DoDD 6000.12

Department of Defense

DIRECTIVE
NUMBER 6000.12
April 29, 1996
Certified Current as of November 24, 2003

Incorporating Change 1, January 20, 1998
ASD(HA)

SUBJECT: Health Services Operations and Readiness
References: (a) Title 10, United States Code
(b) Title 37, United States Code
(c) DoD 6010.13-M, "Medical Expense and Performance Reporting System
for Fixed Military Medical and Dental Treatment Facilities," October
1995
(d) DoD 5025.1-M, "DoD Directives System Procedures," August 1994
(e) through (r), see enclosure 1

1. PURPOSE
This Directive:
1.1. Establishes policy and assigns responsibilities under references (a) and (b) for
matters related to health services operations and readiness, including, but not limited to,
medical manpower, medical personnel, medical compensation, military medical training,
medical logistics, patient movement and the Armed Services Blood Program (ASBP).
Detailed procedures on the above matters, as required, shall be prescribed in DoD
Instructions and policy memoranda.
1.2. Authorizes the publication of reference (c), consistent with reference (d).
1.3. Designates the Secretary of the Army as the DoD Executive Agent for the
ASBP Office (ASBPO).
1.4. Replaces references (e) through (r).

1

DoDD 6000.12, April 29, 1996

2. APPLICABILITY
This Directive applies to the Office of the Secretary of Defense, the Military Departments
(including, for supplemental healthcare, the Coast Guard when it is not operating as a
Military Service in the Navy by agreement with the Department of Transportation), the
Chairman of the Joint Chiefs of Staff, the Combatant Commands, the Inspector General
of the Department of Defense, the Uniformed Services University of the Health Sciences
(USUHS), the Defense Agencies, and the DoD Field Activities (hereafter referred to
collectively as "the DoD Components").

3. DEFINITIONS
Terms used in this Directive are defined in enclosure 2.

4. POLICY
The following is DoD policy:
4.1. Entry Grade Credit
4.1.1. The award of service credit to any person being appointed, assigned, or
designated as a "health professions officer" in any of the Military Departments shall be
equitably determined and uniformly applied throughout the Military Departments.
4.1.2. Credit for prior service as a commissioned officer (other than as a
commissioned warrant officer) shall be granted to recognize previous military
experience, while maintaining cognizance of the level of professional (technical)
expertise.
4.2. Active Duty Service Obligation of Health Professions Officers
4.2.1. The minimum term of service for first-term personnel fulfilling an active
duty obligation shall be 2 years following internship for physicians and 3 years for other
health professions officers. The minimum term is not additive to active duty obligations
incurred for education or training. Prior active duty service and internship or any other
initial qualifying training program (e.g., psychology or dietetic internship) may not count
toward fulfilling that requirement.
4.2.2. Participants of the F. Edward Hébert School of Medicine at the USUHS
and the F. Edward Hébert Armed Forces Health Professions Scholarship Program and
Financial Assistance Program (AFHPSP and FAP) shall incur an active duty obligation,
as specified in Sections 2114 and 2123 of 10 U.S.C. (reference (a)), respectively.

DoDD 6000.12, April 29, 1996
4.2.3. Active duty obligations for Graduate Professional Education (GPE) for
physicians, dentists, and veterinarians shall be specified by the Assistant Secretary of
Defense for Health Affairs (ASD(HA)).
4.3. The F. Edward Hébert AFHPSP and FAP
4.3.1. The number of persons who may be designated as members of the
program shall not at any time exceed 5,000. Persons enrolled in the program shall not be
counted against any other prescribed military strength.
4.3.2. Program eligibility shall be in accordance with Section 2122 of 10
U.S.C. (reference (a)). Participants shall be appointed as O-1s in the Reserve
components, unless eligible to hold a higher grade under other statute.
4.4. Medical Special Pays. Special pay authorities for Medical Department officers
shall be administered in accordance with Sections 301d., 302, 302a., 302b., 302c., 302d.,
302e., 303, and 303a of 37 U.S.C. (reference (b)) and in a fiscally responsible manner
that will assist in attracting and retaining the number and the quality of health professions
officers needed in the Military Departments.
4.5. Medical Training
4.5.1. Comprehensive systems for providing, assessing, and monitoring
medical skills training essential for all military personnel shall be developed and
sustained.
4.5.2. Medical training of active duty and Reserve component personnel,
medical and non-medical, shall be structured to achieve medical readiness that shall
ensure the maximum effectiveness of those personnel to provide essential medical
support during military operations.
4.6. The ASBP. The ASBP shall be a single, integrated, blood products system
composed of the Military Departments' and the Combatant Commands' blood programs.
That program shall ensure, to the maximum extent possible, the provision of all blood
and blood products to DoD Component medical treatment facilities (MTFs) for both
peacetime and wartime. The ASBP shall be coordinated by the ASBPO, a joint DoD
field operating agency, subject to the authority, direction, and control of the Secretary of
Defense. The ASBPO shall coordinate with the Chairman of the Joint Chiefs of Staff on
all program related operational matters. The Secretary of the Army, through the Surgeon
General, shall serve as the DoD Executive Agent for the ASBPO. The Director of the
ASBPO shall communicate directly with Government and civilian agencies involving
blood and related items. The ASD(HA) shall implement policies for the ASBP through
the ASBPO, maintaining maximum standardization of procedures and equipment. The
ASBP shall adhere to the manufacturing practices and regulations published by the U.S.
Food and Drug Administration and the American Association of Blood Banks Standards.

