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What is fraud and abuse?
- Fraud - when a person or organization deliberately deceives others to gain some sort of unauthorized benefit.
- Abuse - when providers supply services or products that are medically unnecessary or that do not meet professional standards.
You're an important partner in the ongoing fight against fraud and abuse. If you suspect anything out of the ordinary, report it!
Report Suspected Fraud or Abuse
To report suspected fraud or abuse within the TRICARE Program, you should report directly to the appropriate contractor (see table below for direct links and information)
Any other suspected fraud or abuse should be reported to the DHA Office of the Inspector General.
| Type of Care/Program |
Who to Contact |
| Medical |
All TRICARE Plans except TRICARE For LifeMedicare-wraparound coverage for TRICARE-eligible beneficiaires who have both Medicare Part A and B.TRICARE For Life and the US Family Health Plan:
TRICARE For Life (Wisconsin Physicians Service):
US Family Health Plan:
|
| Pharmacy |
Contact Express Scripts:
|
| Active Duty Dental Program |
Contact United ConcordiaGo to United Concordia Fraud and Abuse:
United Concordia Companies Inc.
Special Investigations Unit
1800 Center Street, Suite 2B 220
Camp Hill, PA 17011
Fax: 1-877-603-6091
|
|
Federal Employee Dental and Vision Insurance Program (FEDVIP)
|
Contact Office of Personnel Management OIGOPM OIG
or
Contact BENEFEDS:
- Call the "Fraud Hotline" at 1-603-433-3815
|
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Last Updated: October 08, 2024