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Federal Register / Vol. 86, No. 115 / Thursday, June 17, 2021 / Rules and Regulations grant or deny a claim and may adjust the settlement amount contained in the Initial Determination either upwards or downwards, as appropriate.

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Section 45.14 Final and Conclusive Resolution Section 45.14 states that, as provided in the statute, the adjudication and settlement of a claim is final and conclusive. Unlike the FTCA, the Military Claims Act, 10 U.S.C. chapter 163, which provides the authority for this regulation, does not give Federal courts jurisdiction over claims. Thus, the administrative adjudication process for all claims under the Military Claims Act, including medical malpractice claims under this part, is final and not subject to judicial review in any court.
No claim may be paid unless the amount tendered is accepted by the claimant in full satisfaction. Settlement agreements will incorporate the statutory requirements regarding limitations on attorneys fees, as well as a bar to any other claim against the United States or DoD health care providers arising from the same set of facts.
Section 45.15 Other Claims Procedures and Administrative Matters Finally, 45.15 sets out other claims procedures and administrative matters.
If the claimant is represented by counsel, all communications will be through the claimants counsel.
Laws applicable to false claims and false statements to the Government are applicable to claims and information relating to claims under this new authority.
This section also notes the requirement of 10 U.S.C. 2733ae that not later than 30 calendar days after a determination of medical malpractice or the payment of a claim, a report is sent to the Director, Defense Health Agency to be used for all necessary and appropriate purposes, including medical quality assurance. This means that DoD Final Determinations made under this new claims systemeven if, due to offsets for compensation under the comprehensive system discussed above, no money is paidwill be reviewed under the Military Health System Clinical Quality Management Program, in accordance with DoD
Instruction 6025.13 7 and Defense Health Agency Procedural Manual 6025.13.8 That program features 7 Available at https www.esd.whs.mil/Portals/
54/Documents/DD/issuances/dodi/
602513p.pdf?ver=2019-03-11-081734-313.
8 Available at https health.mil/About-MHS/
OASDHA/Defense-Health-Agency/Resources-andManagement/DHA-Publications.

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comprehensive activities to monitor the quality of health care in MTFs, identify opportunities for improvement, and maintain appropriate accountability for health care providers. That system includes procedures to grant and take specified adverse actions on clinical privileges and report certain events to the National Practitioner Data Bank NPDB maintained by the Department of Health and Human Services as a data repository available to health care systems throughout the United States.9
NPDB reporting includes cases where DoD compensation is paid through the Disability Evaluation System or survivor benefits attributable to medical malpractice by a DoD health care provider and now, under this part, paid malpractice claims. Reports to the NPDB
are accompanied by reports to State licensing boards and certifying agencies of the health care providers involved.
Therefore, in addition to providing an additional potential compensation remedy, 10 U.S.C. 2733a reinforces DoD
Clinical Quality Management Program procedures for appropriate accountability of DoD health care providers.
IV. What To Expect in the Claims Process a. Who may File a Claim. Service members or former/retired Service members you may file a claim. Your authorized representative may file a claim on your behalf if you are deceased or incapacitated. DoD will acknowledge receipt of your claim via mail and/or email using the contact information you provided in your claim.
b. What to Include with a Claim. Your claim must provide, in writing, the reason why you believe a DoD health care provider committed malpractice and the amount of money you believe you should receive. No specific form or format is required.
If you have an attorney, you need to include in your claim filing an affidavit confirming that you have authorized the attorney to represent you.
You usually will need to provide an affidavit with your claim filing that you consulted with a health care professional who opined that a DoD
health care provider breached the medical standard of care and caused harm to you. You do not need to provide this affidavit if the malpractice is obvious, such as an operation on the wrong body part.
Because all claims differ, nothing else is required at the time you file your claim. DoD may find during the review of your claim that additional 9 Available
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information is needed. DoD will ask you for this information at that time. You may, but are not required to, submit any other information that you believe supports your claim at the time you file it.
c. Where to File a Claim. You should submit the claim to your Military Department.
Army: Claims should be presented to the nearest Office of the Staff Judge Advocate, to the Center Judge Advocate of the Medical Center in question, or with US Army Claims Service, 4411
Llewellyn Avenue, Fort Meade, Maryland 20755, ATTN: Tort Claims Division.
Navy: Information, directions and forms for filing a claim may be found at https www.jag.navy.mil/. Claims should be mailed to the Office of the Judge Advocate General, Tort Claims Unit, 9620 Maryland Avenue, Suite 205, Norfolk, Virginia 235112949.
Air Force: Claims should be presented either at the Office of the Staff Judge Advocate at the nearest Air Force Base, or sent by mail to AFLOA/JACC, 1500
W Perimeter Road, Suite 1700, Joint Base Andrews, MD 20762. POC:
Medical Law Branch, AFLOA/JACC
2406124620 or DSN 6124620.
d. Time for Filing a Claim. Generally, you must file your claim by the later of 1 two years from the date of the injury or death; or 2 the date you knew, or with the exercise of reasonable diligence should have known, of the injury or death and that the possible cause of the injury or death was malpractice. A
special rule existed in 2020 that allowed claims from 2017 to be filed in 2020, but that rule has expired.
e. Initial Determination on Your Claim. Once you have filed your claim, DoD will locate medical records held by DoD and VA and review your claim to determine whether malpractice occurred.
DoD may ask you for additional information about your medical care as part of this review. If DoD concludes that medical malpractice occurred, DoD
may ask you for information about the harm to you as a result of malpractice to determine the amount of money you will be offered as a settlement. This amount of money is also called damages.
If DoD intends to deny your claim and you have not yet submitted an expert report in support of your claim, DoD
will provide you with an opportunity to submit one before denying your claim.
You usually will have 90 days to provide an expert report.
Once DoD has completed its review of your claim, you will be issued an Initial Determination. This Initial
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