What counts as Medicare fraud
Medicare is run by the HHS / Centers for Medicare & Medicaid Services. Common schemes include:
- Charges on your Medicare Summary Notice for care or equipment you never got
- Unneeded tests, genetic tests or equipment pushed by phone
- Hospice or home health billed for patients who do not qualify
- Kickbacks to doctors or marketers
Honest mistakes and disputes over a single bill are not fraud. Fraud means someone knowingly took money they were not entitled to.
Where to report it
| Contact | Handles |
|---|---|
| HHS Office of Inspector General 1-800-HHS-TIPS (1-800-447-8477) | Fraud in Medicare, Medicaid and other HHS programs |
| Medicare 1-800-MEDICARE (1-800-633-4227) | Questions about charges on your own Medicare statement |
| Senior Medicare Patrol | Free local help reviewing Medicare statements |
| America.gov/fraud (WHIP reward portal) | Required route if you want a WHIP award of $10,000–$30,000 |
Can you get a reward?
Yes. HHS / Centers for Medicare & Medicaid Services programs are covered by the federal Fraud Whistleblower Incentive Program (WHIP): a written tip that leads to criminal charges can earn $10,000–$30,000. For larger frauds, the False Claims Act pays 15–30% of what the government recovers.
- WHIP: submit in writing at America.gov/fraud, include your contact details, and do not take part in the fraud. Step-by-step guide.
- False Claims Act: a sealed lawsuit filed through a lawyer; worthwhile mainly for frauds of $1 million or more. Compare the routes.
- State laws: many states have their own false claims acts. Check your state's page in the case database.
Estimate your own case with the reward calculator.
What to include in your report
- Who: names of people and businesses, addresses, provider or license numbers if you have them
- What: the service, benefit or loan involved and what was wrong with it
- When and how often, and roughly how much money
- How you know: what you saw, and any documents or photos you are allowed to share
Where Medicare fraud is being prosecuted
States with the most Medicare announcements in our database since January 20, 2025; the largest amount named is $1.2B (billed):
| State | Announcements |
|---|---|
| Massachusetts | 39 |
| Florida | 37 |
| California | 33 |
| Texas | 25 |
| New York | 23 |
| Louisiana | 19 |
| New Jersey | 17 |
| Missouri | 12 |
Recent Medicare fraud cases
Source: U.S. Department of Justice press releases. Charged cases are allegations. All 397 Medicare announcements
Frequently asked questions
Where do I report Medicare fraud?
HHS Office of Inspector General (1-800-HHS-TIPS (1-800-447-8477)): Fraud in Medicare, Medicaid and other HHS programs. Medicare (1-800-MEDICARE (1-800-633-4227)): Questions about charges on your own Medicare statement. Senior Medicare Patrol: Free local help reviewing Medicare statements. America.gov/fraud (WHIP reward portal): Required route if you want a WHIP award of $10,000–$30,000.
Can I get a reward for reporting Medicare fraud?
Yes. HHS / Centers for Medicare & Medicaid Services programs are covered by the federal Fraud Whistleblower Incentive Program (WHIP): a written tip that leads to criminal charges can earn $10,000–$30,000. For larger frauds, the False Claims Act pays 15–30% of what the government recovers.
Can I report Medicare fraud anonymously?
Most inspector general hotlines accept anonymous tips. To be paid a WHIP award, though, you must give contact information and disclose your identity to the Justice Department before payment; you can stay anonymous during the process only through a lawyer.
How common is Medicare fraud prosecution?
Our database has 397 Justice Department announcements involving Medicare since January 20, 2025, counting each press release separately.