Medicare General Information, Eligibility and Entitlement Manual (Pub. 100-01), Ch. 6 § 130.2
Type of Information
130.2 - Type of Information
(Rev. 1, 09-11-02)
We expect that most requests from TriCare for information will involve primarily Part B
Medicare operations in such areas as identification of physicians and other medical
practitioners who may be engaging in providing excess services or fraud. Before we
release this information to a requesting TriCare contractor that is not also a Medicare
contractor, a Medicare contractor must have previously released the information in the
administration of Title XVIII to:
•
An official of a medical or other applicable professional society or
•
An official of a State licensing board, or
•
Any other officer, agency, establishment or department of the Federal
Government charged with the duty of conducting an investigation to determine
whether there has been a violation of any provision of Federal law (see §120 of
this chapter).
We may also disclose to TriCare the types of data covered in §100.2 of this chapter, upon
request when authorized by the beneficiary or the beneficiary's legal representative. In
addition, we will, upon request, make available to TriCare Economic Index Data (as
prescribed by §§405.502(a) and 405.504(a) of Regulations No. 5) that might affect the
limits on prevailing charge levels.