Do No Harm: Whistleblowing on Medicare Fraud

Abstract

ABSTRACT The high incidence of healthcare fraud in the United States resulted in the creation of multiple outlets to report fraud, such as the Medicare Hotline, the Office of the Inspector General, and the filing of False Claim Act lawsuits associated with whistleblower rewards. Despite the high incidence, examinations of whistleblowing factors in this industry, such as whistleblowers’ professional roles and fraud types, are scarce, and the interaction effects of these factors are unknown. In this study, participants from two different professional roles disclose their likelihood of reporting Medicare fraud through the aforementioned three reporting outlets conditional on two different billing fraud types. The results indicate that although workers in both professional roles show similar likelihoods to report fraud regardless of the reporting outlet, fraud type and its interaction with the professional role influence some but not all the reporting likelihoods.