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Thursday, May 2, 2013

Are Medicare Fraud Tipsters in Line for a Big Payday?

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Medicare fraud tipsters may soon be rolling in the money, thanks to a recent HHS proposed rule that would increase reward money for a successful tip from a maximum of $1,000 all the way up to $9.9 million. Currently, HHS offers a reward of 10 percent of the total amount recovered, capped at $1,000, while the proposed rule would bump the rate up to 15 percent, capped at $9.9 million. HHS said the increase in reward money was based on a rewards program run by the Internal Revenue Service that has proven to be highly successful. The proposed rule, which was published in the April 29 Federal Register, will be open to comments until June 28.

I spoke with Kirk Ogrosky, an attorney at Arnold & Porter and the former head of criminal health care enforcement at the Department of Justice, and he said the new reward structure will only be successful if DOJ works with the health care industry to block qui tam whistleblower suits that are filed after a fraud tip has been submitted. "Currently, the pile of ill-advised qui tams continues to grow, and the government doesn’t address them, so what will happen to all the tips filed with CMS," Ogrosky told me.

 

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