Successful Healthcare Fraud Whistleblowers Get Higher Rewards from False Claims Act

Reporting Medicare fraud directly to CMS will not result in significant rewards for whistleblowers. Although CMS has a Medicare Incentive Reward Program, it will only reward whistleblowers up to 10% of the amount recovered, or a maximum amount of $1000, whichever is less. No such cap exists in the False Claims Act, which provides that successful whistleblowers are entitled to 15-30% of the total recovery from the Defendant, whether through a favorable verdict or settlement.  Notably, from 1986 through September 2013, the total amount of whistleblower rewards paid to relators, pursuant to the False Claims Act, was approximately $4.2 billion, and most of it that amount was paid specifically to healthcare fraud whistleblowers.