DoDD 6000.12, April 29, 1996
The readiness posture of the program shall be maintained through an active voluntary
blood donor program, an adequate blood products storage and distribution program, a
comprehensive blood training program at all personnel levels, a dedicated blood research
and development program, and an aggressive involvement in joint exercises.
4.7. Department of Defense Medical Standardization Board (DMSB). The DMSB,
a joint DoD activity, shall provide policy and standardization guidance relative to the
development of deployable medical systems and medical materiel used for the delivery of
healthcare in the Military Health Services System.
4.8. Medical Expense and Performance Reporting System (MEPRS). A uniform
expense and manpower reporting system shall be maintained in all fixed MTFs and
dental treatment facilities to provide standardized expense and manpower data for
management of healthcare resources. DoD 6010.13-M (reference (c)) outlines provisions
for reporting MEPRS data.
4.9. National Disaster Medical System (NDMS). The NDMS, a joint Federal, State,
and local mutual aid organization, shall respond to the healthcare requirements of a U.S.
national emergency, a major U.S. domestic disaster, or a conventional military conflict
involving U.S. Armed Forces. The NDMS is activated by the ASD(HA) for support of
military contingencies when casualties exceed the combined capabilities of the
Department of Veterans Affairs and DoD contingency care system. The NDMS may be
activated by the Director of Federal Emergency Management Agency or the Assistant
Secretary of Health, Department of Health and Human Services, in response to a U.S.
domestic disaster, and the DoD Components shall participate in relief operations to the
extent compatible with U.S. national security.
4.10. Military-Civilian Health Services Partnership Program. Military and civilian
healthcare resources shall be combined, through the implementation of the MilitaryCivilian Health Services Partnership Program, to improve the cost-effectiveness of the
DoD healthcare delivery system. Beneficiaries of the Civilian Health and Medical
Program of the Uniformed Services (CHAMPUS) shall receive inpatient care and
outpatient services through the CHAMPUS from civilian personnel providing healthcare
services in MTFs and from Uniformed Service professional providers in civilian
facilities. That policy applies when the MTF is unable to provide sufficient healthcare
services for CHAMPUS beneficiaries.
4.11. DoD Policies for Planning Fixed Military Health Facilities. The Department
of Defense shall provide quality healthcare for active duty military personnel, their
dependents, and other authorized personnel; provide sufficient military health facilities to
maintain the combat effectiveness of the military forces; provide for essential teaching
and training of the military medical force; and ensure support for expanded missions
during periods of mobilization or national emergency.

DoDD 6000.12, April 29, 1996
4.12. Supplemental Health Care Program (SHCP) (formerly Active Duty Claim
Program)
4.12.1. The Department of Defense shall establish payment rules for the SHCP
as they apply under CHAMPUS. The Director, Office of CHAMPUS (OCHAMPUS)
shall assist the Uniformed Services in the administration of the SHCP.
4.12.2. Claims from inpatient or outpatient facilities for services rendered
under the SHCP shall first be submitted on a claim form by the provider to the
appropriate Service MTF and/or claims office. The MTF and/or claims office shall verify
the active duty member's eligibility for services and validate that the claim should be
priced under the SHCP. Before they are forwarded to the CHAMPUS contractor for
pricing, claims shall be stamped with a stamp that reads "SHCP" and contain the MTF
and/or claims office Defense Medical Information System code. The CHAMPUS
contractor shall inform the MTF or claims office of the action taken on each claim. The
MTF shall issue the appropriate payment to the institution or individual professional
provider based on the pricing information provided by the CHAMPUS contractor.
4.12.3. The Department of Defense may authorize waivers to claim payments,
as necessary, to ensure availability of healthcare services rendered under the SHCP.
Pricing of claims under the SHCP may be accomplished at the MTF if the parent Service
determines that the MTF has access to, and is proficient in, pricing claims using current
CHAMPUS maximum allowable charges or other CHAMPUS pricing data and
guidelines. The Military Services shall reimburse OCHAMPUS for costs incurred for
claims pricing and annual diagnosis related group pass-through costs of capital and direct
medical education.
4.13. Patient Movement
4.13.1. The Commander in Chief (CINC) of U.S. Transportation Command
(USTRANSCOM) shall be the DoD single manager for patient movement, other than
intra-theater patient movement. Commanders of outside the continental United States
(OCONUS) Combatant Commands shall be responsible for intra-theater medical
regulating and movement, and shall establish Theater Patient Movement Requirements
Centers (TPMRCs) in their respective theaters.
4.13.2. The CINC, USTRANSCOM, shall:
4.13.2.1. Make recommendations, through the Chairman of the Joint
Chiefs of Staff, to the ASD(HA) on the capability, capacity, characteristics, design, and
other DoD policies that may be appropriate to implement this Directive.
4.13.2.3. Establish and maintain automated information systems (AIS) for
medical regulating and movement, and provide standardized procedures for use of such
systems by other DoD units and resource providers. The primary mission of the DoD

