If you report Medicare fraud you could get a whistleblower reward. Why does the government pay rewards for reporting Medicare fraud?
Here’s the problem. It is estimated that ten percent of Medicare costs are lost due to fraud by healthcare providers. Because the Medicare program spends $500 billion a year, it means $50 billion a year goes down the drain by healthcare providers submitting fraudulent bills. On its own, the government is unable to catch those cheating Medicare. It’s no wonder we have a healthcare crisis.
Now here’s the solution. The government was wise enough to create a new reward program to invite whistleblowers to step forward. The twist that makes the reward program successful is paying a reward based upon a combination of how good the information was and the result.
First, there are no rewards for simply calling a hotline with a tip and hoping that the government opens an investigation and develop proof. Instead, the new whistleblower reward program requires you to hire an attorney to file a qui tam complaint alleging specific and detailed evidence of fraudulent billings by a healthcare provider.
Second, the reward is based on results. You get a reward of between 15% and 25% of what the government collects back from the fraudster—no matter how much is recovered. In one Medicare fraud case I worked at as an attorney with the Department of Justice, a whistleblower alleged that a large chain of hospitals was keeping two sets of books to keep track of how much it was cheating Medicare. We ended up settling the case for $641 million and paid the whistleblower $100 million!
Here’s why the new Medicare whistleblower reward program works. The incentive is large enough to make it worth the effort. In fact, the average whistleblower reward is $1 million and the largest rewards top $100 million. So far, whistleblowers have received $2.9 billion in rewards for helping the government collect back $18.5 billion in fraudulent billings. This is one of the best returns on investment the government has ever done. By paying whistleblower rewards of roughly 16% of what it would not have otherwise recovered, the Medicare program netted over $15 billion!
Rewards are available for reporting all types of Medicare fraud, whether it is a doctor, hospital, nursing home, dentist, or durable medical equipment provider. Unlike the government budget, there is no limit to the number or amount of rewards because whistleblowers get a portion right of the top of the money brought in for reporting Medicare fraud.
The whistleblower reward program is working wonderfully, but there is much more work ahead because most people still don’t know that it exists. Here’s how you can do your part. First, if you know of Medicare fraud, report it. Second, and more importantly, pass along this blog to everyone you know. The more who know about the whistleblower reward program the better because more people will report Medicare fraud and the more who do the less brazen will be those who think they can get away with ripping off Medicare leaving you and me to pay for it.
Let’s go out and change the world by doing the right thing of reporting Medicare fraud and get a reward in the process.