Tricare is a federal healthcare program similar to Medicare that is offered to active-duty military personnel, veterans, reservists, and their families. Each year, Tricare pays tens of billions of dollars to doctors, hospitals, pharmacies, and other healthcare providers that provide services, drugs, and medical devices to Tricare recipients.
Starting in 2015, many publications shared content specific to what they indicated is a growing trend of TRICARE billing fraud and abuse. Here are just some of these articles:
The Federal government also has several pages dedicated to the topic of TRICARE fraud:
Additionally, according to the TRICARE.mil website here are the definitions of “fraud” and “abuse”:
In efforts to prevent TRICARE fraud from continuing, the number of investigations likely will increase. Your company, however, may have acted with good intentions and conducted billing practices in a manner that you believed to be compliant with all regulations. The risks of not addressing the situation, nonetheless, are very real and could lead to significant penalties – even a criminal conviction in certain circumstances.
What you should know are:
This web page allows people to report on suspected TRICARE fraud and abuse. People can report suspected activity to either the Defense Health Agency (DHA) or the FBI.
Some of the types of companies which could be investigated include:
If you have received notice of a TRICARE fraud or abuse investigation, or if you would like counsel to minimize the risks of such as investigation, then you are welcome to contact the law firm of James S. Bell, PC. James Bell and the firm’s other defense attorneys has years of experience defending clients in Federal investigations including those pertaining to the health care industry.
Contact us today for more information and to schedule an appointment with James Bell. You are welcome to see James in a video discussing TRICARE fraud and other videos related to TRICARE and health care fraud: