We handle cases brought under the False Claims Act. If you work in healthcare and have witnessed fraud against Medicare or Medicaid, you may have a qui tam claim. Reach out for a confidential conversation. There is no obligation.
We handle cases brought under the False Claims Act. If you work in healthcare and have witnessed fraud against Medicare or Medicaid, you may have a qui tam claim.
Reach out for a confidential conversation. There is no obligation.
Medicare and Medicaid fraud takes many forms. So does the courage it takes to come forward. Khurana Law Firm, P.C. represents healthcare insiders who have witnessed fraud against the federal and state governments. We handle cases brought under the False Claims Act, the federal law that allows individuals with direct, first-hand knowledge of fraud to file a qui tam lawsuit on behalf of the government and receive a share of any financial recovery.
Select a practice area below to learn more about the specific types of fraud we handle, the legal basis for each, and what the process looks like if you decide to come forward. All consultations are confidential. There is no obligation to proceed.
The False Claims Act is the federal law behind every qui tam case this practice handles. It makes it illegal to submit false or fraudulent claims for payment to the federal and state governments, including Medicare and Medicaid, and allows healthcare insiders to file a qui tam lawsuit on behalf of the government and share in any recovery. If the government intervenes, the relator receives between 15% and 25% of the total recovery. If the government declines and you proceed independently, that share rises to between 25% and 30%.
Medicare fraud occurs when healthcare providers submit false or inflated claims for services that were not provided, not medically necessary, or misrepresented to increase reimbursement. This practice area covers billing fraud, Medicare Advantage fraud, upcoding, unbundling, and phantom billing.
Medicaid fraud involves false claims submitted to state and federally funded Medicaid programs. Common schemes include billing fraud, billing for services never performed, upcoding, and false patient eligibility certifications by providers seeking reimbursement for ineligible patients.
The Anti-Kickback Statute prohibits payments or benefits exchanged to induce or reward Medicare or Medicaid referrals. This practice area covers Anti-Kickback Statute violations, illegal referral and marketing arrangements, physician compensation schemes, and Stark Law (Physician Self-Referral Law) violations.
Home health fraud typically involves billing Medicare for visits that never occurred, falsely certifying patient eligibility for home health services, or inflating the number of visits or services provided. Employees of home health agencies who have witnessed these practices may have the basis for a qui tam case. The Anti-Kickback Statute prohibits payments or benefits exchanged to induce or reward Medicare or Medicaid referrals. This practice area covers Anti-Kickback Statute violations, illegal referral and marketing arrangements, physician compensation schemes, and Stark Law (Physician Self-Referral Law) violations.
Hospice fraud occurs when providers enroll patients who do not meet terminal illness eligibility criteria, improperly recertify patients to continue billing, or submit inflated claims for hospice services. Federal enforcement in this area has intensified significantly, with multiple major prosecutions in 2025 and 2026.
This practice area covers billing for unnecessary services, submitting false diagnoses, upcoding the severity of patient conditions to receive higher reimbursement, and inpatient admission fraud, where providers bill for inpatient stays when only outpatient services were provided or medically justified.
Pharmaceutical fraud against Medicare and Medicaid includes off-label marketing of drugs for unapproved uses, drug pricing fraud, Medicaid rebate fraud, and the reporting of false or inflated Average Wholesale Price (AWP) information to inflate government reimbursement rates.
Medical device fraud involves billing Medicare or Medicaid for devices that were unnecessary, defective, or never delivered, as well as the concealment of device defects and submission of false reimbursement claims. Unnecessary prescriptions written to justify device billing may also form part of a fraud scheme.
Laboratory fraud includes billing for unnecessary or excessive testing, billing for tests that were never performed, and laboratories paying kickbacks to physicians for lab service referrals in violation of the Anti-Kickback Statute. Genetic testing fraud has been a sustained federal enforcement priority.Medical device fraud involves billing Medicare or Medicaid for devices that were unnecessary, defective, or never delivered, as well as the concealment of device defects and submission of false reimbursement claims. Unnecessary prescriptions written to justify device billing may also form part of a fraud scheme.
Telemedicine fraud involves billing Medicare for remote services never provided, using telehealth arrangements to generate illegal kickbacks, and ordering unnecessary tests or durable medical equipment for patients seen via telemedicine platforms. Telehealth fraud has been a top Department of Justice enforcement priority in recent years.
DME fraud occurs when providers bill Medicare or Medicaid for equipment that was unnecessary, never delivered, or obtained through illegal kickback arrangements. Common schemes involve wheelchairs, orthotics, oxygen equipment, and other DME categories where billing abuse is difficult for auditors to detect without insider knowledge.
Nursing home fraud involves false Medicare and Medicaid reimbursement claims submitted by skilled nursing facilities, including billing for care that was never rendered or billing at a higher level of care than was actually provided. Nursing staff, billing employees, and administrators may have direct knowledge of these schemes.
The False Claims Act applies to fraud against TRICARE and the Department of Veterans Affairs in the same way it applies to Medicare and Medicaid. Healthcare providers who treat military personnel or veterans and submit fraudulent claims to these programs may be subject to qui tam liability.
Arvind Bob Khurana has over 25 years of experience in complex litigation including qui tam and False Claims Act litigation. We work on contingency. There is no upfront cost and no obligation to proceed.
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