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On July 2, 2012, it was announced that TriWest lost its appeal to keep the West Region contract. [8] In September 2011, TriWest paid $10 million to settle a Justice Department lawsuit after whistle-blowers claimed TriWest "systematically defrauded" Tricare by billing the government higher rates than they had negotiated with health care providers.
Tricare (styled TRICARE) is a health care program of the United States Department of Defense Military Health System. [1] Tricare provides civilian health benefits for U.S Armed Forces military personnel , military retirees, and their dependents , including some members of the Reserve Component .
In the late 1980s, because of escalating costs, claims paperwork demands and general beneficiary dissatisfaction, DOD launched a series of demonstration projects. Under a program known as the CHAMPUS Reform Initiative (CRI), a contractor provided both health care and administrative-related services, including claims processing.
On July 21, 2016, the U.S. Department of Defense awarded Humana Government Business the TRICARE 2017 contract for the East Region, with WPS MVH as a subcontractor. WPS will provide information technology support, claims processing, and customer service functions. The East Region includes 30 states and approximately 6 million TRICARE beneficiaries.
In 1752, Benjamin Franklin founded the first American insurance company as Philadelphia Contributionship.In 1820, there were 17 stock life insurance companies in the state of New York, many of which would subsequently fail.
The department had also sued to block UnitedHealth's $3.3 billion acquisition of Amedisys Inc, citing concerns that the deal would reduce competition in the home health services market.
The United States Department of Defense established the DHA as part of a larger effort meant to reorganize its health care programs and services. The reorganization was based in part on the recommendations of a task force that issued a report on the management of U.S. military health care in 2011. [ 1 ]
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