Tricare Audit & Fraud Archives - Medicare RAC Audits & Appeals Services
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Is It Legal to Purchase Medicare Leads?

This summary, co-written by former DOJ healthcare fraud prosecutors, attempts to answer a question of increasing importance: under what circumstances is it legal to purchase patient leads? What is the difference between a raw and a qualified lead—and why does it matter? What is the Justice Department’s position on the...

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Federal Authorities are Targeting Addiction Clinic Owners in Tricare Fraud Investigations Under the False Claims Act

Addiction clinics that serve military personnel, veterans, and their family members who are Tricare beneficiaries are at risk of being targeted in federal healthcare fraud investigations. In just one of many recent examples, on March 14, 2019, the U.S. Department of Justice (DOJ) announced that a physician hired to serve...

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What Do Healthcare Providers Need to Know about Tricare Audits and Investigations?

For healthcare providers who serve military servicemembers, veterans, and their families, ensuring compliance with the Tricare billing requirements is just as important as complying with the Medicare and Medicaid regulations. Even if treating Tricare beneficiaries makes up only a relatively small percentage of your practice, you are held to the...

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What to do in a Tricare Audit?

Oberheiden, P.C. Direct: 888-680-1745 Including Weekends The federal government has dramatically increased the number of investigations against Tricare healthcare providers. The Tricare Pharmacy Program is administered by Express Scripts. Many Tricare providers such as physicians, pharmacies, compound pharmacies, and toxicology groups affected by these audits are confronted with an...

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Who Are the Targets of Tricare Fraud Investigations and What Should They Do?

  Dr. Nick Oberheiden, Esq. 888-680-1745 Call Us on Weekends The attorneys of Oberheiden, P.C. have represented healthcare executives, physicians, marketers, and pharmacies accused of Tricare Fraud in proceedings across the country. Our deep involvement in the current Tricare investigations and our ongoing dialogues with government officials in charge...

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Avoiding Criminal Charges in Tricare Compound Pharmacy Investigations

  Oberheiden, P.C. 888-680-1745 Including Weekends Oberheiden, P.C. has represented pharmacies, pharmacy owners, marketers, physicians, and healthcare executives in compound pharmacy investigations across the United States. Our attorneys have provided individuals and companies effective tools to approach Express Scripts audits, grand jury subpoenas, telemedicine investigations, and criminal prosecutions. We...

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Defending Tricare Fraud: Choosing the Right Lawyer

Dr. Nick Oberheiden, Esq. Attorney-at-Law Tricare Fraud is a serious offense. Penalties range from civil monetary damages to years of incarceration in federal prison. The government is aggressively prosecuting Tricare Fraud cases and no time should be wasted to develop a smart and effective defense strategy for those that find...

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Defending Compound Pharmacies in Tricare Fraud Investigations

Dr. Nick Oberheiden, Esq. (Managing Partner) Direct: 888-680-1745 In early 2015, Tricare, which provides insurance coverage to U.S. military members and their families, held a meeting with representatives of the compounding and pharmaceutical industries.  The impetus for this meeting was Tricare’s realization that the average compounded drug billed to Tricare...

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