TriWest Healthcare Alliance Corp. has agreed to pay the United States $179,700,000 to resolve claims that it received overpayments from the US Department of Veterans Affairs (VA) in connection with its administration of certain VA healthcare programs, the Department of Justice announced. TriWest, an Arizona corporation headquartered in Phoenix, is in the business of administering government healthcare programs, including those operated by the VA. TriWest is responsible for administering certain portions of the VA Patient-Centered Community Care Program (PC3) and the VA’s former Veterans Choice Program (Choice). Both programs have enabled veterans to obtain medical care from providers in their communities. As an administrator of these programs, TriWest is paid by the VA to coordinate medical appointments and make payments to healthcare providers. The settlement resolves allegations that TriWest retained overpayments from the VA in connection with its administration of the PC3 and Choice Programs. The alleged overpayments included payments by the VA to TriWest twice for the same services as well as payments for services for which TriWest received full or partial reimbursement from certain healthcare providers.
