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 HotlineGoes to the DHA OIG Complaint Submission site.
| 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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2020 Annual Fraud and Abuse Report capturing all the activities of the Program Integrity Office to thwart fraud, waste and abuse.
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2019 Annual Fraud and Abuse Report capturing all the activities of the Program Integrity Office to thwart fraud, waste and abuse.
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May 3, 2019
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2018 Annual Fraud and Abuse Report capturing all the activities of the Program Integrity Office to thwart fraud, waste and abuse.
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Last Updated: September 01, 2023