TRICARE

The TRICARE program is a government program for the military and their dependents. It is the successor to the Civilian Health and Medical Program of the Uniformed Services (“CHAMPUS”). CHAMPUS was a program created by the Dependents’ Medical Care Act of 1955, Pub. L. 84-569, 70 Stat. 250 (1956) for dependents of active duty members. The program was then expanded to include retirees, their dependents and survivors.

TRICARE limits the amounts physicians can beneficiaries in TRICARE, even if physicians are not participating in the program. However, if the physician becomes "non-authorized" under TRICARE, then in at least one case the physician has been allowed to enter into private contracts with the TRICARE beneficiaries at free-market rates. Note that the status "non-authorized" is more removed from TRICARE than merely "non-participating".

Note, however, that active duty members do not have authority to waive limitations on fees.