E/M Coding Alert - 2003 Issue 40
TRICARE: MEDICARE/MEDICAID CLAIMS AREN'T THE ONLY FCA TARGETS
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Article Overview
This short article discusses a TRICARE-related False Claims Act settlement involving a device manufacturer and highlights that federal health care billing scrutiny extends beyond Medicare and Medicaid. It is aimed at providers, billing professionals, compliance teams, and others who handle claims for government payers. The piece covers the general compliance context, a reported enforcement action, and the role of whistleblowers in government program investigations.
Why This Topic Matters
It helps readers recognize that billing and coverage problems in non-Medicare, non-Medicaid government programs can still lead to significant enforcement risk and settlement exposure.
What You Will Learn
- How TRICARE fits into broader government-payer compliance risk
- Why False Claims Act issues can arise in non-Medicare and non-Medicaid claims
- How whistleblower actions can lead to enforcement attention
- What a reported settlement can signal for provider and manufacturer billing compliance
Who Should Read This
- Health care providers
- Medical billing and coding professionals
- Compliance officers
- Device manufacturers
- Health care attorneys
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