The Department of Justice issued a press release the Friday prior to the 10th Anniversary of 9/11 that it had settled a case against TriWest Healthcare Alliance. TriWest was accused of bilking TriCare, which is the health care system that troops use for their medical needs.
TriWest Healthcare Alliance Corporation, a contractor to TRICARE Management Activity, has agreed to pay $10 million to resolve civil false claims allegations, the Justice Department announced today. TRICARE is the U.S. medical benefit plan which covers uniformed personnel, retirees, their dependents and reserve components.
The settlement resolves a lawsuit filed by four former TriWest employees, Judi Jerdee, Deborah Thornton, Linda Glassgow and Paige Fiorillo, under the qui tam, or whistleblower provisions, of the False Claims Act. The United States partially intervened in the case on Aug. 29, 2011. The United States and the qui tam plaintiffs allege that between 2004 and 2010, TriWest failed to give TRICARE the benefit of negotiated discounts with service providers under letters of agreement (LOAs). Notwithstanding contractually binding LOAs with health care providers, TriWest submitted claims to TRICARE at higher rates billed by the providers, failing to pass on to TRICARE the savings negotiated through the LOAs. Together, the qui tam relators will receive $1.7 million as their share of the government’s recovery.
“Those who overbill TRICARE threaten to undermine the health care provided to our men and women in uniform,” said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. “At a time when the federal government must tighten its belt, settlements like this one help maintain important programs that people depend on.”
I’m a little perturbed that TriWest would still be a legal contractor after this gross violation of the public trust, especially when our troops are needing health care more than ever after ten years of sustained combat. I also wonder why the press hasn’t picked this up.