Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Alabama

Medicare and Medicaid fraud cost Alabama taxpayers billions of dollars each year. While many medical service providers and drug companies are honest and work within the system, there are those who don’t. When fraud happens, everyone can lose. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to file lawsuits on behalf of the government to help report these kinds of scams.

The state and federal governments place a great deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, it counts on regular folks in Alabama to come forward to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Alabama.

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the industry. understand that stepping forward is challenging and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, for court, and work tirelessly with you and the federal or state government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Alabama

Medicaid fraud in the state of Alabama costs taxpayers millions each year.  The Alabama Medicaid Fraud Control Unit investigates hundreds of reports of fraud and abuse annually.  Medicaid fraud can result in serious criminal charges and civil judgments. Many of the financial recoveries from these companies and individuals that defraud the state result from whistleblowers and healthcare workers who report knowledge of fraud. 

 

Although Alabama does not have a state false claims act, an individual with knowledge or evidence of Medicaid fraud in Alabama may file a qui tam lawsuit under the federal False Claims Act. This Act empowers an individual to sue a company or entity on behalf of the government for Medicare and Medicaid fraud.

 

Under the federal False Claims Act, a whistleblower with evidence of fraud can seek recovery on behalf of the government. The government can choose to enter the suit or not. A whistleblower can receive between 15-25% of the recovery when the government enters into the suit and 25-30% if litigated alone. 

 

Furthermore, the whistleblower who reports a violation under the False Claims Act is protected from any employer retaliation as a result of their reporting. 

Liability of the Defendant in Alabama

Under the federal False Claims Act, the defendant may be ordered to pay up to three times the amount of harm to the government. The defendant can also be ordered to pay fines of $5,500 to $11,000 per violation.

Statute of Limitations in Alabama

The statute of limitations for a qui tam lawsuit is six years from the date of the violation or three years after the government knew or should have known about the material fact, but not more than ten years after the violation. 

Working With an Experienced Whistleblower Attorney

If you have become aware of Medicaid fraud in Alabama, you should get skilled legal counsel to advise you of your rights and protections under the False Claims Act and guide you if you choose to undertake a whistleblower lawsuit.  Contact Khurana Law Firm for a confidential, no-cost consultation.

What is

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.

Khurana Law Firm, P.C.
Medicare Fraud
Medicare Fraud is a Serious Problem

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. 

$ 0
Recovered only in 2020
YOU, the healthcare worker, provide the most vital role in combating Medicare abuse and fraud.

Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.

So what is Medicare Fraud?

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. 

Who defrauds Medicare?

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.

How do people and companies commit Medicare fraud?

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. 

What laws protect Medicare from fraudulent activity?

The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity. 

What government agencies protect against Medicare fraud?

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.

How can I help?

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. 

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WORKING WITH An Experienced WHISTLEBLOWER LAWYER

If you’ve become aware of fraudulent activity involving Medicare or Medicaid, you require the advice of a skilled whistleblower lawyer, someone who can ensure that your claim is fully investigated and submitted accurately and quickly. By working with a skilled attorney you are increasing the chance that the federal or state government will intervene, therefore increasing the chance for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  do not attempt 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 fight against Medicare and Medicaid fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we may represent you in a qui tam claim to help report the scams and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay nothing until there is a recovery. Contact us today to learn how we can be of help.

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