# 2026-02437: Medical Billing for Healthcare Services Provided by Department of Defense Military Medical Treatment Facilities to Civilian Non-Beneficiaries 2026-02437, Medical Billing for Healthcare Services Provided by Department of Defense Military Medical Treatment Facilities to Civilian Non-Beneficiaries, is a Federal Register rule from Defense Department published 2026-02-06, effective 2026-03-09; deemed significant under Executive Order 12866 (as of 2026-06-11). - Canonical: https://policyrisk.com/federal-register/2026-02437 - As of: 2026-06-11 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Document number: 2026-02437 - Title: Medical Billing for Healthcare Services Provided by Department of Defense Military Medical Treatment Facilities to Civilian Non-Beneficiaries - Type: Rule - Agencies: Defense Department - Citation: 91 FR 5303 - Published: 2026-02-06 - Effective: 2026-03-09 - Comments close: not stated - Significant: yes (FR_METADATA) - Touches household money: no - Regulation identifier numbers: 0720-AB87 - Last updated: 2026-06-11 ## Summary Starting March 9, 2026, the Department of Defense is changing how it bills civilians who get medical care at military hospitals but aren’t covered by military health benefits. They’re introducing a sliding fee scale and fee waivers to make bills fairer and less costly, plus they’ll accept insurance payments as full payment except for small extra fees. This helps protect civilians from big medical bills while supporting military healthcare providers’ training. ## Abstract As required by the James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 (NDAA-23), this rule reduces financial harm to civilians who are not covered beneficiaries of the Military Health System (MHS), and who receive healthcare services at DoD military medical treatment facilities (MTF). The rulemaking implements the MHS Modified Payment and Waiver Program (MPWP) through which the DoD applies a sliding fee scale and/or a catastrophic fee waiver to medical invoices of certain non-beneficiaries and accepts payments from health insurers of non-beneficiaries as full payment except for copays, coinsurance, deductibles, nominal fees and non- covered services. ## Effects PRIA read - Income-Based Discounts and Caps: benefit, high. If you are a civilian treated at a DoD military medical treatment facility (MTF), you can apply to the Military Health System Modified Payment and Waiver Program (MHS MPWP). If your household income is at or below 100% of the Federal Poverty Guidelines (FPGs) you get a 100% discount (bill reduced t… - Nominal Fee Schedule for Sliding Scale: benefit, medium. Under the sliding fee for households >100% and up to 400% of the FPGs, outpatient nominal fee is $50 and inpatient nominal fees are tiered by income bands (examples: 101%–120% = $750 inpatient; 121%–140% = $1,250; 141%–160% = $2,000; ... up to 381%–400% = $14,000 inpatient). Applicants at 0%–100% F… - Insurance Billing and Patient Consent Rule: benefit, medium. If you have health insurance and are treated at an MTF, DoD will ask you to complete a DD Form 2569 and must have your consent to file claims on your behalf; you are not eligible for the MHS MPWP if you refuse to permit DoD to file claims. DoD will bill insurers and accept insurer remittances as fu… - Medicare Patients Not Balance Billed: benefit, medium. If you are a Medicare patient treated at an MTF, you will not be balance billed for care received in the MTF; Medicare will cover costs associated with stabilization and transfer. MTFs operate as non-participating providers under the DHA's election agreement with Medicare. - Collections Pause, Debt Recall, Payment Plans: benefit, medium. While your MHS MPWP application is being reviewed, DoD will suspend collection actions against you (excluding insurance processing). If approved, DoD will reset the delinquency clock and recall debts from the Department of the Treasury's Cross-Servicing Program. You may be offered installment plans… - Waivers for Training-Value Care — Tax Reporting: mixed, medium. The Director of the Defense Health Agency may partially or fully waive already-discounted bills when competent medical authority confirms the care enhanced military providers' knowledge, skills, and abilities (KSAs). Waivers require DD Form 3201-1 and internal DD Form 3201-1A confirmation; waivers… - Limits: Pre-2023 Debts and Tort/Third-Party Rules: cost, medium. Debts for MTF care incurred before June 21, 2023 are not eligible for the MHS MPWP (the statute is prospective). Discounts or waivers under the MHS MPWP do not apply to tortfeasors or third‑party payers, and applicants must cooperate with recovery against liable third parties to be eligible for dis… ## Related documents - [2026-19160](https://policyrisk.com/federal-register/2026-19160): Federal Acquisition Regulation: Revolutionary Federal Acquisition Regulation Overhaul Parts 16, 17, and 35, 2026-09-18 - [2026-18317](https://policyrisk.com/federal-register/2026-18317): Updated Definition of “Waters of the United States”, 2026-09-09 - [2026-11505](https://policyrisk.com/federal-register/2026-11505): DoD Assistance to Non-Government, Entertainment-Oriented Media Productions, 2026-06-09 - [2026-09067](https://policyrisk.com/federal-register/2026-09067): Defense Federal Acquisition Regulation Supplement: Mitigating Risks Related to Foreign Ownership, Control, or Influence (DFARS Case 2021-D0…, 2026-05-07 - [2026-09038](https://policyrisk.com/federal-register/2026-09038): Defense Federal Acquisition Regulation Supplement: Disclosure of Greenhouse Gas Emissions (DFARS Case 2024-D021), 2026-05-07 - [2025-20402](https://policyrisk.com/federal-register/2025-20402): Updated Definition of “Waters of the United States”, 2025-11-20 ## Sources - [2026-02437 on federalregister.gov](https://www.federalregister.gov/documents/2026/02/06/2026-02437/medical-billing-for-healthcare-services-provided-by-department-of-defense-military-medical-treatment) - [2026-02437 as published (PDF)](https://www.govinfo.gov/content/pkg/FR-2026-02-06/pdf/2026-02437.pdf) ## Related - [Previous: 2026-02431, Implementation of the Executive Order Entitled “Zero-Based Regulatory Budgeting…](https://policyrisk.com/federal-register/2026-02431) - [Next: 2026-02450, Establishment of United States Area Navigation (RNAV) Routes Q-190 and T-497, a…](https://policyrisk.com/federal-register/2026-02450) - [All Federal Register documents](https://policyrisk.com/federal-register) Source: PRIA, https://policyrisk.com/federal-register/2026-02437 (as of 2026-06-11).