Report fraud against public funds and receive a reward

It is the law that gives any person — not only government employees — the legal right to sue on the Government of Puerto Rico's behalf against whoever defrauds it, and to collect a percentage of what the Government recovers because of that lawsuit. The role is called "Delator" and the mechanism is known in English as the "Qui Tam Provision".

Any person, employee, contractor or agent with knowledge of a violation of this law's Chapter IV: submitting a false claim to a Government Program or to the Medicaid Program, using a false record or statement to obtain payment, or evading or reducing an obligation to pay or transmit money or property to the Government. Expressly excluded from being a Delator, and from collecting a reward: staff or contractors of the Medicaid Fraud Control Unit, of the Medicaid or ASES integrity programs, of the government's Medicaid information system, and any employee or contractor whose job is to detect fraud against Medicaid or government programs; also excluded is anyone who builds their suit on information detected by one of those excluded people.

• Having knowledge of the violation: personal knowledge, deliberate ignorance of its truth or falsity, or reckless disregard for the truth. No proof of specific intent to defraud is required.Verified against the official source
• Not being on the list of people excluded from being a Delator: staff or contractors of the Medicaid Fraud Control Unit, of the Medicaid or ASES integrity programs, of the Medicaid information system, or of any government fraud-detection function.Verified against the official source
• Filing the suit on the Government's behalf in the Tribunal de Primera Instancia, Sala Superior de San Juan, and serving the Secretary of Justice that same day, with a copy of the complaint and all evidence and information in your possession.Verified against the official source

• The complaint itself and a written disclosure of all evidence and information you have about the fraud. The law does not publish a form: it is a civil complaint like any other before the Tribunal de Primera Instancia.

1. 1

   Step 1: Confirm this is the kind of fraud this law covers

   It applies to anyone who submits a false or fraudulent claim to a Government Program — including Medicaid — or to a service contract; uses a false record or statement to obtain a payment or authorization; or evades or reduces an obligation to pay or transmit money or property to the Government, without that obligation needing to be tied to a specific program or contract, after Act 176-2026.

2. 2

   Step 2: Verify you are not on the excluded-persons list

   If you work or contract for the Medicaid Fraud Control Unit, the Medicaid or ASES integrity programs, the government's Medicaid information system, or any fraud-detection function, the law expressly excludes you from being a Delator and from collecting a reward.

3. 3

   Step 3: File the suit under seal and notify the Secretary of Justice

   The suit is filed in the Tribunal de Primera Instancia, Sala Superior de San Juan, on the Government's behalf. That same day, you must serve the Government through the Secretary of Justice and give them a copy of the complaint and all evidence. The suit stays sealed — not disclosed to the defendant — for at least 60 days.

4. 4

   Step 4: Wait for the Government's decision on whether to intervene

   Within those 60 days — extendable if the Secretary of Justice shows good cause — the Government decides whether to intervene and take over the suit, or not to intervene, in which case you can continue the case on your own. That decision is the Secretary of Justice's exclusive discretion and is not subject to judicial review or challenge.

5. 5

   Step 5: Collect your percentage once the Government receives payment

   If the Government intervenes and wins or settles, you receive 15%-25% of what is recovered — or 10% if the court determines your information was easily accessible to anyone. If the Government declines and you win the case on your own, you receive 25%-30%. The right to collect only activates once the Government actually receives payment, not before.

The suit is filed in the Tribunal de Primera Instancia, Sala Superior de San Juan, the exclusive forum for these causes of action regardless of which judicial region the fraud occurred in. Notice to the Government is served through the Secretary of Justice of the Puerto Rico Department of Justice.

• Thinking only a government employee can file the suit: any person with knowledge of the fraud can do it.
• Notifying or talking to the defendant before the court allows it: the suit must stay sealed during the initial investigation period.
• Believing the reward is collected upon winning the case: it is only collected once the Government actually receives payment of the judgment or settlement.
• Assuming any government employee can be a Delator: those whose job is detecting fraud against Medicaid or government programs are expressly excluded.
• Overlooking that participating in the fraud itself disqualifies you: if the court finds you conspired or helped commit the violation, your compensation is reduced or, if you are convicted, eliminated entirely.

These are the government pages this guide is based on.

• Departamento de Justicia de Puerto Rico

  Justicia

  bvirtualogp.pr.gov

• Act 176-2026 — technical amendment to the reverse false claim provision

  Asamblea Legislativa de Puerto Rico

  bvirtualogp.pr.gov