Many Medicare fraud schemes rely on “patient recruiters” to scour local communities for senior citizens who, knowingly or not, can provide personal information that can be used to generate false bills.
The CMS has long zeroed in on this potential weakness in fraud conspiracies by offering up to $1,000 to seniors who report patient recruiters to authorities. Now a new CMS proposal would dramatically increase potential payouts to such whistle-blowers, capping such awards at nearly $10 million.
The proposed rule, which was published in full in the Federal Register today (PDF), would transform the existing incentive reward program for Medicare beneficiaries into a system akin to the False Claims Act system, which gives whistle-blowers a percentage of any money recouped from fraud schemes.
The proposal would give Medicare beneficiaries whose tips lead to fraud busts 15% of any money recovered, with a maximum award of $9.9 million for any scheme that nets more than $66 million in recoveries.
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