A reward sends a clear message to potential whistleblowers that their information is valuable to the government and can mitigate the risks of retaliation by their employers.

What is the reward for healthcare whistleblowers for reporting Medicare billing fraud or insurance fraud?

"A whistleblower is typically entitled to a share of the financial recovery, which is typically between 15% and 30%.  A whistleblower is called the “relator” and if they are not an employee at the time of filing the case, it is then called a qui tam case.  In order to receive an award the whistleblower must have: 1) Specific personal knowledge about the violations, 2) Cannot (or minimally) have participated in the violation, and preferably protested on record about the violations, 3) Have evidence in hand, such as emails, texts, contracts, specific transactions, with names, dates, numbers, that would lead the U.S. Department of Justice investigators to start their investigations.  Some of the larger awards given to whistleblowers are well above $100 million, it will depend on the case at hand; and many of them include healthcare providers, insurance companies, and pharmaceuticals.

How Much Reward a Whistleblower Will Get Depends on the following:

  • Did the whistleblower and their attorney help with the investigation and litigation?
  • How widespread and extensive is the fraud?
  • How much effort the government had to put into the case?
  • Did the government already know about the fraud before the whistleblower reported it?
  • Did the whistleblower participate in the wrongful conduct?
  • How big was the settlement?
  • Did the whistleblower get adversely affected as a result of the whistleblower lawsuit?

The rewards under the False Claims Act are calculated as follows:

1) Actual Damages to the government - the amount of overpayment received, plus

2) Treble Damages - three times the amount of the actual damages, plus

3) For example as of 2021, Federal Penalties on the low side are $11,803 per claim filed, and on the high side are $23,607 per claim filed; hence supposing 100 false claims could result in penalties ranging from $1,180,300 to $2,360,700.  Obviously, this would be significantly different if there were 10,000 claims, hence the amount would be $118,030,000 to $236,070,000 in penalties, plus

4) Florida FCA Penalties are not less than $5,500 and not more than $11,000 per claim, plus treble damages for the claim submitted.  Other states have similar penalties.

Plus there are other penalties and fines that will likely apply. 

Under the False Claims Act, the penalties are often much higher than the actual or treble damages.  The healthcare whistleblower would then be entitled to essentially a bounty fee equal to a portion of that recovery between 15% and 30%.

Remember you cannot win an Award unless you file a Lawsuit.

If you think you have a situation that you would like to discuss with an attorney in confidence, do not hesitate to contact our team directly, call Cell/Text at 954-634-2370 or email at [email protected].  We are a team of lawyers ready and standing by to correct the wrong, and we will do our best to earn you an award.  We only make money if you get an award from the government. The right team of attorneys can make all the difference.  We stand by to earn your business.