Improved Procedures To Identify Active Duty Army Personnel in Civilian Medical Facilities Can Reduce Costs

GAO conducted a limited review at Madigan Army Medical Center (MAMC) to determine whether savings were being achieved by the timely transfer of active duty personnel hospitalized in civilian hospitals to Federal medical treatment facilities.

Under current regulations, the Army is authorized to pay for care from civilian sources when it cannot be provided by a Federal medical treatment facility. When a member on leave, pass, or temporary duty obtains civilian medical care, the member is responsible for notifying the medical center commander in the area where the care is being provided. Prompt contact should occur to determine the patient's condition and the feasibility of evacuation to a Federal medical treatment facility. GAO found that MAMC usually learned that an active duty member was in a civilian hospital only after they were discharged. This occurred because Army personnel were not following the established procedures. A review of 26 cases showed that 5 of the patients could not have been transferred because of their serious medical condition or because care was preauthorized, 2 of the cases could definitely have been transferred, and there was insufficient information to evaluate the remaining cases. MAMC has taken positive actions to solve this problem by planning briefings for Army personnel in the area and by publicizing Army policies and requirements to civilian hospitals. GAO believes that these actions should be repeated on a periodic basis to maintain an awareness of Army requirements.