FM BUMED FALLS CHURCH, VA//M09B1// TO SECDEF WASHINGTON DC//USDP/DSAAA// USDAO BEIRUT LE//JJJ// HQ USAF BOLLING AFB DC//SGHC//

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1 FM BUMED FALLS CHURCH, VA//M09B1// TO SECDEF WASHINGTON DC//USDP/DSAAA// USDAO BEIRUT LE//JJJ// HQ USAF BOLLING AFB DC//SGHC// AFSVA RANDOLPH AFB TX//SVPM// NAVCONTDEP HONG KONG HK//JJJ// CDRPERSCOM ALEXANDRIA VA//TAPX-PED// AFOSI DIST 19 TRAVIS AFB CA//JJJ//HQ USAFE RAMSTEIN AB GE//SVXM// USAF GCCS STA LAJES FLD PO//JJJ// COMDT COGARD WASHINGTON DC//JJJ// NSF REP NEW ZEALAND CHRISTCHURCH NZ//JJJ// DFAS CENTER CLEVELAND OH//JJJ// DFAS OPLOC ROME NY//JJJ// AIG 7783 AIG 6947 CINCUSNAVEUR EAM CELL NAPLES IT//JJJ// NAVREGCONTCEN NAPLES IT//JJJ// USDAO ABIDJAN IV//JJJ// USDAO ABU DHABI TC//JJJ// USDAO ADDIS ABABA ET//JJJ// USDAO AIROPS RIYADH SA//JJJ// USDAO ALGIERS AG//JJJ// USDAO ALMATY KZ//JJJ// USDAO AMMAN JO//JJJ// USDAO ANKARA TU//JJJ//

2 USDAO ANTANANARIVO MA//JJJ// USDAO ASHGABAT TX//JJJ// USDAO ASUNCION PA//JJJ// USDAO ATHENS GR//JJJ// USDAO BAKU AJ//JJJ// USDAO BANGKOK TH//JJJ// USDAO BEIJING CH//JJJ// USDAO BEIRUT LE//JJJ// USDAO BELGRADE YO//JJJ// USDAO BERLIN GE//JJJ// USDAO BERN SZ//JJJ// USDAO BOGOTA CO//JJJ// USDAO BR OFC RIO DE JANEIRO BR//JJJ// USDAO BRASILIA BR//JJJ// USDAO BRATISLAVA LO//JJJ// USDAO BRAZZAVILLE CF//JJJ// USDAO BRIDGETOWN BB//JJJ// USDAO BRUSSELS BE//JJJ// USDAO BUCHAREST RO//JJJ// USDAO BUDAPEST HU//JJJ// USDAO BUENOS AIRES AR//JJJ// USDAO CAIRO EG//JJJ// USDAO CANBERRA ACT AS//JJJ// USDAO CARACAS VE//JJJ// USDAO CHISINAU MD//JJJ//

3 USDAO COLOMBO CE//JJJ// USDAO COPENHAGEN DA//JJJ// USDAO DAKAR SG//JJJ// USDAO DAMASCUS SY//JJJ// USDAO DHAKA BG//JJJ// USDAO DOHA QA//JJJ// USDAO DUBLIN EI//JJJ// USDAO GABORONE BC//JJJ// USDAO GUATEMALA CITY GT//JJJ// USDAO HANOI VM//JJJ// USDAO HARARE ZI//JJJ// USDAO HELSINKI FI//JJJ// USDAO HONG KONG HK//JJJ// USDAO ISLAMABAD PK//JJJ// USDAO JAKARTA ID//JJJ// USDAO KIEV UP//JJJ// USDAO KINGSTON JM//JJJ// USDAO KINSHASA CG//JJJ// USDAO KUALA LUMPUR MY//JJJ// USDAO LA PAZ BL//JJJ// USDAO LAGOS NI//JJJ// USDAO LIMA PE//JJJ// USDAO LISBON PO//JJJ// USDAO LJUBLJANA SI//JJJ// USDAO LONDON UK//JJJ//

