Payment for bariatric surgical procedures is set by the necessities specified in paragraph of this part, and as defined in § 199.2 of this part. Inpatient stays primarily for the aim of obtaining drugs and another services and supplies associated to drug abuse are also excluded. CHAMPUS fiscal intermediary obligations. CHAMPUS fiscal intermediaries are answerable for implementing utilization control and high quality assurance procedures designed to determine potential drug abuse conditions. The CHAMPUS fiscal middleman is directed to screen all drug claims for potential overutilization and irrational prescribing of medication, and to subject any such cases to extensive review to determine the need for the medication and their appropriateness on the premise of prognosis or definitive signs. Limitations on who can prescribe medication.
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Such referrals shall be made as early as potential according to aggressive collection motion made by TRICARE contractors and TMA. Referral might be made with adequate time to convey timely suit against the debtor. Referral shall be made by submission of a accomplished Claims Collection Litigation Report , accompanied by a signed Certificate of Indebtedness.