When to Hire a Tricare Fraud Defense Attorney

Tricare Fraud Attorney

Tricare is similar to Medicare in many ways. The main difference is that the Tricare is for those who currently serve in the military, retired military personnel, and their families.

Management of the Tricare program is conducted by the Defense Health Agency. As with any large federal agency, there are numerous patients and participating physicians across the world that operate within the Tricare system. As a result, fraudulent claims for payment under Tricare is common.

With so many fraudulent claims being processed and investigated, physicians and pharmacies are often suspected and sometimes accused of Tricare insurance fraud, a very serious federal crime.

Tricare defense lawyer specialize in Tricare fraud defense. If you feel you and your staff are being investigated, you should consult a Tricare defense lawyer immediately. Waiting is a mistake because it gives federal prosecutors and their investigators more time to build a case against you.

Tricare insurance fraud has become so rampant that investigators are often dangerously over-zealous, even in cases involving mere clerical errors.

Regardless of the reason for why you may be suspected of Tricare insurance fraud, you will find yourself up against experienced prosecutors whose only goal is to obtain convictions. They deeply investigate your background in an attempt to find pieces of information that can be used against you. Without a reliable experienced Tricare fraud defense lawyer, you stand a greater chance of being convicted and face restitution payment, fines, and even imprisonment. 

Many innocent defendants assume that the accusations against them will blow over. Unfortunately, that is seldom the case. Being charged with Tricare insurance fraud is a very serious charge that requires the immediate consultation of an experienced Tricare insurance fraud lawyer.


Examples of Tricare Fraud Cases

As an example of just how serious Tricare fraud can be, a physician and a pharmacy recently convicted of processing fraudulent prescriptions were charged $510 million in fines.

Due to the growing number of people being charged with Tricare fraud, the Defense Criminal Investigative Service was formed, spearheaded by the Medicare Fraud Strike Force. 115 physicians, nurses, and other medical professionals were convicted this year alone. In addition, 412 non-medically professional defendants were charged with participating in schemes that involved submitting fraudulent claims for treatment that involved Medicare, Medicaid, and Tricare. 

False claims made submitted by physicians is not the only method by which Tricare insurance fraud is committed. Some people attempt to falsely claim that they are retired military servicemembers. With so many individuals enrolled in the Tricare program, it may take months or years to discover, as was the case involving a defendant who posed as a retired lieutenant commander of a submarine service. His friendship with Tricare beneficiaries allowed him to obtain the information necessary to carry on the fraudulent scheme.

If you have become a defendant a Tricare insurance fraud case, your Tricare defense lawyer will be your best ally, experienced in all of the complications and exceptions involving the Tricare program. Tricare defense attorneys are prepared to counter any accusations made by the prosecution. 

No matter how minor the accusations may be, most judges give little deference to the defendant testimony in healthcare fraud cases. An experienced attorney, however, can speak intelligently on matters of healthcare fraud cases. 


Are You Being Investigated For TRICARE Fraud?

There are two ways for prosecutors to investigate suspected Tricare fraud.

  1. Criminal Charges

Criminal charges will be investigated in depth. Criminal healthcare fraud is unique due to the complicated language.

      2. Civil Liability

Federal investigations often lead to defendants being required to pay restitution and fines as high as $11,000 for each false claim. They may also be required to pay damages fees for the government attorneys. In addition, they may no longer participate in federal healthcare programs.


Fraudulent practices often spread like disease through healthcare entities. Common offenders include companies owned by physicians or hospitals that produce medical devices. Physicians, their staff members, and nurses can all be charged separately in healthcare fraud cases. Toxicology laboratories are another target of investigation, as are pharmacies and individual pharmacists.

Perhaps the entities most vulnerable to Tricare medical fraud are compound pharmacies.

Sometimes patients are unable to tolerate certain medication due to certain ingredients. In these cases, compounding pharmacy sometimes omit these ingredients. Alternatively, some potentially helpful medications are in such small demand that no pharmaceutical companies produce them regularly. In these situations, compounding pharmacies prepare small quantities of certain medication upon the request of physicians.

Given the specialized nature of these instances, both the cost of ingredients and the time involved in preparing the medication can be easily inflated. This leaves the door wide open for submission of fraudulent requests for Tricare payment. As a result, Tricare fraud in the compounding pharmacy industry is one of the government’s most challenging and costly problems.


When Charges Are Filed

You may become aware of being investigated during the course of your career. Sometimes the first indication of this may come when charges are filed against you for attempting to defraud the government by submitting fraudulent claims for payment.

If you suspect that you or your company is being investigated for Tricare fraud, you must obtain a Tricare defense lawyer as soon as possible. The Tricare insurance fraud arena is far too complex for the average lawyer to handle. Tricare defense lawyers are experienced in the rules, regulations, and exclusions of Tricare insurance fraud. Therefore, your Tricare defense lawyer will be in a position to counter every accusation that prosecutors may present.


You Need Experience In Complicated Matters

Tricare fraud cases are some of the most common as well as the most complicated kind of healthcare fraud. Without a Tricare insurance fraud lawyer, you may find yourself subject to heavy fines, orders to pay restitution, prosecuting attorney fees, and even prison time. Worst of all, you may also suffer the loss of your license to practice medicine

Don’t take a chance of being convicted with Tricare insurance fraud. If you are suspected, do not to discuss the cases with co-workers, friends, acquaintances, or even family members. It is very important to have an experienced Tricare lawyer at your side during every step of the process. A Tricare defense lawyer will be ready to analyze your case, investigate the charges levied against you, and be prepared to anticipate and challenge prosecutors.


Hire Proven Tricare Fraud Lawyer Today & Save Your Career

Healthcare fraud costs the government millions of taxpayers dollars each year. Since Tricare fraud makes up a large portion of this lost revenue, federal investigators are extremely aggressive. Defendants have little chance of overcoming Tricare fraud allegations without the protection and guidance of Tricare attorneys.

Without having experienced legal representation, your chances of being released without penalties are slim. If you have any questions or think that you may be the target of a Tricare investigation, schedule a consultation with our attorneys or call 888-402-4054 today.