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Diane Publishing Books
Improper Payments: TRICARE Measurement and Reduction Efforts Could Benefit from Adopting Medical Record Reviews
Vijay A. Däó»Souza (au)
The Defense Health Agency (DHA), an agency within the Department of Defense (DOD), administers the military health program known as TRICARE. Improper payments -- payments that were made in an incorrect amount or should not have been made at all -- are a contributor to excess health care costs. For programs identified as susceptible to significant improper payments, federal agencies are required to annually report estimates of improper payments, their root causes, and corrective actions to address them. In FY 2013, DOD spent about $21 billion for TRICARE and estimated improper payments of $68 million, or an error rate of 0.3%. That year, $36 billion, or 10.1%, of the total $357 billion in Medicare payments were improper. This report addresses (1) TRICARE and Medicare improper payment measurement comparability; and (2) the extent to which each program identifies root causes of, and develops corrective actions to address improper payments. Figures and tables. This is a print on demand report.
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