International SOS, as part of the TRICARE Overseas Program (TOP), is committed to
detecting, correcting and preventing health care fraud and abuse.
You are the most important link in finding and reporting fraud and abuse; not only to save valuable benefit
dollars, but also to make certain that your identity is safe and you will receive appropriate medical care.
Click here for more information regarding protecting your identity.
The following information will help you identify and report any suspected cases
of fraud or abuse as they relate to the TOP health care benefits you receive or
You can also reference the TRICARE 32 Federal Code of Regulations (CFS 199.9),
Administrative Remedies for Fraud, Abuse & Conflicts of Interest by clicking here.
Fraud Tip Hotline
Please report, anonymously or by name, any suspected fraudulent or abusive behavior
by beneficiaries or providers using one of the following options:
Click here to download and complete
a Fraud and Abuse Report form.
Mail correspondence to:
ATTN: TRICARE Program Integrity
1717 W. Broadway
P.O. Box 7635
Madison, Wisconsin 53707
Please provide as much information as possible to assist in the investigation. Any
information you provide will remain strictly confidential.
* Note: It is current Hotline Policy not to respond directly to written communications.
What is Fraud?
Fraud is intentional deception or misrepresentation that an individual knows to
be false or does not believe to be true, when that individual knows that the deception
could result in some unauthorized benefit to himself or herself or some other person.
This also includes identity theft (e.g. if someone else utilizes your TRICARE card to
The most frequent kind of fraud arises from a false statement or misrepresentation
in order to obtain some benefit or payment for which no entitlement would otherwise
exist. These acts may be committed either for the person’s own benefit or for the
benefit of some other party. In order to prove that fraud has been committed against
the Government, it is necessary to prove that fraudulent acts were performed knowingly,
willfully, and intentionally.
What is Abuse?
Abuse involves actions that are inconsistent with accepted, sound medical, business,
or fiscal practices. Abuse directly or indirectly results in unnecessary costs to
the TRICARE program through improper payments. Abuse does not necessarily involve
fraud, violation of laws, regulations, or provisions of a contract or grant agreement.