Question: “I have a personal injury client who was formerly on active military duty. Because my client’s medical treatment took place entirely on the base, Tricare has not paid any bills or provided any lien information. Is Tricare entitled to a lien although it has not provided us notice of any charges?”
Answer: Thanks for reaching out to us. Tricare asserts recovery for injury-related care pursuant to the Federal Medical Cost Recovery Act - 42 U.S.C. §2651-2653 and 32 C.F.R. § 199.12. Any amount paid by Tricare for medical care and services provided to a military beneficiary is considered a claim in favor of the US against any third party for medical care or services provided.
From our experience, Tricare will incorporate care provided at a military treatment facility into its recovery claim. Because this care is not initially billed by a private Tricare provider, medical bills are not originally created. However, when third party liability scenario is identified, Tricare accesses military treatment facility medical records in order to create quantifiable bills for that care. These bills are included with the injury-related Tricare bills paid to private providers, and then combined into one recovery claim.
Tricare expects the plaintiff to include and coordinate the collection of the government’s interest in the plaintiff’s claim, per 32 C.F.R. § 757.18. If Tricare is not satisfied that its interest is being protected, the government may: 1.) require assignment to the extent of the recovery right 2.) intervene in plaintiff’s case or 3.) bring its own action.
Please let us know if we can be of any further assistance.
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