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Medicare and Medicaid fraud cost Alabama taxpayers billions of dollars every year. While most medical service providers and drug companies are honest and work within the legal channels, there are those who don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys help people who work in the healthcare system to submit suits on behalf of the government to help report this type of fraud.
The state and federal governments put a good deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government depends on private citizens in Alabama to come forward to report scams. People like you.
At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the industry. We know that coming forward is difficult and many things may be at stake. When you come to us, your case is held in the strictest confidence at all times.
With our extensive experience representing whistleblowers nationwide, we completely examine your claim, diligently and carefully prepare your case, and work relentlessly with you and the state of federal government to assist in bringing fraudulent Medicaid or Medicare activity to justice.
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:
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
Coders are directed to add codes based on other information in the chart.
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
Coders are directed to add codes based on other information in the chart.
If you suspect Medicare Advantage Fraud, you are a healthcare worker in Birmingham, Alabama, get in touch with us 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 see abuse and fraudulent activity you should report it. In some cases, you may even be entitled to a reward. If you are a healthcare worker in Birmingham, Alabama, you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation.
When you become aware of fraud that may involve Medicaid or Medicare in Birmingham, Alabama, you require the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is completely investigated and filed accurately and without delay. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, thus increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is an intricate matter – don’t attempt to do this alone, we are here to help.
At Khurana Law Firm, P.C., we have years of experience as national qui tam legal representatives to help in your fight against Medicaid and Medicare fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we believe that you have a legitimate claim, we may represent you in a qui tam claim to report the scams and allow you to gather a reward. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can be of help.
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