Officials with TRICARE Communications issued a statement last month urging people enrolled in TRICARE to remain vigilant about fraud and abuse, and to report it when it is seen.
“Most TRICARE providers act with honesty and integrity,” Jennifer Dietz, director of Health Care Fraud Resolution for the Defense Health Agency Office of the Inspector General, said in a statement. “But when fraud or abuse happens, it diverts resources that should be used to provide access to appropriate and quality medical care.”1
Examples of fraud include:
- Billing for services that weren’t provided
- Falsifying medical records or claims
- Misrepresenting services to charge a higher rate
- Using someone else’s information
- Hiding other health coverage
Abuse involves improper practices that may or may not be intentional but result in unnecessary costs to TRICARE.
Examples of abuse include:
- Waiving copayments or cost-shares without proper documentation
- Billing for services that aren’t necessary
- Keeping poor or incomplete records
- Repeated improper billing practices
- Refusing medical record requests
How to Spot Fraud or Abuse
In the statement, TRICARE urged participants to “pay attention if you see anything suspicious or unfamiliar on your bill,” and carefully review the explanation of benefits.
For enrolled participants who believe they have been the victim of fraud, TRICARE urges that the participant contact their regional or overseas contractor, or, if needed, contact the Defense Health Agency Office of the Inspector General.
Reference
- TRICARE Communications. Unlock Your Health: How to Report Fraud and Abuse With TRICARE. June 5, 2025. Accessed June 17, 2025. https://newsroom.tricare.mil/News/TRICARE-News/Article/4207018/unlock-your-health-how-to-report-fraud-and-abuse-with-tricare