilities in other countries.

Countries where administrative charges billed separately on claims may be payable:

Germany

Japan

Indonesia

Republic of Korea

HT940219R0001 Page 1 of 1

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