4 USDAO LUANDA AO//JJJ// USDAO LUSAKA ZA//JJJ// USDAO MADRID SP//JJJ// USDAO MANAGUA NU//JJJ// USDAO MANILA RP//JJJ// USDAO MAPUTO MZ//JJJ// USDAO MEXICO CITY MX//JJJ// USDAO MINSK BO//JJJ// USDAO MONROVIA LI//JJJ// USDAO MOSCOW RS//JJJ// USDAO MUSCAT MU//JJJ// USDAO NAIROBI KE//JJJ// USDAO NDJAMENA CD//JJJ// USDAO NEW DELHI IN//JJJ// USDAO NICOSIA CY//JJJ// USDAO OSLO NO//JJJ// USDAO OTTAWA ON CAN//JJJ// USDAO PANAMA CITY PM//JJJ// USDAO PARAMARIBO NS//JJJ// USDAO PARIS FR//JJJ// USDAO PHNOM PENH CB//JJJ// USDAO PORT AU PRINCE HA//JJJ// USDAO PRAGUE EZ//JJJ// USDAO PRETORIA SF//JJJ// USDAO QUITO EC//JJJ//

5 USDAO RABAT MO//JJJ// USDAO RANGOON BM//JJJ// USDAO RIGA LG//JJJ// USDAO RIO DE JANEIRO BR//JJJ// USDAO RIYADH SA//JJJ// USDAO SAN JOSE CS//JJJ// USDAO SAN SALVADOR ES//JJJ// USDAO SANAA YM//JJJ// USDAO SANTIAGO CI//JJJ// USDAO SANTO DOMINGO DR//JJJ// USDAO SARAJEVO BK//JJJ// USDAO SEOUL KOR//JJJ// USDAO SINGAPORE SN//JJJ// USDAO SKOPJE MK//JJJ// USDAO SOFIA BU//JJJ// USDAO STOCKHOLM SW//JJJ// USDAO SUVA FJ//JJJ// USDAO TALLINN EN//JJJ// USDAO TASHKENT UZ//JJJ// USDAO TBILISI GG//JJJ// USDAO TEGUCIGALPA HO//JJJ// USDAO TEL AVIV IS//JJJ// USDAO THE HAGUE NL//JJJ// USDAO TIRANA AL//JJJ// USDAO TOKYO JA//JJJ//

6 USDAO TUNIS TS//JJJ// USDAO TUZLA AB BH//JJJ// USDAO ULAANBAATAR MG//JJJ// USDAO VIENNA AU//JJJ// USDAO VILNIUS LH//JJJ// USDAO WARSAW PL//JJJ// USDAO WELLINGTON NZ//JJJ// USDAO WINDHOEK WA//JJJ// USDAO YAOUNDE CM//JJJ// USDAO YEREVAN AM//JJJ// USDAO ZAGREB HR//JJJ// SECOND MARDIV BT//JJJ// UNCLAS //N00000// MSGID/GENADMIN/M8// SUBJ/FY 18 BUMED ENTERPRISE ALLOTMENT ACCOUNT (EAA) FOR PATIENT TRAVEL// REF/A/DOC/NAVSO P-1000/YMD: /NOTAL// REF/B/DOC/JTR/YMD: // REF/C/DOC/DOD FMR R VOL 3 CH 11/YMD: // REF/D/DOC /TRICARE OVERSEAS PROGRAM HANDBOOK/YM:201705// REF/E/DOC/TRICARE PRIME AND PRIME REMOTE HANDBOOK/YM:201508// NARR/REF A SETS DON FUNDING POLICY AND RESPONSIBILITY FOR ACTIVE DUTY TAD TRAVEL. REF B CONTAINS GUIDANCE FOR TRICARE PRIME TRAVEL BENEFIT AND MEDICAL TRAVEL FOR OCONUS SPONSORED FAMILY MEMBERS. REF C CONTAINS GUIDANCE ON UNSUPPORTED EXPENDITURES. REF D CONTAINS GUIDANCE FOR TRICARE OVERSEAS PROGRAM. REF E CONTAINS GUIDANCE FOR TRICARE PRIME AND PRIME REMOTE. ALL COMMANDS AND MEDICAL PROFESSIONALS ARE HIGHLY ENCOURAGED TO VISIT WEBSITES IDENTIFIED WITHIN THE REFERENCES TO OBTAIN PERTINENT PROGRAM INFORMATION RELATING TO PROGRAM ELIGIBILITY, OVERSIGHT RESPONSIBILITIES, COVERAGE AREAS, AND PROCEDURES FOR ACCESSING CARE UNDER THE TRICARE OVERSEAS PROGRAM TOP.//

