If this was a game of jeopardy and that was the answer, the question would be, “How much Medicare Fraud is there per year?” Even with all the efforts to police Medicare and Medicaid, the government still is stung for an average of $60 billion dollars a year according to an interview Attorney General Jeff Sessions did with the AARP (https://www.aarp.org/money/scams-fraud/info-2018/jeff-sessions-interview.html)
How much of a whistleblower award could that be? Technically, under the False Claims Act (FCA) a relator could receive up to 30% of the amount the government receives. So doing the math, if all that was the result of relators and whistleblowers, there could be $18 Billion dollars a year in whistleblower awards. More than likely though, the relator share would be around 20% if the government intervenes, so that still would be a lofty $12 Billion dollars available to whistleblowers each year for doing the right thing and blowing the whistle on Medicare Fraud.
Opioids have become a priority for this administration. Sessions indicated, “Some of the more blatant problems were highlighted in our Medicare fraud takedown recently where we had a sizable number of physicians that were overprescribing opioid pain pills which were not helping people get well, but instead were furthering an addiction being paid for by the federal taxpayers.”
If the case has an opioid nexus and there is false billing, over prescription of opioids leading to addiction and other issues, there’s a strong chance that the government will streamline the case and intervene.
Not every case will win. But you can’t win unless you try. If you’re wondering, “how do I blow the whistle on Medicare Fraud,” and what are some sample whistleblower awards, you should speak with a whistleblower lawyer to go over your options and find out if you might have a viable case that can serve up a piece of that large pie for doing the right thing.