If you see something, say something. Medicare fraud costs taxpayers over $100 billion per year. Your report could help recover millions — and you may be entitled to a reward.
Follow these steps to file an effective fraud report
Collect everything you can before reaching out. The more detail, the better the investigation.
Call the OIG hotline (1-800-HHS-TIPS), submit online at OIG.HHS.gov, or email HHSTips@oig.hhs.gov. For whistleblower rewards, consult a False Claims Act attorney first.
Provide the provider name, NPI, dates, locations, and a clear description of what happened. Include any supporting documents.
Save your reference number. You may be contacted for additional information. Anonymous reports are accepted but named reports lead to better outcomes.
Having these ready will make your report much more effective
Report billing errors, suspicious charges on your Medicare statements, or providers charging for services you didn't receive.
Every state has a Medicaid Fraud Control Unit (MFCU) that also handles Medicare fraud referrals.
Find Your State's MFCU →Your report is logged and reviewed by OIG analysts. They assess whether the complaint warrants further investigation.
If warranted, investigators examine billing records, interview witnesses, and subpoena documents. This can take months to years.
Cases may result in civil settlements, criminal charges, or exclusion from Medicare. The DOJ recovered $2.2B in healthcare fraud in FY2023.
Federal law protects you from retaliation. If your employer fires you for reporting fraud, you may have a wrongful termination claim.
Under the federal False Claims Act (also called "qui tam"), private citizens who report fraud against the government can receive 15–30% of the total amount recovered. In major Medicare fraud cases, this can mean millions of dollars.
Important: Qui tam cases require an attorney experienced in False Claims Act litigation. The complaint must be filed under seal — do not publicly disclose the fraud before filing. Many healthcare fraud attorneys work on contingency (no upfront cost).
Billing for a more expensive service than was actually provided (e.g., 99214 instead of 99213).
Billing for services, procedures, or supplies that were never provided to the patient.
Ordering tests, procedures, or treatments that are not medically necessary.
Receiving or paying for patient referrals — illegal under the Anti-Kickback Statute.
Billing separately for services that should be billed as a package at a lower rate.
Using someone else's Medicare number to bill for services.
Last Updated: February 2026
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.