Which entity issues TRICARE rules?

Which entity issues TRICARE rules?

• A. Department of Defense (DoD)
• B. Centers for Medicare & Medicaid Services (CMS)
• C. Medicare Administrative Contractors (MACs)
• D. Office of Inspector General (OIG)

Answer: (A)

TRICARE is the health care program operated by the Department of Defense for military service members, retirees, and their families. The rules that govern TRICARE—such as who is eligible, what benefits are available, how to enroll, and how care is accessed—are issued by the Department of Defense, typically through the Defense Health Agency. This program-specific policy distinguishes TRICARE from other federal health programs. The Centers for Medicare & Medicaid Services administers Medicare and Medicaid for the civilian population, so it does not issue TRICARE rules. Medicare Administrative Contractors process Medicare claims within that program, not TRICARE. The Office of Inspector General is responsible for oversight, audits, and ensuring compliance, not for creating program rules.

TRICARE is the health care program operated by the Department of Defense for military service members, retirees, and their families. The rules that govern TRICARE—such as who is eligible, what benefits are available, how to enroll, and how care is accessed—are issued by the Department of Defense, typically through the Defense Health Agency. This program-specific policy distinguishes TRICARE from other federal health programs.

The Centers for Medicare & Medicaid Services administers Medicare and Medicaid for the civilian population, so it does not issue TRICARE rules. Medicare Administrative Contractors process Medicare claims within that program, not TRICARE. The Office of Inspector General is responsible for oversight, audits, and ensuring compliance, not for creating program rules.