DoDD 6000.12, April 29, 1996
patient movement system is to safely transport U.S. military casualties from the combat
zone to fixed MTFs and/or field hospitals rearward in or out of the combat zone, as
required. Other patients may be provided movement on a non-interference basis if the
patient's medical condition, lack of local care, and patient movement costs warrant such
movement.
4.13.3. The CINCTRANSCOM shall establish and maintain the Global Patient
Movement Requirements Center (GPMRC). The GPMRC will provide medical
regulating and AE scheduling for the continental United States (CONUS) and intertheater operations, and provide support to TPMRCs. The GPMRC shall coordinate with
supporting resource providers to identify available assets and communicate lift and bed
requirements to providers. With the approval of the Combatant Commander of the
destination theater, inter-theater evacuations may be made directly from the supported
combat theater to the MTFs of the destination theater.
4.13.4. Requests for medical regulating should be submitted to the appropriate
Patient Movement Requirements Center after competent medical authority attests to the
need to move the patient, and after the MTF commander determines that less expensive,
acceptable quality care is not available locally. Patients will be regulated to the nearest
appropriate MTF.

5. RESPONSIBILITIES
5.1. The Assistant Secretary of Defense for Health Affairs under the Under
Secretary of Defense for Personnel and Readiness, shall:
5.1.1. Supplement policy in section 4., above.
5.1.2. Provide procedures and standards required to implement policy in
section 4., above.
5.1.3. Ensure that the Director, TRICARE Support Office (TSO), shall be
responsible for contracting for healthcare services and obtaining appropriate
reimbursement from the Services: Provide policy and oversight for medical regulating.
5.2. The Chairman of the Joint Chiefs of Staff shall coordinate with the ASBPO on
all blood program plans and actions that involve military operations.
5.3. The Heads of the DoD Components shall:
5.3.1. Administer the policy in section 4., above.
5.3.2. Carry out the procedures and standards specified by the ASD(HA) in the
implementation of policy in section 4., above.

DoDD 6000.12, April 29, 1996
5.3.3. Recommend policy changes to this Directive to the ASD(HA).
5.4. The Commander in Chief, United States Transportation Command, as the
single manager for patient movement, other than for intra-theater patient movement,
shall:
5.4.1. Implement the policy in section 4., above.
5.4.2. Recommended policy changes to this Directive to the ASD(HA) via the
Chairman of the Joint Chiefs of Staff.
5.5. The Secretary of the Army, as the DoD Executive Agent for the ASBPO, shall:
5.5.1. Manage the ASBPO and provide administrative support for its internal
administrative operation including civilian personnel requirements, civilian personnel and
security administration, inspection, space, facilities, supplies, and other administrative
provisions and services, as required to ensure that the responsibilities of the ASBPO shall
be properly discharged.
5.5.2. Program, budget, and finance the operational costs and staff of the
ASBPO, except the pay, allowances, and permanent change of station travel of military
personnel members and assigned staff that are the responsibility of the Military
Department providing those personnel.
5.5.3. Fund for blood procurement from civilian sources including the costs of
transportation to the appropriate Armed Services Whole Blood Processing Laboratory
when overall military requirements exceed the organic capability of the Military Services.

