HHS Proposed Rule Would Increase Medicare Whistleblower Reward

The Department of Health and Human Services (HHS) released a proposed rule last week that would increase the reward for tips uncovering Medicare fraud under the Incentive Reward Program to as much as $9.9 million.

In order to receive the reward, the tip must lead to a recovery of Medicare funds.  Currently, the reward is 10 percent of the final amount collected, although HHS pays only on the first $10,000 it collects as a result of the information.

The proposed rule would increase the tipster’s share to 15 percent and would require HHS to pay a reward up to the first $66 million recovered.  Thus, a tip could potentially lead to a $9.9 million reward if HHS recovers $66 million or more.

The Incentive Reward Program has recovered $3.5 million and only paid $16,000 on 18 rewards since its inception in 1998.  The proposed increases are modeled after an IRS whistleblower program that has recovered over $2 billion since 2003.

The proposed rule can be read here.