7 POC/SAMUEL FONTANEZ-BERRIOS/CIV/M841/LOC:FALLS CHURCH, VA/TEL:COM // /TEL:DSN : / SAMUEL.FONTANEZ-BERRIOS.CIV AT MAIL.MIL// POC/WANDA FORD /CIV/M841/LOC:FALLS CHURCH, VA/TEL:COM // /TEL:DSN : / WANDA.F.FORD.CIV AT MAIL.MIL// POC/MENDEZ/MR/M3B1/LOC:FALLS CHURCH, VA/TEL:COM // / BRYCE.H.MENDEZ.CIV AT MAIL.MIL// PURPOSE: TO OUTLINE GUIDANCE REGARDING INPATIENT TRAVEL. RMKS/1. INPATIENT TRAVEL. FOR USE WHEN TRAVELING FROM ONE MEDICAL FACILITY TO ANOTHER FACILITY AS AN INPATIENT. THIS DOES NOT INCLUDE TRAVEL AS AN OUTPATIENT TO A MEDICAL FACILITY FOR INPATIENT ADMISSION. THE LINE OF ACCOUNTING (LOA) PROVIDED WILL BE LIMITED TO NAVY & MARINE CORPS ACTIVE DUTY PATIENTS AND THEIR AUTHORIZED NONMEDICAL ATTENDANTS (NMA) WITHIN CONUS, AND FOR NAVY AND MARINE CORPS ACTIVE DUTY PATIENTS, SPONSORED FAMILY MEMBERS, AND NMA FOR OCONUS INPATIENT TRAVEL. ONLY ONE NMA WILL BE FUNDED TO ACCOMPANY CONUS AND/OR OCONUS INPATIENT TRAVEL. NMA WILL NOT BE A MINOR CHILD. AUTHORITY TO CHARGE THE LOA IS LIMITED TO ARMY AND AIR FORCE MTFS AND NAVY AUTHORIZED ORDER-WRITING ACTIVITIES IN SUPPORT OF THE ABOVE PATIENTS AND NMA FOR INPATIENT TRAVEL. EACH PATIENT AND NMA WILL BE PROVIDED A SEPARATE STANDARD DOCUMENT NUMBER AND LOA SPECIFIC TO THE INDIVIDUAL S REQUEST. UPON ISSUANCE, THE LOA IS TO BE CITED EXACTLY AS PROVIDED. NMA MUST LODGE IN GOVERNMENT FACILITIES. NON-AVAILABILITY STATEMENTS FOR EACH LODGING FACILITY LISTED ON THE MEMO TO REQUEST TRAVEL ARE REQUIRED IF GOVERNMENT LODGING IS NOT AVAILABLE. TO REQUEST A LOA, EACH ACTIVITY SHOULD CONTACT BUMED M841 STAFF VIA AT USN.NCR.BUMEDFCHVA.LIST.BUMED-EAA AT MAIL.MIL WITH THE SPECIFICS, DOCUMENTING THE NEED FOR INPATIENT CARE AND/OR NMA COVERAGE. THE SHOULD PROVIDE THE INPATIENT S AND NMA S NAME, RANK, THE NAME OF THE TRANSFERRING AND RECEIVING HEALTH CARE FACILITIES, AN ESTIMATED COST FOR THE INPATIENT AND NMA (REQUIRED), THE PROPOSED DATES OF TRAVEL. THE MEMBER AND NMA MUST FIRST BE ENTERED IN DTS BEFORE A LOA IS PROVIDED. A REQUEST TO CROSS ORG ACCOUNTING INFORMATION VIA DTS WILL REQUIRE THE MEMBERS NAME, RANK AND FULL SSN. DEPENDANTS (INFANTS) WITHOUT A SSN MUST BE PROVIDED WITH A SEPARATE IDENTIFICATON NUMBER IN DTS IN THE FORM OF A SSN (NO DUPLICATES). PLEASE REFER TO THE DATA SHEET FOR CROSS- ORGANIZATIONAL LOA IN SUPPORT OF INPATIENT TRAVEL AND THE TRAVEL MISSION CRITICALITY ATTESTATION FORMS. THE NAVY MEDICINE TRAVEL MISSION CRITICALITY ATTESTATION FORM MUST BE SIGNED AND SUBMITTED BY THE PROVIDERS COMMAND AUTHORITY AND INCLUDED IN THE TRAVEL REQUEST PACKAGE. A STATEMENT FROM THE MTF'S DIRECTOR OF ADMINISTRATION MUST ACCOMPANY A NMA'S REQUEST TO TRAVEL. CIVILIAN NMA'S MUST FILL OUT AND SUBMIT AN INVITATIONAL TRAVEL ORDER (ITO) STATEMENT. A LOA WILL NOT BE PROCESSED WITHOUT SUBMITTAL OF THESE REQUESTS. DUE TO AUDIT REQUIREMENTS, BUMED WILL APPROVE ALL DTS AUTHORIZATIONS AND VOUCHERS. A COPY OF THE INPATIENT S DEERS PRINT SCREEN IS REQUIRED FOR ELIGIBILITY PURPOSES. INPATIENT SPECIAL ACCOMMODATIONS TO ACCOMMADATE INJURIES SHOULD BE ARRANGED VIA AN AMC FLIGHT. GOVCC EXPIRATION DATES AND ACTIVATIONS MUST BE CHECKED PRIOR TO REQUEST SUBMISSION.

