The Federal Medical Care Recovery Act allows the government to be reimbursed for costs associated with treating a TRICARE beneficiary who has been injured in an accident caused by someone else. When a claim appears to have possible third-party involvement, certain actions must be taken that can affect total processing time.

Knowing the third-party liability process can help you take steps to ensure more timely payment of such claims.

All potential third-party recovery claims will be identified and investigated by Humana Military. Any inpatient claims with diagnosis code 800-999, regardless of dollar value, or any outpatient claim with diagnosis code 800-999 that exceeds TRICARE liability of $500, will be considered a potential third-party liability claim.

These claims will not be processed until the beneficiary completes and submits a Statement of Personal Injury—Possible Third-Party Liability Form (DD Form 2527). You can also find this form online at the TRICARE Web site.

Please inform the beneficiary that the DD Form 2527 must be completed, signed and submitted within 35 calendar days, or the claim will be denied.

If the illness or injury was not caused by a third party but the diagnosis code still falls within 800–999, the beneficiary may still be responsible for filling out the DD Form 2527.

The seven-year partnership between the National Cancer Institute (NCI) and the Department of Defense (DoD) gives TRICARE beneficiaries more options for cancer care and access to the latest advances in cancer treatment. Through the DoD/NCI Cancer Clinical Trials Demonstration Project, TRICARE beneficiaries can participate in phase II and phase III NCI-sponsored trials.

Phase II trials focus on and study a particular type of cancer and provide information on a particular treatment. A phase III trial compares a new agent or treatment, or the new use of a standard treatment, with a current standard therapy.

By providing the opportunity for your patients to enroll in an NCI-sponsored cancer clinical trial, you are giving them access to the latest and most promising advances in cancer research.

No patients receive placebos or go without treatment when there is a standard cancer therapy available.

More than 2,000 health care facilities around the country, including military hospitals, participate in NCI-sponsored clinical trials. The costs of screening tests to determine trial eligibility, and the cost of taking part in the trial are covered under the agreement between the DoD and NCI.

To learn more about NCI/DoD cancer clinical trials, visit the National Cancer Institute Web site for the latest news in cancer research and general information on clinical trials.