The VA’s Own Community-Care Administrator Kept the Overpayments: $179.7M

TriWest ran pieces of VA’s community-care programs — and, per the settlement, received VA overpayments and kept them. $179.7 million, the largest VA-specific corporate resolution in this library. It remained a VA contractor.

TriWest administered portions of VA’s Patient-Centered Community Care Program (PC3) and the former Veterans Choice Program, under which VA paid it to coordinate appointments and pay community providers for veterans’ care.

The settlement resolves claims that TriWest received overpayments from VA in connection with administering those programs and kept them — $179,700,000 worth, every dollar of it VA-connected. It is the single largest VA-specific corporate resolution in this library.

And the coda that defines the system: TriWest remained a VA Community Care Network contractor. The settlement resolves claims by agreement; it is not a criminal conviction.

"agreed to pay the United States $179,700,000 to resolve claims that it received overpayments from the VA"
— VA Office of Inspector General bulletin (DOJ announcement)

Source: VA Office of Inspector General bulletin (DOJ announcement). Case file in the VA Fraud case files — part of the VA Fraud record. Cases are published as the courts decided them; amounts are stated as the Justice Department states them (billed, stolen, or ordered in restitution, as labeled).