Who can report
Employees, billing staff, nurses, pharmacists, patients, and contractors may all witness healthcare fraud. You do not need to be a lawyer to raise a concern — but choosing the right channel matters.
Hotlines and agency tips
HHS-OIG, state Medicaid fraud units, and CMS contractors accept tips. These paths are useful for alerting regulators but typically do not pay whistleblower rewards.
When a qui tam case fits
Systematic fraud involving substantial federal funds may support a False Claims Act case filed under seal by a relator and attorney. Recoveries can include relator shares of 15–30%.
Protect yourself
Use personal contact methods for initial attorney consultations. Document what you saw lawfully, and do not remove confidential records without legal guidance.