Civil Money Penalties and Assessments Under the Military Health Care Fraud and Abuse Prevention Program

Résumé

This final rule implements civil money penalties authority provided to all Federal health care programs, including the TRICARE program, under the Social Security Act. This authority allows the Secretary of Defense as the administrator of a Federal health care program to impose civil money penalties (CMPs or penalties) as described in section 1128A of the Social Security Act against providers and suppliers who commit fraud and abuse in the TRICARE program. This final rule establishes a program within the DoD to impose CMPs for certain unlawful conduct in the TRICARE program. To the extent applicable, this final rule adopts the Department of Health and Human Service's (HHS's) well-established CMP rules and procedures. The program to impose CMPs within TRICARE is called the Military Health Care Fraud and Abuse Prevention Program. The Defense Health Agency (DHA) shall be the agency within the DoD responsible for administering the Military Health Care Fraud and Abuse Prevention Program.