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    TRICARE announces changes to pharmacy benefit, warns of ‘secret shopper’ scam

    TRICARE announces changes to pharmacy benefit, warns of ‘secret shopper’ scam

    Courtesy Photo | Tricare logo. read more read more



    Story by James Goodwin 

    Joint Base Myer-Henderson Hall

    JOINT BASE MYER-HENDERSON HALL, Va. - New TRICARE pharmaceutical policy –

    Starting Oct. 1, TRICARE beneficiaries who take particular brand-name drugs regularly will be required to fill those prescriptions via the mail-in program or at a military treatment facility, such as the Andrew Rader U.S. Army Health Clinic, according to an Aug. 21 Department of Defense news article.

    In the article, the Defense Health Agency’s George Jones, pharmacy operations division chief, is cited as saying that the new policy will not affect active duty service members, overseas beneficiaries, nursing home residents or those with other health insurance.

    TRICARE beneficiaries who will be impacted will be notified by letter this month.

    “Rader Clinic does not generally offer brand name medications, and the mail order program will be the best option for most patients,” said Rader Clinic Chief of Ancillary Services Maj. Thomas Lehmann via email.

    The policy change is meant to save the DoD money, according to the DoD news article.

    Questions regarding which drugs impacted by this new policy can be answered by calling
    1-877-363-1303, or by visiting

    TRICARE warns of ‘Secret Shopper’ fraud targeting beneficiaries –

    A new mail fraud scheme targeting TRICARE beneficiaries lures victims by including a counterfeit TRICARE WPS check for $3,775 and instructions labeled as a survey on how to obtain the money via a phone number, according to a recent TRICARE news release.

    The Defense Health Agency, Office of Program Integrity has received a “significant number” of return envelopes from mailings by a bogus organization identified as Tricare Survey, Inc., to TRICARE beneficiaries across the country attempting to solicit beneficiaries to be “secret shoppers” for Tricare.

    Beneficiaries should know that TRICARE does not employ “secret shoppers,” according to the article.

    The scam works when beneficiaries cash the check, retain a percentage of the money and utilize the remaining amount to purchase six “Vanilla Reload” cards at $500 each at various stores across the country. The “secret shopper” is instructed to provide the company agent with the card numbers once they are bought, complete the survey and mail it, and wait for the next assignment, according to the article. However, once money has been loaded onto the card, they are immediately available for transfer and the bogus company zeros out the monies on the cards.

    The Office of Program Integrity advises beneficiaries not to participate in this or any activity thought to be a scam. The potential exists for beneficiaries to be personally liable for the entire $3,775 in restitution to the bank.

    Those contacted by the fraudulent company to participate in this scam are advised by the Office of Program Integrity not to contact the company or attempt to cash the counterfeit check. Reports of fraud can be submitted via a Fraudline report online at Once on the web site, use the “Report Health Care Fraud” tab to access the report.



    Date Taken: 09.10.2015
    Date Posted: 09.10.2015 17:31
    Story ID: 175637

    Web Views: 75
    Downloads: 0