Small DOHA Seal DHA/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 1110b. 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. .

     Chapter 17 of the CHAMPUS Regulation (title 32 Code of Federal Regulations, section 199.17) authorizes a DoD-managed healthcare program called TRICARE. The Defense Health Agency (DHA) manages TRICARE. (DoD Directive 5136.13, dated September 30, 2013).

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


This page was last updated on:
January 8, 2016