Fraud by program in Puerto Rico
| Program | Announcements | More |
|---|---|---|
| Unemployment | 4 | All Unemployment cases |
| Medicaid | 2 | All Medicaid cases |
| Medicare | 2 | All Medicare cases |
| Social Security | 1 | All Social Security cases |
| Disaster | 1 | All Disaster cases |
| VA benefits | 1 | All VA benefits cases |
| PPP/EIDL | 1 | All PPP/EIDL cases |
Where to report fraud in Puerto Rico
| Type of fraud | Report to |
|---|---|
| Medicaid provider fraud | Puerto Rico Medicaid Fraud Control Unit (PRMFCU) · Puerto Rico Department of Justice (Departamento de Justicia) · 787-721-2900 ext. 1560/1561 |
| SNAP, child care assistance, cash assistance | Your state SNAP agency (USDA directory) |
| Unemployment benefits | Departamento del Trabajo y Recursos Humanos – Fraude por Desempleo (Negociado de Seguridad de Empleo) |
| Medicare and other HHS programs | HHS-OIG · 1-800-HHS-TIPS |
| Any WHIP-covered federal program, if you want a reward | America.gov/fraud (how to submit) |
Whistleblower rewards in Puerto Rico
| Program | What it pays | Law |
|---|---|---|
| False Claims to Government of Puerto Rico Programs, Contracts, and Services Act (Ley de Reclamaciones Fraudulentas a los Programas, Contratos y Servicios del Gobierno de Puerto Rico) Covers all government programs and service contracts (any federal or state program whose funds the PR government administers, plus government service contracts), not only Medicaid | 15–25% if the Government proceeds (10% if based on readily accessible information rather than the relator's own investigation); 25–30% if the Government does not proceed | Act No. 154-2018, as amended by Act No. 64-2023 (relator share at Art. 4.03) |
| Federal WHIP | $10,000–$30,000 per tip that leads to criminal charges | DOJ terms |
| Federal False Claims Act | 15–25% of the recovery if the government intervenes; 25–30% if not | 31 U.S.C. § 3730(d) |
Puerto Rico does have an FCA with qui tam: Law 154-2018 (approved 7/23/2018). Its qui tam chapter took effect 180 days after approval. The same law set up the PR MFCU in the Department of Justice. Law 64-2023 amended Arts. 4.01–4.06: the 15–25% intervened share was left unchanged and the 25–30% non-intervened share was restated, but the flat 5% cut for a relator who took part in the fraud was replaced by a discretionary reduction. Puerto Rico is not on HHS-OIG's DRA review list.
Estimate federal awards for your case with the calculator, or compare programs in WHIP vs the False Claims Act.
Latest announcements
Source: U.S. Department of Justice press releases, classified by WHIP Reward. Each row is one press release; the same case can appear at several stages, so amounts should not be added. Charged cases are allegations. Search all 9 in the database.
Frequently asked questions
How do I report Medicaid fraud in Puerto Rico?
Report provider fraud to the Puerto Rico Medicaid Fraud Control Unit (PRMFCU) (Puerto Rico Department of Justice (Departamento de Justicia)), or to the HHS Office of Inspector General at 1-800-HHS-TIPS. To be eligible for a federal WHIP award, also submit the tip in writing at America.gov/fraud.
Does Puerto Rico pay whistleblowers?
Yes. Under the False Claims to Government of Puerto Rico Programs, Contracts, and Services Act (Ley de Reclamaciones Fraudulentas a los Programas, Contratos y Servicios del Gobierno de Puerto Rico) (Act No. 154-2018, as amended by Act No. 64-2023 (relator share at Art. 4.03)), a whistleblower who files a case receives 15–25% if the Government proceeds (10% if based on readily accessible information rather than the relator's own investigation); 25–30% if the Government does not proceed. Federal programs (WHIP and the federal False Claims Act) apply as well.
How many fraud cases has the DOJ announced in Puerto Rico?
9 announcements since January 20, 2025 in our database, counting each press release separately (a case can appear at charge, plea and sentencing). 2 of them announced a sentence.
Sources
- U.S. Department of Justice: Whistleblower Rewards Program
- bvirtualogp.pr.gov/ogp/Bvirtual/leyesreferencia/PDF/2-ingles/0154-2018.pdf
- bvirtualogp.pr.gov/ogp/Bvirtual/leyesreferencia/PDF/2020/0064-2023.pdf
- justicia.pr.gov/secretarias-y-oficinas/oficina-del-jefe-de-los-fiscales/prmfcu-complaint-form-in-english
- trabajo.pr.gov/fraude_por_desempleo.asp
- oig.hhs.gov/fraud/state-false-claims-act-reviews
- U.S. Department of Justice press releases (justice.gov/news)