Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Decatur, Alabama

Medicare and Medicaid fraud cost Alabama taxpayers billions of dollars each year. Although most medical companies and drug companies are ethical and work within the legal channels, some do not. When scams are perpetrated, everybody loses. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to file lawsuits on behalf of the government to report this sort of fraud.

The federal and state governments place a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government relies on regular folks in Alabama to come forward to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Decatur, Alabama

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the industry. understand 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, for court, and work relentlessly with you and the state of federal government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Decatur, Alabama

Medicaid fraud in the state of Alabama costs residents of the state millions each year. The Alabama Medicaid Fraud Control Unit examines hundreds of reports of scams and abuse annually. Medicaid scams can lead to serious criminal charges and civil judgments. Much of the financial recoveries from companies and people that defraud the state arise from whistleblowers and health care workers who report knowledge of scams.

 

Although Alabama does not have a state false claims act, an individual with awareness or proof of Medicaid scams in Alabama may submit a qui tam lawsuit under the federal False Claims Act. This Act empowers a private citizen to sue a business or another entity on behalf of the government for Medicare and Medicaid fraud.

 

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

 

In addition, the whistleblower who reports a violation under the False Claims Act is safeguarded from any company retaliation as an outcome of their reporting.

Liability of the Defendant in Decatur, Alabama

Under the federal False Claims Act, the offender might be ordered to pay up to three times the amount of damage to the state government. The offender 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 claim is six years from the date of the infraction or 3 years after the state government knew or ought to have learnt about the product fact, however not more than 10 years after the violation.

Working With an Experienced Whistleblower Attorney

If you have become aware of Medicaid scams in Decatur, Alabama, you should get knowledgeable legal counsel to advise you of your rights and protections under the False Claims Act, as well as 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 are a healthcare worker in Decatur, Alabama, get in touch with us 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. If you are a healthcare worker in Decatur, Alabama,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

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Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Decatur, Alabama

If you’ve become aware of deceitful activity as it concerns Medicare or Medicaid in Decatur, Alabama, you require the guidance of a skilled whistleblower attorney, someone who can guarantee that your claim is totally examined and filed accurately and quickly. By dealing with a knowledgeable lawyer you are increasing the chance that the government will step in, hence increasing your chances for a reward. Reporting Medicaid and Medicare scams 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 lawyers to assist in your fight against Medicaid and Medicare scams. 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 fraud and allow you to gather a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to learn how we can help.

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