Practice Areas

TRICARE and VA Fraud

The False Claims Act applies to fraud against TRICARE and the Department of Veterans Affairs in the same way it applies to Medicare and Medicaid. Healthcare providers who treat active duty military personnel, their families, or veterans and submit false claims to these programs may be subject to qui tam liability. If you have witnessed any of these practices, you may have the basis for a qui tam case. Reach out for a confidential conversation. There is no obligation.

Practice Areas

TRICARE and VA Fraud

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WHAT IS TRICARE AND VA FRAUD?

TRICARE is the federal healthcare program administered by the Defense Health Agency that provides coverage for active duty service members, their families, National Guard and Reserve members, and military retirees. The Department of Veterans Affairs (VA) operates a separate healthcare system that provides medical care to eligible veterans. Both programs are funded by the federal government and both are subject to the False Claims Act.

TRICARE and VA fraud occurs when healthcare providers submit false or inflated claims to these programs for services that were not provided, were not medically necessary, or were misrepresented to increase reimbursement. It also includes schemes that involve kickbacks to physicians or other referral sources for directing patients to particular providers or ordering particular services that are then billed to TRICARE or the VA. Healthcare insiders with direct, first-hand knowledge of these practices may be eligible to file a qui tam lawsuit on behalf of the government and receive a share of any financial recovery.

Advanced Urology and its owner agreed to pay $14 million in April 2026 to settle False Claims Act allegations of fraudulent billing and unnecessary medical procedures billed to TRICARE and the VA. The case was initiated by two separate whistleblower complaints filed by former employees of the practice.

Source: U.S. Department of Justice, April 2, 2026 | justice.gov

Legal basis: 31 U.S.C. § 3729 (False Claims Act) | 10 U.S.C. § 1071 et seq. (TRICARE/military health care) | 38 U.S.C. § 1701 et seq. (veterans health care) | Source: uscode.house.gov

TYPES OF TRICARE AND VA FRAUD THIS PRACTICE HANDLES

TRICARE and VA fraud encompasses a range of false billing schemes that arise in Medicare and Medicaid fraud, applied to military and veterans healthcare programs. The following are the most common types handled by this practice.

Military Healthcare Fraud: Submitting false claims to TRICARE for services that were not provided, were not medically necessary, or were misrepresented to obtain higher reimbursement. This includes upcoding procedures billed to TRICARE, billing for services that were performed on patients covered by other programs but billed under TRICARE, and structuring referral or compensation arrangements in ways that violate the Anti-Kickback Statute when TRICARE is the paying program. Providers who contract with TRICARE or who see a mixed patient population including TRICARE beneficiaries may be in a position to observe discrepancies in how TRICARE claims are handled compared to other payers.

Veterans Healthcare Fraud: Submitting false claims to the Department of Veterans Affairs for services not provided, unnecessary services, or services billed under inflated codes. The VA also contracts with community healthcare providers through the VA Community Care program, and false claims submitted by community providers through that program fall within the scope of the False Claims Act. VA employees, community providers, and administrative staff who are aware of fraudulent billing practices affecting the VA healthcare system may have direct knowledge of a qui tam case.

Legal basis: 31 U.S.C. § 3729(a)(1)(A) and § 3729(a)(1)(B) (False Claims Act) | 10 U.S.C. § 1071 et seq. (TRICARE) | 38 U.S.C. § 1701 et seq. (veterans health care) | 42 U.S.C. § 1320a-7b (Anti-Kickback Statute) | Source: uscode.house.gov

WHO CAN REPORT TRICARE AND VA FRAUD?

The strongest TRICARE and VA fraud qui tam cases come from current or former employees who have direct, first-hand knowledge of the fraudulent conduct from inside the organization. This includes billing staff at practices or facilities that treat TRICARE or VA patients and who are aware of claims being submitted for services not rendered or misrepresented, clinical staff including nurses, technicians, and physicians who know what services were and were not provided to military or veteran patients, compliance officers who have identified billing practices that do not accurately reflect the care delivered to TRICARE or VA beneficiaries, and administrators or finance staff at practices that participate in TRICARE or the VA Community Care program who are aware of systematic billing discrepancies.

You do not need all the documentation before contacting us. If you have witnessed conduct that you believe constitutes false claims to TRICARE or the VA, that is enough to start a confidential conversation. We investigate thoroughly before asking for any commitment.

In fact, many former employees come forward with knowledge of fraudulent practices by their former employers after they have been demoted or terminated for complaining to their supervisors about the fraudulent practices or leaving their employment because they refuse to participate in the fraud.

Legal basis: 31 U.S.C. § 3730(b) (qui tam provisions) | Source: uscode.house.gov

YOUR PROTECTIONS AS A WHISTLEBLOWER

When you file a qui tam complaint, it is submitted under seal and served on the Department of Justice and any state agencies that have been impacted by the alleged fraud. During the time the case is under seal, your employer is not notified and does not receive a copy of the complaint. Your identity remains protected throughout the government’s investigation.

The False Claims Act prohibits your employer from firing, demoting, suspending, harassing, or otherwise retaliating against you for reporting fraud or participating in a qui tam case. These anti-retaliation protections apply to both current and former employees.

If your employer retaliates against you, you have legal remedies that include reinstatement, two times the amount of back pay owed, interest on that back pay, and compensation for special damages including litigation costs and attorney fees.

Legal basis: 31 U.S.C. § 3730(h) (anti-retaliation) | 31 U.S.C. § 3730(b) (under seal filing) | Source: uscode.house.gov

WHISTLEBLOWER REWARDS

When a qui tam lawsuit results in a financial recovery, the False Claims Act entitles the relator to receive a percentage of the total amount recovered by the government. If the government intervenes and takes over the case, the relator may receive between 15% and 25% of the recovery. If the government declines to intervene and the relator proceeds independently, the share can rise to between 25% and 30%. There is no cap on the dollar amount of the reward. We work on a contingency fee basis. There is no upfront cost, and if there is no recovery, you owe us nothing.

Legal basis: 31 U.S.C. § 3730(d)(1) and § 3730(d)(2) | Source: uscode.house.gov

About This Practice

Arvind Bob Khurana has over 27 years of experience in qui tam and False Claims Act litigation, complex commercial litigation, and class action matters. He began his career at a top international defense firm and joined a national class action firm in 2005, becoming partner in 2009, where he worked on ERISA actions, qui tam cases, securities fraud, and antitrust matters. He is admitted to the New York State Bar and represents whistleblowers in federal courts nationwide.

We are selective. Before we ask for any commitment, we investigate the claim, explain the facts and the risks, and give you a complete picture of what you are facing. We never ask you to sign a retainer agreement until you have the full picture and have decided, on your own terms, that you want to move forward. You remain in control throughout.

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Whistleblower Attorney

Arvind Bob Khurana has over 27 years of experience in complex litigation. We work on contingency. There is no upfront cost and no obligation to proceed.