Publicly Released: September 10, 2021
The purpose of this memorandum is to inform DoD leadership of potential internal control weaknesses that we identified regarding TRICARE payments for the administration of coronavirus disease–2019 (COVID-19) vaccines administered to TRICARE beneficiaries from December 2020 through April 2021 and to document our recommendations to Defense Health Agency (DHA) officials. We announced the “Research on Potential Topics in the Military Health System for Future Audit Projects” (Project No. D2021-D000AW-0007.000) on October 1, 2020, to evaluate potential audit topics and high-risk areas by gathering and analyzing data, making inquiries, and conducting general research on the DoD Military Health System.
During the research project, we analyzed TRICARE claims payments paid to health care providers for administering COVID-19 vaccines to TRICARE beneficiaries and identified potential internal control weaknesses related to paying more than once for administering the same dose of COVID-19 vaccines, applying cost shares for the administration of COVID-19 vaccines, and paying providers to administer vaccines in a manner that did not meet Centers for Disease Control and Prevention (CDC) requirements. We discussed these potential weaknesses with TRICARE Health Plan officials from the DHA and also obtained comments from the TRICARE managed care support contractors (MCSC).