Small DOHA Seal TRICARE/CHAMPUS  

     Medical and dental care within the Department of Defense is authorized by Chapter 55 of title 10 United States Code, section 1071 through section 1106. The "Civilian Health and Medical Program of the Uniform Services," or CHAMPUS, is defined by title 10 United States Code, section 1071(4) as the program authorized under sections 1079 and 1086, including contracts under sections 1091 or 1097 and demonstration projects under section 1092. CHAMPUS is administered by an office formerly known as the Office of CHAMPUS (OCHAMPUS) pursuant to the
CHAMPUS Regulation (DoD 6010.8-R), title 32 Code of Federal Regulations, Part 199.

     Chapter 17 of the CHAMPUS Regulation (title 32 Code of Federal Regulations, section 199.17) authorizes a DoD-managed healthcare program called TRICARE. The TRICARE Support Office (TSO) is the successor of OCHAMPUS, which has been disestablished by DoD Directive 5105.46, July 31, 1997. The Directive states that the mission of the TSO is to provide operational support for the Uniformed Services in the management and administration of the TRICARE program; administer CHAMPUS; and serve as the primary contracting activity for TRICARE-managed care support contracts and other related healthcare services contracts. The TSO issues program guidance in the TRICARE/CHAMPUS Policy Manual (OCHAMPUS 6010.47-M).

     Chapter 10 of the CHAMPUS Regulation (title 32 Code of Federal Regulations, section 199.10) provides that administrative hearings may be held to review appeals by beneficiaries and providers of adverse decisions made by TSO and/or its contractors. Under a memorandum of understanding by and between TSO and the Defense Office of Hearings and Appeals (DOHA), DOHA Administrative Judges, acting as hearing officers, are responsible for conducting these hearings and making recommended decisions to the Director, TSO. Final decisions are made by the Director, TSO, who forwards to the appealing parties copies of the recommended decisions.


This page was last updated on:
October 31, 1997