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Military Health System

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Sample Compliance Committee Charter

Form/Template
9/15/2015

Use this sample charter to develop the Compliance Committee Charter for your MTF.

UBO Compliance Plan/Code of Conduct Receipt

Form/Template
9/15/2015

Each employee/service member/contractor should complete and sign this acknowledging they have received and read the Compliance Plan and Code of Conduct.

MSA Claim Post-Submission Review Worksheet

Form/Template
9/15/2015

Use this review worksheet to help establish a consistent UBO billing submission framework.

Memorandum Template for a Uniform Business Office Compliance Plan

Form/Template
9/15/2015

Use this template to develop your memorandum to create a UBO Compliance Plan.

MAC Claim Post-Submission Review Worksheet

Form/Template
9/15/2015

Use this review worksheet to help establish a consistent UBO billing submission framework.

UBO Compliance Audit Checklist

Form/Template
9/15/2015

This Compliance Audit Checklist Template is an element of our MTF’s Internal Control Review and is part of your compliance program. It covers the basic points of TPC, MSA, and MAC programs. It can also be used in business case analysis/reengineering initiatives for the Uniform Business Office.

Annual Review of Compliance Program Effectiveness Checklist

Form/Template
9/15/2015

The UBO Compliance Officer will regularly review the implementation and execution of the compliance program elements. This review will be conducted as least annually and will include an assessment of each of the basic elements individually, as well as the overall success of the program. It will help identify any weaknesses in your compliance program and implement appropriate changes. A copy of this review should be provided to the Base Commander and UBO Service Manager.

TPCP Claim Post-Submission Review Worksheet

Form/Template
9/15/2015

Use this review worksheet to help establish a consistent UBO billing submission framework.

AHLTA-Theater/AHLTA-Mobile/Mobile Computing Capability (AHLTA-T/AHLTA-M/MCC)

Form/Template
9/9/2015

This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the AHLTA-Theater/AHLTA-Mobile/Mobile Computing Capability (AHLTA-T/AHLTA-M/MCC) system.

Coding and Compliance Editor (CCE)

Form/Template
8/11/2015

This Military Health System (MHS) Privacy Impact Assessment (PIA) summarizes the Coding and Compliance Editor (CCE) system.

UFBPA Appendix for the Nov 2015 DOD P&T Meeting: Namenda XR

Form/Template
8/7/2015

UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Namenda XR

UFBPA Appendix for the Nov 2015 DOD P&T Meeting: Namzaric

Form/Template
8/7/2015

UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Namzaric

UFBPA Appendix for the Nov 2015 DOD P&T Meeting: Acne Isotretinoids

Form/Template
8/7/2015

UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Acne Isotretinoids

UFBPA Appendix for the Nov 2015 DOD P&T Meeting: Antirheumatics Injectable Methotrexate

Form/Template
8/7/2015

UFBPA Appendix for the Nov 2015 DOD P&T Meeting for Antirheumatics Injectable Methotrexate

UFBPA Appendix for the Nov 2015 DOD P&T Meeting: GI-2 Agents, Miscellaneous

Form/Template
8/7/2015

UFBPA Appendix for the Nov 2015 DOD P&T Meeting for GI-2 Agents, Miscellaneous

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Last Updated: October 22, 2021
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