Quick answer
Report Medicare fraud to HHS OIG at oig.hhs.gov or call 1-800-HHS-TIPS (1-800-447-8477). Reports can be anonymous and whistleblowers may earn up to 30% of recovered funds.
How to Report Medicare Fraud: Protect the Program and Earn a Reward
Quick answer: Report Medicare fraud to the HHS Office of Inspector General at oig.hhs.gov or call 1-800-HHS-TIPS (1-800-447-8477). You can report anonymously and may be eligible for a financial reward of up to 10% of the amount recovered.
Important: Medicare fraud reporting notice
This guide is for general educational guidance only and is not legal, medical, or billing advice. Medicare fraud reports may lead to government investigation of providers, beneficiaries, or businesses, so submit only accurate information you believe to be true.
Keep bills, Medicare Summary Notices, dates of service, provider names, and related communications. If the issue involves immediate medical danger, contact emergency services or the appropriate care provider first.
Medicare fraud costs U.S. taxpayers over $60 billion per year. It includes billing for services never provided, upcoding procedures, paying kickbacks for referrals, and using stolen Medicare numbers. Reporting it is free, can be done anonymously, and whistleblowers can receive significant financial rewards under the False Claims Act.
What Counts as Medicare Fraud?
Medicare fraud includes: billing for medical services or equipment never provided, billing for a higher-cost service than was actually performed (upcoding), paying or receiving kickbacks for patient referrals, using someone else’s Medicare card, billing for unnecessary medical equipment or tests, and home health agencies billing for patients who do not qualify. If something on your Medicare Summary Notice looks wrong — report it.
Where to Report Medicare Fraud
| Type of Fraud | Agency | Contact |
|---|---|---|
| All Medicare fraud (start here) | HHS OIG | oig.hhs.gov | 1-800-447-8477 |
| Billing errors on your statement | Medicare directly | 1-800-633-4227 |
| Large-scale or organised fraud | FBI | ic3.gov | 1-800-CALL-FBI |
| Medicaid fraud | State Medicaid Fraud Unit | Find your state AG |
| Whistleblower lawsuit (False Claims Act) | Private attorney + DOJ | justice.gov |
How to Report Medicare Fraud Step by Step
- Review your Medicare Summary Notice carefully. Medicare mails this quarterly (or you can view it online at mymedicare.gov). Look for services you did not receive, incorrect dates, or duplicate charges. Mark anything suspicious.
- Call Medicare directly for billing errors. For straightforward billing errors, call 1-800-MEDICARE (1-800-633-4227). They can correct billing mistakes and flag the provider for review.
- Report fraud to the HHS Office of Inspector General. Go to oig.hhs.gov/fraud/report-fraud or call 1-800-HHS-TIPS (1-800-447-8477). You can submit online 24/7. Provide: your name and Medicare number (optional), the provider’s name and address, the type of fraud, and approximate dates.
- Contact your State Health Insurance Assistance Program (SHIP). SHIP offers free, unbiased help reviewing your Medicare statements and filing complaints. Find your local SHIP at shiphelp.org.
- Report to the FBI for large-scale fraud. If you have evidence of organised Medicare fraud schemes involving multiple providers or large sums, report to the FBI at tips.fbi.gov or call 1-800-CALL-FBI.
- Consider a False Claims Act whistleblower lawsuit. If you are a healthcare insider (doctor, nurse, biller, administrator) with evidence of systematic Medicare fraud, you may be entitled to 15–30% of any government recovery under the False Claims Act. Consult a whistleblower attorney — most work on contingency.
- Protect your Medicare card. Guard your Medicare number like a credit card number. Never give it to door-to-door salespeople or over the phone unless you initiated the call to a known provider.
- Follow up on your report. HHS OIG will send confirmation of your report. Major investigations can take 12–24 months. You are not required to testify unless you file a whistleblower lawsuit.
Can I Get a Reward for Reporting Medicare Fraud?
Yes. Under the False Claims Act, whistleblowers who file a lawsuit on behalf of the government (called a qui tam lawsuit) can receive between 15% and 30% of whatever the government recovers. In major cases this has amounted to millions of dollars. You must be an insider with direct knowledge of the fraud — not just a patient — and you must file through an attorney. Ordinary reports to HHS OIG do not qualify for rewards, but they are still valuable and acted upon.
Frequently Asked Questions
Can I report Medicare fraud anonymously?
Yes. HHS OIG accepts fully anonymous reports online and by phone. You do not need to provide your name or Medicare number. Anonymous reports are investigated the same as named reports.
What happens after I report Medicare fraud?
HHS OIG reviews all reports and prioritises cases by severity and evidence. You may be contacted for more information. Substantiated cases are referred for investigation, civil action, or criminal prosecution. You will not necessarily be informed of the outcome unless you are a named whistleblower.
How do I know if a charge on my Medicare statement is fraud?
Compare your Medicare Summary Notice to your own records of doctor visits, tests, and equipment received. Red flags include: services on dates you were not seen, equipment you never received, duplicate charges for the same service, or providers you do not recognise.
Is reporting Medicare fraud the same as reporting Medicaid fraud?
No. Medicare fraud is reported to HHS OIG. Medicaid is a state-administered program, so Medicaid fraud is reported to your state’s Medicaid Fraud Control Unit — find yours through your state Attorney General’s office.
What is the most common type of Medicare fraud?
The most common types are billing for services not rendered, upcoding (billing for a more expensive service than provided), and durable medical equipment fraud (billing for wheelchairs, braces, or devices never delivered). Home health fraud is also widespread.
For related guides see: How to Report Someone to the IRS, How to Report a Lost EBT Card, and our Government & Benefits Reporting Hub.