HHS Would Hike Whistleblower Rewards to $10M
The federal government has recovered more than $14.9 billion in fraud over the past three years, thanks in part to whistleblowers. Under the proposed changes, a person who provides information leading to the recovery of money can collect a reward of 15% of the amount recovered, up from 10% under the current rules. If CMS recovers more than $66 million under the proposed change, the reward is capped at $9.9 million.
The proposed changes are modeled on an IRS program that has returned $2 billion in fraud since 2003, HHS said in a media release.
The proposed rule would also strengthen some provider enrollment provisions including allowing HHS to deny enrollment of providers affiliated with an entity that has unpaid Medicare debt, deny or revoke billing privileges for individuals with felony convictions, and revoke privileges for providers and suppliers who abuse billing privileges, HHS said.
The volunteer-based Senior Medicare Patrol program has since 1997 taught more than 3.5 million beneficiaries how to recognize and fight fraud and abuse. More than 7,000 tips have been called in to the Centers for Medicare & Medicaid Services and the Office of the Inspector General.
To expand the SMP program's capacity, the Administration for Community Living issued new funding that makes each of the current 54 SMP projects eligible for rewards from a pot of up to $7.3 million, HHS said.
John Commins is a senior editor with HealthLeaders Media.
- CMS Mulls Income-Adjusting MA Stars
- Providers Prep for New Payment Models as Population Health Grows
- Providers' Push to Consolidate Roils Payers
- 3 Ways to Rev Employee Development Programs
- Transforming Decision Support and Reporting
- As Retail Clinics Surge, Quality Metrics MIA
- Aligning Executive Compensation with Provider Mission
- Nurse Ethics Comes to a Head at Guantanamo Bay
- In Lakeport, CA, a Population Health Laboratory is Born
- 6 Not-So-Good Reasons for Avoiding Population Health