Fraud Spread to Makati Medical Center (MMC)

We have a recent report that the doctors at MMC have also doubled their fees in direct violation of the TRICARE Management Activity directive that says, “To be included on the approved list, a provider must agree to accept reimbursement at the lower of the usual and customary charges and the established fee schedule.”

We have no feedback that indicates they were also advised by ISOS/Global 24 to double their fees to TRICARE demonstration patients but given the now widespread and consistent doubling of outpatient fees it should be safe to assume that these doctors were also pulled into the fraud by the contractor.

A recent inquiry to Global 24 resulted in a statement that all providers had signed an agreement that forbid them from increasing fees for processing claims but this appears to be exactly that or an incentive offered by ISOS/Global 24 to get physicians to sign onto a program they were reluctant to get involved in again.

The result is a doubling of the cost of care to beneficiaries and the taxpayer alike; so much for TRICARE’s claim this program will reduce the cost of care and fraud.

About TRICARE Overseas Philippines

We are U.S. Military retirees working to insure we obtain the medical benefit promised in spite of the Defense Health Agency.
This entry was posted in Closed Network, CMAC Table, International SOS, Tricare Management Activity (TMA), Tricare Overseas Program Philippines. Bookmark the permalink.

6 Responses to Fraud Spread to Makati Medical Center (MMC)

  1. John says:

    So many instances if TRICARE allowing fraud, and nothing is done to stop it.

    Liked by 1 person

  2. Sam Houston says:

    I am using a certified provider in Olongapo and paying cash. Not sure what will happen when I file my claims with Tricare.

    Liked by 1 person

  3. wgraue says:

    “One by one, they all fall down!” Still no lucid response from ISOS, TMA or the Glob, I take it.
    It seems they have all pulled their heads down waiting for the storm to pass.

    Liked by 1 person

  4. Well Dick if you don’t care if you get defrauded I don’t care. But unfortunately you are not the only one being defrauded, all other beneficiaries forced to use this system as well as the taxpayer. In the past when many local groups charged these overcharges Tricare closed them down and then blamed the fraud on retirees like you who also said I don’t care if they charge more because they file claims. The history in the Philippines, between some providers and ISOS, fraud for personal profit. As in the past there are a few beneficiaries who embrace any fraud as better than nothing. I’ve seen others like you defend many of the past defrauders for the very same reasons. In other words you and they have said in the past and are saying now, fraud is fine if I think I can benefit from it. Fortunately the majority of beneficiaries have higher standards than that.

    Liked by 1 person

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