January 23 is National Report Pharmaceutical Fraud Day, Founded by Whistleblower Advocate and Former Department of Justice Attorney Joel D. Hesch

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National Report Pharmaceutical Fraud Day is officially celebrated on January 23. The purpose is twofold. First, National Report Pharmaceutical Fraud Day brings awareness to the amount of Medicare fraud by pharmaceutical companies. Second, it teaches the public how to obtain a whistleblower reward for reporting fraud by drug companies.

Ten percent of all Medicare funds are lost due to fraud.* Because the government spends $650 billion a year on Medicare, $65 billion a year is lost to Medicare fraud.** One of the biggest culprits of Medicare fraud allegations are pharmaceutical drug companies.

To combat fraud, Congress authorized the Department of Justice (DOJ) to pay whistleblower rewards of between 15% and 30% of funds recovered based upon a whistleblower reporting fraud against Medicare or other government programs. The government reward program has been a huge success with billions of dollars in rewards already paid to whistleblowers.

Statistics for the DOJ whistleblower reward program

Here are some statistics about DOJ rewards for reporting Medicare fraud:***

  • The largest whistleblower reward was $150 million in a single case
  • The average whistleblower reward is $691,918
  • The total amount DOJ recovered in whistleblower initiated healthcare fraud cases is over $30 billion ($30,394,268,694)
  • The total whistleblower rewards paid by DOJ in healthcare cases is nearly $5 billion ($4,966,593,085)

How to celebrate National Report Pharmaceutical Fraud Day?

Celebrate National Report Pharmaceutical Fraud Day in two ways. First, by educating yourself as to pharmaceutical fraud schemes and how to obtain a reward under the Department of Justice (DOJ) whistleblower reward program. Click here for a free e-book outlining Medicare Fraud and the DOJ Reward Program.

Second, share this national day with everyone you know so that they can participate in stamping out fraud by drug companies. Only when drug companies know that the public knows how to spot pharmaceutical fraud and can get a reward for reporting it will they think twice about ripping off our healthcare programs.

How to report pharmaceutical Medicare fraud?

There are two very different ways of reporting pharmaceutical Medicare fraud, with two very different results.

1. File for a Reward

The first way to report pharmaceutical fraud is to have a whistleblower attorney, such as Mr. Hesch, help you blow the whistle under the Department of Justice (DOJ) reward program. If you report fraud under the DOJ program, the government must open an investigation and inform your attorney of the results. Thus, applying for a reward through a whistleblower attorney is the only way to ensure an investigation takes place (rather than just calling a hotline).

For more details or how to ask Mr. Hesch to evaluate in complete confidence your potential Medicare Fraud allegations, simply visit Mr. Hesch’s website. His free e-book also provides step-by-step instructions for reporting all types of Medicare Fraud, including pharmaceutical fraud.

2. Report fraud to the agency

The second way to report pharmaceutical fraud is to report it directly to the Centers for Medicare & Medicaid Services (CMS), which runs the Medicare program. You can do this without an attorney and even anonymously. There are a few downsides by reporting the fraud to CMS. First, the reward is limited to $1,000 (rather than the DOJ program that pays up to 30% with no limit or cap). Second, CMS does not have to open an investigation. Third, CMS does not have to tell you the results of any investigation. Nevertheless, there are times when it makes sense to report fraud directly to CMS through its website or by calling its hotline. Here is how to contact CMS directly:

CMS website: https://oig.hhs.gov/fraud/report-fraud/index.asp.

CMS hotline: 1-800-MEDICARE (1-800-633-4227).

Who created National Report Pharmaceutical Fraud Day?

National Report Pharmaceutical Fraud Day started in 2017. It was formed by Joel Hesch, a whistleblower attorney who spent over 15 years working in Department of Justice whistleblower reward office. While at DOJ, Mr. Hesch obtained over $1 billion in recoveries back for the government from those cheating Medicare and paid out hundred of millions in rewards to whistleblowers. Mr. Hesch was also assigned to the Pharmaceutical Fraud Task Force within the Civil Fraud Section of the Department of Justice in Washington, D.C. One Medicare Fraud case Mr. Hesch worked on recovered $641 million and paid a whistleblower award of $100 million. Mr. Hesch formed his own law firm and now exclusively represents whistleblowers nationwide in filing for rewards for reporting fraud against the government, including pharmaceutical Medicare fraud. To help whistleblowers properly report Medicare fraud, he authored a free e-book and created a website that explains what steps are necessary to be eligible for a whistleblower reward.

It’s time the public stands up and put an end to Pharmaceutical Medicare fraud and get a reward in the process.


*https://www.fbi.gov/stats-services/publications/financial-crimes-report-2010-2011/financial-crimes-report-2010-2011#Health (“Estimates of fraudulent billings to health care programs, both public and private, are estimated between 3 and 10 percent of total health care expenditures.”); http://www.howtoreportfraud.com/false-claims-act-general-information-and-statistics/ (10% of all government spending lost to fraud)

(Medicare spending in 2015 was $646.2 billion); https://www.google.com/amp/abcnews.go.com/amp/Politics/medicare-funds-totaling-60-billion-improperly-paid-report/story%3fid=32604330 (CMS estimates that “last year some $60 billion of American taxpayer money, or more than 10 percent of Medicare’s total budget, was lost to fraud, waste, abuse and improper payments.”)

***DOJ Statistics for Healthcare whistleblower cases as of FY 2017, located at: *** DOJ Statistics for Healthcare whistleblower cases as of FY 2017, located at: http://www.howtoreportfraud.com/wp-content/uploads/2017/12/2017-FCA-statistics-Department-of-Health-and-Human-Services.pdf

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