Any government system is susceptible to a certain amount of abuse, and health care programs like Medicare and Medicaid are no exception. With the programs providing so many with the assistance they need to care for themselves and their families, fraud is a large concern – partly because tax dollars should go where they are needed, and not into the pockets of the unscrupulous, but most importantly because every penny misdirected fraudulently is one that has been taken from people whose health and well-being depends on it.
The Center for Medicare and Medicaid Services (CMS) takes every step it can to fight fraud and ensure that cash spent through Medicare and Medicaid is allocated properly. One of their tools in this endeavor is the Medicare Incentive Reward Program (MIRP) – a program meant to give people who witness fraud an additional incentive to come forward and report it. The program offers a bounty to those who report Medicare fraud – a cash payout of 10% of the money recovered from any fraud settlements, up to a cap of $1000.
But, the CMS takes fraud very seriously, and has been pushing to expand the MIRP. By increasing the bounty from 10% to 15% of the money recovered, and by removing the limit of $1000 imposed on the incentive, the CMS hopes to further encourage anyone who has seen fraudulent behavior or who has evidence that someone is attempting to swindle the Medicare or Medicaid programs to report what they know.
And because defrauding Medicare or Medicaid is also defrauding the US Government, any such suits also fall under the False Claims Act, which gives any whistleblower the power to file a qui tam suit on behalf of the Government as a relator. Relators are eligible for a portion of recovered funds from any such qui tam lawsuits, up to a cap of $66 million, which is awarded separately from any bounties paid by the CMS. Such incentives show just how dedicated the US Government is to fighting fraud.
If you think you have grounds to expose misconduct in the health care industry, or have evidence of someone attempting to defraud Medicare or Medicaid, then you need a law firm with experience and expertise with qui tam suits. Call our offices for a free consultation, and we’ll review your case.