The Department of Health and Human Services (HHS) proposed a rule to increase whistleblower payouts for people who come forward with information about healthcare fraud. The current cap on payments is $1,000; under the new rule, fraud reporters could receive up to 15 percent of any recovery resulting from their information, up to $9.9 million.
The Centers for Medicare and Medicaid Services, a division of HHS, proposed the rule last Wednesday. HHS Secretary, Kathleen Sebelius, said the rule is a “signal to Medicare beneficiaries and caregivers, who are on the front lines of this fight, that they are critical partners in helping protect taxpayer dollars.”
In 2009, a bipartisan coalition supported strengthening the False Claims Act, and in the 2010 healthcare law, the Obama administration pushed for more money and tougher tools to fight fraud. According to USA Today, whistleblower cases are one of the main tools the Justice Department uses to fight fraud. Tony West, an assistant Attorney General in the civil division of the Justice Department told USA Today last year, “We’ve made healthcare fraud such a high priority; we’ve been using this tool very, very aggressively.”
Over the past two decades, whistleblower cases have increased substantially, and average nearly three times the amount of money back to the government as non-whistleblower cases. Last year, the government recovered a record-breaking $4.2 billion, and returned $14.9 billion to taxpayers between 2009 and 2012. About 36 percent of the nearly $16 billion recovered by the Justice Department resulted from whistleblower healthcare fraud cases since 2009.
“These changes in whistleblower rewards go to show just how important whistleblowers are in the fight against fraud on our government. In a time of skyrocketing healthcare costs, one surefire way to reduce the expenses all of us incur is to eliminate as much healthcare fraud as possible. The brave men and women who come forward and expose these crimes deserve to be rewarded for bringing these schemes to light and the perpetrators to justice,” says Chris Paulos, attorney with Levin, Papantonio law firm.
Alisha Mims is a writer and researcher for Ring of Fire.