April 25—A federal proposed rule would increase substantially the percentage and maximum of rewards paid to Medicare beneficiaries and other individuals whose tips about suspected fraud lead to the successful recovery of funds. 

Under the proposed changes, a person that provides specific information leading to the recovery of funds may be eligible to receive a reward of 15 percent of the amount recovered up to $10 million, according to the U.S. Department of Health and Human Services (HHS). HHS currently offers a reward of 10 percent up to $1,000 under the current incentive reward program. 

The proposed rule would also strengthen certain provider enrollment provisions, including allowing HHS to deny enrollment of providers that are affiliated with an entity that has unpaid Medicare debt. Other funding expands Senior Medicare Patrol activities to educate Medicare beneficiaries on how to prevent, detect, and report Medicare fraud, waste, and abuse.

Publication Date: Thursday, April 25, 2013