Medicare whistleblower program increases maximum reward to $9.9M

The proposal “is a signal to Medicare beneficiaries and caregivers, who are on the frontlines of this fight, that they are critical partners in helping protect taxpayer dollars,” Sebelius continued.


In the proposed rule, HHS cited a similar strengthening of the whistleblower program at the Internal Revenue Service (IRS) that is aimed at thwarting tax fraud.

“The IRS program has proved to be highly successful in generating leads that returned far greater sums than the existing Medicare [Incentive Reward Program] IRP, which limited rewards to 10 percent of the first $10,000 of the final amount collected,” the department said in its proposal.

Regulations in the new program would increase the rewards from 10 percent to 15 percent of the total amount of recovered funds. The new proposal would also increase the cap on the recovery fund awards to $66 million, meaning a person can earn as much as $9.9 million if CMS collects more than $66 million as a result of a fraud tip.

HHS said the cost to bolster the program would be $70,000.