Medicare is serious about enlisting your help to fight fraud. If you suspect fraud and you meet all five of these conditions, you could be eligible for a reward of $1,000. Here are the conditions:
1. You report your suspected Medicare fraud. The allegation must be specific, not general.
2. The suspected Medicare fraud you report must be confirmed as potential fraud by the Program Safeguard Contractor, the Zone Program Integrity Contractor, or the Medicare Drug Integrity Contractor (the Medicare contractors responsible for investigating potential fraud and abuse) and formally referred as part of a case by one of the contractors to the Office of Inspector General for further investigation.
3. You aren’t an “excluded individual.” For example, you didn’t participate in the fraud offense being reported. Or, there isn’t another reward that you qualify for under another government program.
4. The person or organization you’re reporting isn’t already under investigation by law enforcement.
5. Your report leads directly to the recovery of at least $100 of Medicare money. The incentive reward can’t exceed 10 percent of the overpayments recovered in the case, or $1,000, whichever is less. If multiple individuals qualify for a reward, the reward is shared among them. If you want to know more about the Incentive Reward Program, call 1-800-MEDICARE.
