New DOJ Program Offers Significant Monetary Rewards to Health Care Fraud Whistleblowers

Posted on Fraud Investigation, Health Care Law News by Sydney Madow

On August 1, 2024, The Department of Justice (DOJ) Criminal Division began a three-year Corporate Whistleblower Awards Pilot Program in its efforts to prosecute corporate crimes. The pilot program offers large financial payouts to whistleblowers who turn over original and truthful information related to financial crime, bribery, foreign corruption involving corporate misconduct, and health care fraud schemes involving private companies. If the information a whistleblower submits results in successful prosecution and criminal or civil forfeiture, they may be entitled to a reward. Rewards are discretionary, but if information provided by a whistleblower leads to forfeiture over $1 million, they may be eligible for an award of up to 30 percent of the amount recovered. Whistleblowers who alert their employers to fraud and misconduct alongside reporting to the DOJ could receive a higher award.

There are a few caveats to the pilot program: the whistleblower is only eligible for a reward from the DOJ if they are not already eligible for an award from another federal agency. They must not be involved in the misconduct, and must not have obtained the information in the course of their work as a compliance officer or internal auditor. In order to receive a reward, the whistleblower must be the first person to offer information regarding the fraud scheme.

In the wake of the COVID-19 Public Health Emergency (PHE) the DOJ has recently increased investigation and prosecution of health care fraud schemes. The newly-announced whistleblower awards are part of the DOJ’s efforts to ramp up enforcement of federal civil and criminal laws relating to health care fraud. In April 2024, the DOJ also launched a pilot program for employees or executives involved in fraud schemes who may be eligible for immunity to prosecution in exchange for information related to the fraud scheme that results in prosecution of those responsible.

For further information regarding the whistleblower scheme, visit the DOJ Criminal Division page.

The attorneys of Nicholson & Eastin routinely represent whistleblowers in connection with health care fraud-related False Claims Act cases.  If you need assistance with a False Claims Act matter, please do not hesitate to contact us to evaluate your case.