CMS Keeps The Carrot Small For Whistleblowers

Just eight months ago, the U.S. Department of Health and Human Services (HHS)'s Centers for Medicare and Medicaid Services (CMS) announced a proposal to raise the ceiling for whistleblower payouts to nearly $10 million from the current cap of $1,000.  This increased monetary incentive was just one of many provisions designed to decrease Medicare fraud. While the intention of the proposed rule was to intensify the fight to prevent Medicare fraud and abuse, many critics believed that it would open the floodgates to unsubstantiated fraud claims.

 It appears that CMS took commenters' concerns seriously. Earlier this month, the agency prepared and released a 140-page final rule that includes many provisions previously announced in April, but conspicuously excludes huge monetary incentives for whistleblowers.  A fact sheet on the final rule can be found here.