8 2. UTILIZE ENCRYPTED FOR ALL CORRESPONDENCE THAT INCLUDES PERSONALLY IDENTIFIABLE INFORMATION (PII). ALL PII INFORMATION MUST BE BLACKENED OUT BEFORE ATTACHING TO THE DTS AUTHORIZATION/VOUCHER. 3. IN THE EVENT TIME DOES NOT PERMIT THE ACTIVITY TO SUBMIT A WRITTEN REQUEST TO THE BUMED M841 STAFF, THE ACTIVITY IS RESPONSIBLE FOR PROVIDING THEIR OWN ACCOUNTING LINE TO REDUCE ANY DELAYS. THE ACTIVITY WILL CONTACT THE BUMED M841 STAFF VIA AND FOLLOW THE GUIDELINES AS OUTLINED IN PARAGRAPH 2. BUMED M841 STAFF WILL PROVIDE A LOA. THE ACTIVITY WILL THEN BE RESPONSIBLE TO COMPLETE A MODIFICATION OF THE ORDERS PREVIOUSLY PROCESSED CITING THE LOA PROVIDED BY THE BUMED M841 STAFF. ALL TRAVEL LIQUIDATIONS SHOULD BE SUBMITTED USING THE LOA PROVIDED BY THE BUMED M841 STAFF. THE ACTIVITY IS RESPONSIBLE FOR ADHERANCE TO THESE PROVISIONS/GUIDELINES TO ENSURE BUMED LOA AUTHORIZATION. TRAVEL IS CONSIDERED EMERGENT WITHIN A 24 HOUR TIMEFRAME. 4. OUTPATIENT TRAVEL. PARENT COMMAND HAS FUNDING RESPONSIBILITY FOR ALL OUTPATIENT TRAVEL FOR NAVY ACTIVE DUTY MEMBERS AND SPONSORED FAMILY MEMBERS OCONUS. THE LOA PROVIDED FOR INPATIENT CARE IS NOT TO BE USED FOR OUTPATIENT TRAVEL. UPON THE DISCHARGE OF THE INPATIENT TO OUTPATIENT STATUS THE PARENT COMMAND IS RESPONSIBLE FOR THE RETURN TO THE ORIGINAL DESTINATION FOR THE INPATIENT AND THE NMA. FOR NAVY AND MARINE CORPS ACTIVE DUTY PATIENTS, THE SPONSORING COMMAND MUST ENSURE THAT FUNDING IS AVAILABLE TO MEET THE MEMBER S NEEDS WHEN THE STATUS CHANGES FROM INPATIENT TO OUTPATIENT, INCLUDING RETURN TRAVEL, PER DIEM, MISC COSTS, ETC. FOR MILITARY MEMBER S ON ORDERS TO JOINT COMMANDS OR JOINT HEADQUARTERS, THE MEMBER S SERVICE ADMINISTRATIVE COMPONENT IS RESPONSIBLE IN INSTANCES THAT THE MILITARY MEMBER REQUIRES OUTPATIENT TRAVEL. 5. BECAUSE OF THE MULTIPLE REFERENCES AND OVERLAPPING GUIDANCE AFFECTING PATIENT TRAVEL IN GENERAL, THE MATRIX BELOW IS PROVIDED TO CLARIFY TRAVEL BENEFITS AND ASSOCIATED FUNDING RESPONSIBILITY FOR NAVY ACTIVE DUTY PATIENTS AND SPONSORED FAMILY MEMBERS. THESE NAVY ACTIVE DUTY PATIENTS AND SPONSORED FAMILY MEMBERS MUST BE ON OFFICIAL TRAVEL ORDERS. THE BUMED M841 OFFICE DOES NOT COVER OTHER CATEGORIES OF PATIENTS SUCH AS RETIREES, FAMILY MEMBERS OF RETIREES, OR CIVILIAN EMPLOYEES OF THE GOVERNMENT.

