On March 30, 2026, the U.S. Department of the Treasury’s Financial Crimes Enforcement Network (FinCEN) issued two significant announcements. The first was a formal advisory to financial institutions nationwide, directing them to increase their vigilance for fraud targeting Medicare, Medicaid, and other federal healthcare programs.
The second was a Notice of Proposed Rulemaking that would, for the first time, establish a comprehensive framework for paying financial awards to individuals who report violations of the Bank Secrecy Act (BSA) and related laws. For people who work in or around healthcare billing, the combination of these two developments marks a shift in how the federal government expects to identify and pursue healthcare fraud cases.
FinCEN’s Advisory Signals a New Level of Scrutiny on Healthcare Fraud
The March 30 advisory, issued in coordination with the FBI and the Department of Health and Human Services Office of Inspector General (HHS-OIG), documents a dramatic rise in suspicious activity reports tied to healthcare fraud. Between 2020 and 2025, FinCEN observed a 330 percent increase in Bank Secrecy Act reporting on healthcare fraud, with financial institutions filing a record of more than 3,800 initial reports in 2025 alone. FinCEN acknowledged that even this volume likely represents only a fraction of the actual fraud taking place.
The advisory describes several patterns that enforcement authorities are now tracking, including:
- The use of straw owners, including non-resident aliens and stolen identities of retired physicians, to register shell companies as healthcare providers or suppliers
- Fraudulent claims submitted under those shell companies for medical services that were never provided, substandard, or medically unnecessary
- Shell company bank accounts opened with falsified beneficial ownership information and fictitious documentation
- Domestic organized crime groups and transnational criminal organizations increasingly participating in these schemes
The advisory was issued as part of the Trump Administration’s stated commitment to combating fraud, waste, and abuse involving federal payments, following an Executive Order signed in March 2025 directing federal agencies to defend against financial fraud and improper payments.
The FinCEN Whistleblower Program
Alongside the advisory, FinCEN published a proposed rule that would formally implement the whistleblower program established under the Anti-Money Laundering Act of 2020 and strengthened by the AML Whistleblower Improvement Act of 2022. Although FinCEN has been accepting tips for several years through a dedicated webpage, it has not yet finalized the regulations necessary to pay out awards to the individuals who submit them.
Under the proposed rule, a qualifying whistleblower could receive a percentage of any monetary penalties collected because of a successful enforcement action by the Treasury or DOJ, provided those penalties exceed $1 million. The program would also offer formal protections, including confidentiality safeguards, for those who come forward.
The rule is still in the comment period, with the deadline falling on June 1, 2026. A final rule would give the program the teeth it has lacked since Congress first authorized it.
How the AML Program Relates to the False Claims Act
The FinCEN whistleblower program operates in addition to, not instead of, the False Claims Act. These are distinct legal tools that can apply to the same underlying conduct.
The False Claims Act is the federal government’s primary mechanism for recovering money that was fraudulently paid out to healthcare providers and suppliers. It allows private individuals to file qui tam lawsuits on behalf of the government, and it entitles relators to a portion of any recovery. When a healthcare provider submits a claim to Medicare or Medicaid for services that were medically unnecessary, never rendered, or billed in connection with a kickback arrangement, that claim violates the False Claims Act.
The AML whistleblower program addresses a different layer of the same problem. When fraudulent Medicare or Medicaid payments are made, those funds move through the financial system. Financial institutions are required under the Bank Secrecy Act to monitor for and report suspicious transactions. Individuals who have information about how fraudulent healthcare proceeds were laundered, or about the financial structures used to conceal the fraud, may have reportable information under the AML program.
In practice, the same fraud that gives rise to a False Claims Act case can also produce information relevant to the AML program. A person who knows how a shell company was used to funnel fraudulent Medicare payments, for instance, may have both an FCA claim and a potential AML whistleblower submission.
What Whistleblowers Should Know About the Proposed Rule’s Limitations
The FinCEN whistleblower program is still taking shape, and advocates have raised concerns about at least one provision in the proposed rule that potential whistleblowers should understand before moving forward.
Under the proposed framework, a whistleblower must submit their information using an official form known as the Form TCR. If a whistleblower first reports to the DOJ, another Treasury component, or their employer, they must also submit that information to FinCEN within a “reasonable time” to remain eligible for an award. The AML Whistleblower Improvement Act itself imposes no such timing requirement, and the National Whistleblower Center has argued in formal comments to FinCEN that this provision was not authorized by Congress and could disqualify otherwise eligible whistleblowers on purely procedural grounds.
The concern is not theoretical. Both the SEC and the IRS have administered nearly identical filing requirements, and both agencies were ultimately forced to walk back strict interpretations after years of litigation showed the rules were penalizing legitimate whistleblowers for technical missteps that had no bearing on the value of their disclosures.
For anyone considering coming forward, this uncertainty is one more reason to consult a whistleblower attorney before taking any steps. An experienced attorney can help ensure that your submission meets the procedural requirements as they currently stand and can monitor how the final rule addresses these concerns once it is published.
Talk to a Whistleblower Attorney Before You Do Anything Else
If you have information about fraud targeting Medicare, Medicaid, or other federal healthcare programs, the decision about how to come forward is one you should not make alone. The two programs described above have different requirements, timelines, and protections. An attorney with experience in whistleblower cases can help you understand which pathway fits your situation and how to protect your legal rights throughout the process.
A whistleblower attorney at Keller Grover can evaluate your information and advise you on your options under both the False Claims Act and any applicable AML reporting avenue. Contact our legal team today if you are considering coming forward with information about healthcare fraud.