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Report File
Date Issued
Submitting OIG
Department of Defense OIG
Agencies Reviewed/Investigated
Department of Defense
Report Number
DODIG-2025-089
Report Type
Audit
Agency Wide
Yes
Questioned Costs
$0
Funds for Better Use
$0
Report updated under NDAA 5274
No

Open Recommendations

This report has 3 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
D-2025-0089-D000AW-0001-0001.a No $0 $0

Rec. 1.a: The DoD OIG recommended that the Director, Defense Health Agency, reassess and revise the state prevailing rate methodology within
the TRICARE guidance to ensure the development of reasonable state
prevailing rates.

D-2025-0089-D000AW-0001-0001.b No $0 $0

Rec. 1.b: The DoD OIG recommended that the Director, Defense Health Agency, develop and issue guidance to require Health Care Fraud Resolution, or another appropriate office, to review the developed state prevailing rates for reasonableness and consistency on an annual basis.

D-2025-0089-D000AW-0001-0001.c No $0 $0

Rec. 1.c: The DoD OIG recommended that the Director, Defense Health Agency, develop and implement an oversight mechanism to ensure that the TRICARE East and West Region contractors take timely and appropriate action to ensure the reasonableness of the new reimbursement rates in accordance with TRICARE Reimbursement Manual, Chapter 1, Addendum E, "Controls for Excessive Charges For Professional Services, And Durable Medical Equipment, Prosthetics, Orthotics, And Supplies/Parenteral And Enteral Nutrition (DMEPOS/PEN) Services Without Established Rates."

Department of Defense OIG

United States