The U.S. Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN) published an advisory urging financial institutions to be more vigilant for fraud schemes targeting Medicare, Medicaid and other federal and state health care benefit programs, and issued a proposed rule intended to fully implement a whistleblower program that would compensate eligible individuals for actionable tips on fraud, money laundering, sanctions violations and certain other national security laws. The advisory outlines how fraudsters, including transnational criminal organizations, can use straw owners and shell providers to submit false reimbursement claims using illicitly obtained beneficiary identities, then launder proceeds through the U.S. and international financial system via wire transfers, digital assets and other typologies, including through complicit insiders. It provides typologies and red flag indicators to support suspicious activity detection and encourages voluntary reporting to FinCEN alongside immediate notification to law enforcement; FinCEN also noted that health care-related suspicious activity reporting rose 20 percent in 2025 versus 2024. Issued in close coordination with the Federal Bureau of Investigation and the Department of Health and Human Services Office of Inspector General, the advisory is framed as supporting FinCEN’s AML/CFT National Priorities and the administration’s effort under Executive Order 14249. The proposed whistleblower rule sets out procedures for submitting information, award eligibility and adjudication, and whistleblower protections, with awards proposed at 10 to 30 percent of monetary penalties from qualifying enforcement actions funded by penalties collected under the Bank Secrecy Act and the International Emergency Economic Powers Act.
U.S. Department of the Treasury 2026-03-30
U.S. Department of the Treasury's Financial Crimes Enforcement Network issues health care benefits fraud advisory and proposes rule to pay whistleblowers 10 to 30 percent of penalties
The U.S. Department of the Treasury’s Financial Crimes Enforcement Network issued an advisory urging heightened vigilance by financial institutions against fraud schemes targeting Medicare, Medicaid and other health care benefit programs, highlighting typologies, red flags and a 20 percent year-on-year increase in related suspicious activity reports. FinCEN also proposed a rule to fully implement a whistleblower program covering fraud, money laundering, sanctions violations and certain other national security laws, with awards of 10 to 30 percent of monetary penalties.