9 CIRCUMSTANCE FUNDING RESPONSIBILTY A. NAVY ACTIVE DUTY INPATIENT BUMED TRAVEL LOA; FUNDED BY M841 OFFICE CONUS MTF TO MTF B. NAVY ACTIVE DUTY INPATIENT BUMED TRAVEL LOA; FUNDED BY M841 OFFICE FROM OCONUS MTF TO MTF C. NAVY ACTIVE DUTY OUTPATIENT FUNDED BY PARENT COMMAND TRAVEL, CONUS (REF A, ) D. NAVY ACTIVE DUTY OUTPATIENT FUNDED BY PARENT COMMAND TRAVEL, OCONUS (REF A, ) E. SPONSORED FAMILY MEMBER SEE REGIONAL TRICARE REPRESENTATIVE INPATIENT TRAVEL, CONUS, AND ENROLLED IN TRICARE PRIME F. SPONSORED FAMILY MEMBER FUNDED BY PARENT COMMAND OUTPATIENT TRAVEL, (REF B, U033101) OCONUS, INCLUDING NON-MEDICAL ATTENDANT (NMA) TRAVEL G. SPONSORED FAMILY MEMBER MTF FUNDED IF PRIME MTF OUTPATIENT TRAVEL FOR SEE REGIONAL TRICARE REPRESENTATIVE (REF B, U033007) REFERRED SPECIALTY IF PRIME NETWORK OR REMOTE CARE, PRIME ENROLLEE WITHIN CONUS, AND MEETS PROGRAM CRITERIA H. NAVY ACTIVE DUTY OR FAMILY BUMED TRAVEL LOA; FUNDED BY M841 OFFICE MEMBER SERVING AS A NON- MEDICAL ATTENDANT (NMA) FOR AN OCONUS INPATIENT TRANSFER I. NAVY ACTIVE DUTY OR FAMILY MTF FUNDED IF PRIME MTF MEMBER SERVING AS NMA SEE REGIONAL TRICARE REPRESENTATIVE (REF B, U033007) FOR A TRICARE IF PRIME NETWORK OR REMOTE PRIME TRAVEL BENEFIT PATIENT

