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{{Short description|Health benefit management corporation}}
▲{{Infobox Company
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| type = Private▼
▲|logo = [[File:TriWest Healthcare Alliance Logo.png]]
▲|type = Private
| foundation = [[Phoenix, Arizona]] (1996)
| location_city = Phoenix, Arizona
| location_country =
<!--modifies "Headquarters" entry-->| origins =
| key_people = David J. McIntyre Jr., President and CEO<br />Elizabeth Kinsley, Exec. VP and CFO<br />Dr. James L. Robbins, CMO<br />James Griffith, CNAO<br />Donna Hoffmeier, SVP<br />Jeanne Ong, CHCO<br />Julie Townsend, CPIO
| area_served = VAPCCC Regions 1, 2, 3, 4, 5, and 6
| industry = [[Health benefits (insurance)|Health benefits]]▼
| products =
▲|industry = [[Health benefits (insurance)|Health benefits]]
|
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| operating_income = ▼
| net_income = ▼
▲|operating_income =
| num_employees = ▼
▲|net_income =
| parent =
▲|num_employees =
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| dissolved = ▼
▲|homepage = [http://www.triwest.com www.triwest.com]
▲|dissolved =
}}
'''TriWest Healthcare Alliance''' is a [[Phoenix, Arizona]] based corporation that manages health benefits under the [[United States Department of
==History==
In 1996, TriWest Healthcare Alliance was established in order to compete for a [[U.S. Government]] contract to manage civilian health care benefits under the newly
The TRICARE Central Region included the following [[U.S. state|states]]: {{Div col}}
* [[
* Southern [[Idaho]]
* [[
* [[
* [[
* [[
* [[
* [[
* [[
* [[
* [[
* [[
* [[El Paso, Texas]]
and [[Wyoming]]. TriWest was awarded an extension to this contract, which continued until 2004.{{Citation needed|date=July 2007}}▼
* [[Utah]]
* [[Wyoming]]
{{Div col end}}
▲
On August 21, 2003, TriWest was awarded the TRICARE Managed Care Support Contract for the TRICARE West Region. The five-year contract, valued at approximately $10 billion, expanded TriWest's service area to 21 states and 2.7 million beneficiaries with the addition of [[Alaska]], [[California]], [[Hawaii]], northern Idaho, [[Oregon]], and [[Washington (U.S. state)|Washington]].<ref>{{cite press release | title = TriWest Healthcare Alliance Awarded $10 Billion Contract to Assist Department of Defense in Meeting Health Care Needs for 21 State TRICARE West Region | publisher = TriWest Healthcare Alliance | date = 2003-08-21 | url = https://www.triwest.com/unauth/content/triwest/newsroom/news/contract/2003/tw_wins_award_03.html | accessdate = 2007-07-25}}</ref>
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On July 13, 2009, TriWest was awarded the contract (also known as the "T-3 contract") to continue providing military families access to health care and manage the 21-state TRICARE West Region for the Department of Defense (DoD).<ref>{{cite press release | title = TriWest Healthcare Alliance Awarded Third TRICARE Contract, Remains Health Care Contractor for Department of Defense in 21-State TRICARE West Region | publisher = TriWest Healthcare Alliance | date = 2009-07-13 | url = http://www.triwest.com/corporate/newslist.aspx?aud=2&xf=071309_tricarecomm | accessdate = 2009-08-14}}</ref>
On March 16, 2012, it was announced that the T-3 West Region contract was awarded to Minnesota
On March 26, 2012, it was announced that TriWest will protest the Department of Defense award of the contract to UnitedHealth. David McIntyre (President and CEO of the TriWest Healthcare Alliance) cited the long history of performance and legal problems with the subsidiary which would handle the T-3 contract.<ref>{{cite press release | title = TriWest Healthcare Alliance to Protest TRICARE Contract Award | publisher = MarketWatch | date = 2012-03-26 | url = http://www.marketwatch.com/story/triwest-healthcare-alliance-to-protest-tricare-contract-award-2012-03-26 | accessdate = 2012-03-26}}</ref>
On July 2, 2012, it was announced that TriWest lost its appeal to keep the West Region contract.<ref>{{cite press release | title = TriWest loses appeal to keep military health contract | publisher = USA Today | date = 2012-07-02 | url = https://www.usatoday.com/money/industries/health/story/2012-07-02/tricare-triwest-united-military/55989350/1 | accessdate = 2012-09-20}}</ref>
==See also==▼
In September 2011, TriWest paid $10 million to settle a Justice Department lawsuit after whistle-blowers claimed TriWest "systematically defrauded" Tricare by billing the government higher rates than they had negotiated with health care providers. The lawsuit also said TriWest sent 3,000 claims through one location a day to intentionally bypass checks to avoid late-payment fees and that it paid claims for ineligible beneficiaries.<ref>{{Cite web|url=https://www.justice.gov/opa/pr/arizona-based-triwest-healthcare-alliance-corp-agrees-pay-10-million-resolve-false-claims-act|title = Arizona-Based TriWest Healthcare Alliance Corp. Agrees to Pay $10 Million to Resolve False Claims Act Allegations Concerning the TRICARE Program|date = 9 September 2011}}</ref><ref>{{cite web |title=Military health care carrier hit with $10M fine |url=http://usatoday30.usatoday.com/news/washington/story/2012-01-27/triwest-military-health-care-fraud/52908332/1 |website=[[USA Today]] |date=2012-02-01 |archive-url=https://web.archive.org/web/20200209024027/https://usatoday30.usatoday.com/news/washington/story/2012-01-27/triwest-military-health-care-fraud/52908332/1 |archive-date=2020-02-09 |url-status=dead |last1=Kennedy |first1=Kelly}}</ref>
In September 2017, VA Inspector General Michael Missal issued a memorandum that listed four major "errors" that had resulted in excess payments to TriWest. These were:
* Duplicate Errors{{snd}}Payments for medical claims that have been paid more than once
* Other Health Insurance (OHI) Errors{{snd}}Payments that were not adjusted for the amount OHI was responsible to pay the provider
* Pass-Through Errors{{snd}}Payments to reimburse the TPA that were more than the TPA paid the provider
* Rate Errors{{snd}}Payments that did not use the appropriate Medicare or contract adjusted rate.
Missal stated in his memorandum that duplicate payments alone racked up almost $40 million in overpayments to TriWest.<ref>{{Cite web |last=Missal |first=Michael J. |date=12 September 2017 |title=Memorandum: Accuracy and Timeliness of Payments Made Under the Choice Program Authorized by the Veterans Access, Choice, and Accountability Act |url=https://www.va.gov/oig/pubs/admin-reports/VAOIG-17-00000-379.pdf |archive-url=https://web.archive.org/web/20171201034417/https://www.va.gov/oig/pubs/admin-reports/VAOIG-17-00000-379.pdf |archive-date=1 December 2017 |url-status=live |publisher=US [[Department of Veterans Affairs]] |access-date=30 December 2022}}</ref>
▲== See also ==
* [[Top 100 US Federal Contractors]]
==References==▼
{{Reflist}}
==External links==
* [
{{Authority control}}
▲==References==
[[Category:1996 establishments in Arizona]]
[[Category:Companies based in Phoenix, Arizona]]
[[Category:Financial services companies established in 1996]]
[[Category:Insurance companies of the United States]]
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