6. EFFECTIVE DATE
This Directive is effective immediately.

Enclosures - 2
E1. References, continued
E2. Definitions

DoDD 6000.12, April 29, 1996
E1. ENCLOSURE 1
REFERENCES, continued

(e) DoD Directive 1312.2, "Entry Grade Credit for Health Services Officers," October
4, 1989 (hereby canceled)
(f) DoD Directive 6000.2, "Minimum Terms of Service and Active Duty Obligations for
Health Services Officers," April 8, 1988 (hereby canceled)
(g) DoD Directive 1340.8, "Special Pay for Dental Corps Officers," February 21, 1986
(hereby canceled)
(h) DoD Directive 1340.13, "Special Pay for Medical Corps Officers," July 23, 1988
(hereby canceled)
(i) DoD Directive 6025.12, "Use of Joint Healthcare Manpower Standards (JHMS),"
March 21, 1989 (hereby canceled)
(j) DoD Directive 1215.4, "Medical Training in the Reserve Components," November
27, 1990 (hereby canceled)
(k) DoD Directive 6430.2, "DoD Medical Standardization Board," June 21, 1984
(hereby canceled)
(l) DoD Directive 6010.13, "Medical Expense and Performance Reporting (MEPR)
System for Fixed Military Medical and Dental Treatment Facilities," February 3,
1986 (hereby canceled)
(m) DoD Directive 6010.17, "National Disaster Medical System (NDMS)," December
28, 1988 (hereby canceled)
(n) DoD Instruction 6010.12, "Military-Civilian Health Services Partnership Program,"
October 22, 1987 (hereby canceled)
(o) DoD Directive 6015.16, "Department of Defense Policies for Planning Fixed
Military Health Facilities," April 15, 1986 (hereby canceled)
(p) DoD Instruction 6010.19, "Active Duty (AD) Claims Payment Program," April 26,
1991 (hereby canceled)
(q) DoD 6025.12-STD, "Joint Healthcare Manpower Standards," November 1989
(hereby canceled)
(r) DoD Directive 5154.6, "Armed Services Medical Regulating," April 29, 1993
(hereby canceled)

ENCLOSURE 1

DoDD 6000.12, April 29, 1996
E2. ENCLOSURE 2
DEFINITIONS

E2.1.1. Active Duty. Full-time duty in the active military service of the United
States. It includes full-time training duty, annual training duty, and attendance, while in
the active military service, at a school designated as a "Service school" by law or by the
Secretary of the Military Department concerned. Such term does not include full-time
National Guard duty.
E2.1.2. TRICARE Support Contractor. An organization with which TRICARE
Support Office has entered into a contract that includes pricing claims for care received
in a particular region.
E2.1.3. Deployable Medical System. A facility that is capable of being located in a
desired or required area of operation during a contingency, war, or national emergency.
Deployable medical systems are composed of fixed contingency hospitals and other than
fixed contingency hospitals that are not operated during peacetime.
E2.1.4. Graduate Professional Education (GPE). Internships, residencies, and
fellowships in their respective professional fields, only for medical, dental, and veterinary
officers.
E2.1.5. Healthcare Resources. Available manpower, facilities, revenue, equipment,
and supplies to produce healthcare and services.
E2.1.6. Health Professions Officers. Includes those officers serving in the Medical
Corps, the Dental Corps, the Veterinary Corps, the Nurse Corps, the Medical Service
Corps, the Army Medical Specialist Corps, the Biomedical Sciences Corps, officers
whom the Secretaries of the Military Departments have designated as "qualified in
specified healthcare functions," and those members in DoD programs leading to
commissioning in, assignment to, or designation for service in any of those Corps.
E2.1.7. Medical Regulating. A process that selects destination MTFs for Uniformed
Services patients being medically evacuated.
E2.1.8. Military Health Facility. A military facility, or complex of facilities,
capable of providing a level of health services or health service support commensurate
with its mission and functions.
E2.1.9. Patient Movement. The act or process of moving a sick, injured, wounded,
or other person to obtain medical and/or dental care or treatment. Decisions made in

ENCLOSURE 2

DoDD 6000.12, April 29, 1996
this process involve coordination between the sending MTF, the gaining MTF, and
GPMRC/TPMRC.
E2.1.10. Provider. Healthcare professional or facility or group of healthcare
professionals or facilities that provide healthcare services to patients.
E2.1.11. Reserve Components. As defined in Section 101(c) of 10 U.S.C.
(reference (a)), the Reserve components include the Army National Guard of the United
States, the Army Reserve, the Naval Reserve, the Marine Corps Reserve, the Air National
Guard of the United States, and the Air Force Reserve.
E2.1.12. Supplemental Healthcare Program (SHCP). The program that provides
payment to civilian (non-Government) healthcare providers for care given to active duty
members of the Uniformed Services and certain other MTF patients for whom healthcare
services are ordered by an MTF provider who maintains full clinical responsibility for the
episode of care.

ENCLOSURE 2