10 TRAVELING WITHIN CONUS AND MEETS PROGRAM CRITERIA J. NAVY ACTIVE DUTY OR FAMILY BUMED TRAVEL LOA; FUNDED BY M841 OFFICE MEMBER SERVING AS NMA FOR A CONUS MTF TO MTF INPATIENT TRANSFER OF ACTIVE DUTY PATIENT K. NAVY ACTIVE DUTY INPATIENT FROM SEE REGIONAL TRICARE REPRESENTATIVE SHIP TO MTF IF AIR AMBULANCE TRANSFER, OTHERWISE BUMED TRAVEL LOA; FUNDED BY M841 OFFICE L. ACTIVE DUTY INPATIENT BUMED TRAVEL LOA; FUNDED BY M841 OFFICE TRANSFERRING TO A PRIVATE SECTOR OR VA FACILITY CONUS (REF B, U033006) M. ACTIVE DUTY INPATIENT BUMED TRAVEL LOA; FUNDED BY M841 OFFICE TRANSFERRING TO A PRIVATE SECTOR CARE FACILITY OCONUS (REF B, U033006) N. ACTIVE DUTY INPATIENT FROM A FUNDED BY PARENT COMMAND/SERVICE BRANCH SERVICE BRANCH OTHER THAN NAVY AND MARINE CORPS IN A NAVY MTF O. FOR ALL OTHER CIRCUMSTANCES OF NMA TRAVEL, PARENT COMMAND HAS DISCRETIONARY AUTHORITY TO AUTHORIZE FUNDING, I.E., NMA TRAVEL NOT COVERED UNDER PRIME BENEFIT, ETC. 6. COPIES OF THE LIQUIDATION FOR INPATIENT AND OUTPATIENT TRAVEL VOUCHERS MUST BE RECEIVED VIA BY BUMED WITHIN FIVE (5) DAYS AFTER TRAVEL. FAILURE TO PROVIDE A LIQUIDATION CLAIM WITHIN THE ALLOTED TIME WILL WARRANT CONTACT WITH THE TRAVELER S EXECUTIVE OFFICER. FAILURE TO PROVIDE SUPPORTING DOCUMENTATION WILL RESULT IN REVERSION OF CHARGES IN ACCORDANCE WITH REF (C) AND ARTICLE 92 OF THE UCMJ FOR NON COMPLIANCE. 7. ALL INPATIENT REQUESTS SHOULD BE ED TO SAMUEL.FONTANEZ- BERRIOS.CIV AT MAIL.MIL, WANDA.F.FORD.CIV AT MAIL.MIL,, AND USN.NCR.BUMEDFCHVA.LIST.BUMED- EAA AT MAIL.MIL. 8. PRIMARY POC INFO IS: SAMUEL FONTANEZ-BERRIOS, DSN: , COMM:(703) , SAMUEL.FONTANEZ-BERRIOS.CIV AT MAIL.MIL; WANDA FORD, DSN: , COMM:(703) , WANDA.F.FORD.CIV AT MAIL.MIL, SHAMEKA LEE, DSN: , COMM:(703) , SHAMEKA.L.LEE2.CIV AT MAIL.MIL; TONY MEJIAS MIRANDA, DSN: , COMM:(703) , TONY.A.MEJIASMIRANDA.CIV "AT" MAIL.MIL.; JACK ANGLO, DSN: , COMM: (703) , JACK-RYAN.A.ANGLO.CIV "AT" MAIL.MIL

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