Report | July 31, 2018

Project Announcement: Termination of the Audit of Payments for TRICARE Urgent Care Benefits (Project No. D2018-D000AW-0140.000)

We announced the subject audit on May 1, 2018.  The objective was to determine whether the DoD appropriately paid for beneficiary health care services covered under the urgent care benefit.  We are terminating this audit because during the planning phase of the audit, the Defense Health Agency informed the audit team that it issued a fee waiver for all point of service charges for covered care for TRICARE eligible beneficiaries from December 1, 2017, through March 30, 2018, which would include point of service fees charged for urgent care services.  Further, the Defense Health Agency informed the audit team that after June 30, 2018, the TRICARE claims processor that processed all claims prior to January 1, 2018, was not contractually obligated to provide explanations of why specific urgent care charges were paid.