Obama Administration Offering Seniors a Reward of
Almost $10 Million for Exposing Medicare Fraud
Also funding expansion of Senior Medicare Patrol to
spread the word on fraud, waste and abuse - elderly are on
'frontlines of this fight,' 'critical partners' in protecting taxpayer
24, 2013 – The Obama Administration made it clear today that it is out
to stop Medicare fraud. The proposal of a new rule today indicates they
want to increase rewards paid to Medicare beneficiaries and other
individuals whose tips about suspected fraud lead to the successful
recovery of funds to as high as $9.9 million from the current limit of
A new funding opportunity, also released this
month, supports the expansion of Senior Medicare Patrol activities to
educate Medicare beneficiaries on how to prevent, detect and report
Medicare fraud, waste and abuse.
“President Obama has made the elimination of fraud,
waste and abuse, particularly in health care, a top priority for the
administration,” said Secretary of Health and Human Services Kathleen
Sebelius today in announcing the new rule.
“Today’s announcement is a signal to Medicare
beneficiaries and caregivers, who are on the frontlines of this fight,
that they are critical partners in helping protect taxpayer dollars.”
Over the last three years we have recovered over
$14.9 billion in fraud. Some of this has resulted from fraud reporting
by individuals –a proven tool for the government to detect fraud, waste
and abuse in the Medicare program.
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
HHS currently offers a reward of 10 percent up to
$1,000 under the current incentive reward program. The changes are
modeled on an IRS program that has returned $2 billion in fraud since
The proposed rule would also strengthen certain
provider enrollment provisions including allowing HHS to deny enrollment
of providers who are affiliated with an entity that has unpaid Medicare
debt, deny or revoke billing privileges for individuals with felony
convictions , and revoke providers and suppliers who are abusing their
The Senior Medicare Patrol (SMP) is a
national, volunteer-based program that empowers Medicare beneficiaries
to prevent and report Medicare fraud, waste, and abuse. Since 1997, more
than 3.5 million beneficiaries have learned how to recognize and fight
fraud and abuse, and more than 7,000 referrals have been made to CMS and
the Office of the Inspector General for investigation.
To expand the SMP program’s capacity to reach more
Medicare beneficiaries, the Administration for Community Living has
issued a new Funding Opportunity. Each of the current 54 SMP projects
is eligible for varying funding levels, up to a total of $7.3 million
across the program.
These proposed changes will support the
administration’s comprehensive approach to program integrity, including
the work being done with the Health Care Fraud Prevention and
Enforcement Action Team, a joint effort by HHS and the Department of
Justice to fight health care fraud that recovered a record $4.2 billion
in taxpayer dollars in Fiscal Year (FY) 2012.
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