Khurana
Law Firm
Medicare whistleblower lawyer
Quit tam and whistleblower lawyers fighting Medicare and Medicaid scams in Wisconsin
Qui Tam Attorney in Wisconsin Medicare and Medicaid fraud cost Wisconsin taxpayers billions of dollars each year. While the majority of medical providers and drug companies are honest and work within the legal channels, some do not. When fraud occurs, everyone can lose. Medicaid and Medicare whistleblower lawyers help people who work in the healthcare system to file suits on behalf of the federal or state government to help report this sort of fraud.
The federal and state government put a a lot of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government depends on regular folks in qui tam attorney in Wisconsin to come forward to report scams. People like you.
Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Wisconsin
At Khurana Law Firm, P.C., as experienced qui tam attorney in Wisconsin Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and fraud in the market. understand that coming forward is difficult and many things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.
Qui tam attorney in Wisconsin and with our comprehensive experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently prepare your case, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.
Medicare Advantage Fraud
Medicare Advantage (MA) plans are privately run healthcare options offering Medicare-eligible individuals additional services that are not included in traditional Medicare. These organizations receive payment from Medicare for each of their members that vary according to their risk adjustment. Some Medicare Advantage organizations overestimate and exaggerate a member’s risk or a patient’s diagnoses to get higher payments from Medicare. They do this by:
Upcoding
The MA provider increases the severity of the patient’s condition, submitting a more serious diagnosis code to get paid by Medicare at a higher rate.
Chart reviews
The MA provider reviews charts to add additional diagnosis codes.
Chart mining
The MA provider mines patient’s charts to look for conditions that are not current but can put as current to increase their payments from Medicare.
Adding unsupported diagnosis
Coders are directed to add codes based on other information in the chart.
Not removing old diagnosis codes
The MA provider increases the severity of the patient’s condition, submitting a more serious diagnosis code to get paid by Medicare at a higher rate.
Sham RADV audits
The MA provider reviews charts to add additional diagnosis codes.
Incentivizing doctors
The MA provider mines patient’s charts to look for conditions that are not current but can put as current to increase their payments from Medicare.
Pre-filling charts
Coders are directed to add codes based on other information in the chart.
If you suspect Medicare Advantage Fraud, you can report it here.
While there are no exact figures concerning Medicare fraud, we do know it is a huge problem. In the fiscal year 2020, the government recovered over $1.8 billion in civil and fraud claims relating to the healthcare industry.
Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.
Fraud, as it relates to Medicare, is when individuals or entities make false statements or representations to benefit themselves at the expense of the Medicare program.
Medicare fraud can involve numerous individuals, organizations, and entities, including physicians and nurses, physician-owned groups, drug companies, home health providers, medical device providers, nursing homes, and others.
Fraud and abuse come in many different forms from coding abuses, to kickbacks, to altering records, to organized crime infiltration. Each method benefits the abuser while costing taxpayers billions.
The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity.
Many government agencies strive to protect and promote the integrity of Medicare. These include the Centers for Medicare and Medicaid Services, Center for Program Integrity, US Department of Health and Human Services, and US Department of Justice, all attempting to keep Medicare fraud at bay. But they rely on people like YOU to be their eyes and ears.
- If you are a healthcare worker
- If you are employed in an office of a Medicare provider
If you see abuse and fraudulent activity you should report it. In some cases, you may even be entitled to a reward. To report Medicare fraud, contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation.
If you’ve become aware of potential fraud that may involve Medicaid or Medicare, you require the guidance of an experienced whistleblower attorney, someone who can guarantee that your claim is fully investigated and filed accurately and quickly. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, hence increasing your chances for a reward. Reporting Medicare and Medicaid scams is an intricate matter – don’t try to do this alone, we are here to help.
At Khurana Law Firm, P.C., we have years of practical experience as national qui tam lawyers to assist in your battle against Medicare and Medicaid scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we can represent you in a qui tam claim to help report the fraud and enable you to gather a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.
