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TriWest to pay $10M to gov't over false claims allegations

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TriWest to pay $10M to gov't over false claims allegations

Company contracted with military's health plan provider failed to pass on savings

TriWest Healthcare Alliance Corp. — a contractor to TRICARE Management Activity, which provides the medical benefit plan for military members and dependents— agreed to pay $10 million to the federal government to resolve false claims allegations, the Justice Department announced Friday.

TriWest was accused of not meeting its contractual obligations by failing to give TRICARE the benefit of negotiated savings with health service providers, said Sandy Raynor, spokeswoman for the U.S. Attorney’s Office, in a press release.

TriWest submitted claims to TRICARE at higher rates billed by health care providers, failing to pass on discounts agreed on in its contract, Raynor said.

The lawsuit was filed by four former TriWest employees — Judi Jerdee, Deborah Thornton, Linda Glassgow and Paige Fiorillo — under the whistleblowers provision. They will receive $1.7 million 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, in the press release.

“At a time when the federal government must tighten its belt, settlements like this one help maintain important programs that people depend on,” West said.

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