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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 provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some members of the Reserve Component. Tricare is the civilian care component of the Military Health System, although historically it also included health care delivered in military medical treatment facilities.
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Under TRICARE, seven managed care support contracts were awarded covering DoD's 12 health care regions. [ 7 ] TRICARE has been restructured several times, with contract regions having been redrawn , Base Realignment and Closure , and by adding "TRICARE For Life" benefits in 2001 for those who are Medicare -eligible.
The Defense Health Agency (DHA) is a joint, integrated combat support agency that enables the U.S. Army, U.S. Navy, and U.S. Air Force medical services to provide a medically ready force and ready medical force to Combatant Commands in both peacetime and wartime.
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.
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In addition to other TRICARE ECHO benefits, beneficiaries who are homebound may qualify for extended in-home health care services. The $2,500 cost share does not apply to the ECHO Home Health Care (EHHC) as there is a benefit cap.