TRICARE beneficiaries are targets of bogus call centers

  • Published
Officials at the Defense Health Agency's Office of Program Integrity have received numerous reports from TRICARE beneficiaries regarding bogus "call center" representatives. 

These representatives are encouraging beneficiaries to provide personal identifying information and health information so that TRICARE can allegedly provide prescribed cream medications to the beneficiary. 

TRICARE and its contractors never call and ask for personal identifying information or health information, and officials warn beneficiaries to be wary of unsolicited attempts by any entity asking for personal or health information, either by phone or in person.

The "call center" imposters normally call and say, "I am a representative calling from XYZ, we are calling to tell you about a benefit TRICARE will cover for you for a prescription pain cream you are eligible for.  Do you have any of the following medical issues (list of issues) or pain?  If so, TRICARE wants to get you taken care of, all we need are your doctor's name and your TRICARE information and we will contact your doctor and get these medications or supplies out to you immediately and submit a claim. " 

Program integrity officials strongly advise against giving any information during these types of unsolicited requests.  Often these bogus representatives have identified what limited information they have through Internet searches or from people who have independently received information directly from you, said officials. 

Officials urge people who receive calls asking for personal information to immediately submit a fraud report to the pharmacy benefit contractor, ESI, via email to TRICAREfraudtip@express-scripts.com or call toll free 866-759-6139.  ESI staff can also flag profiles and reject attempts to bill for these medications.  People receiving unsolicited medication in the mail should refuse delivery, said officials.  (Courtesy of TRICARE News)