Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid scams in Dothan, Alabama

Medicare and Medicaid fraud cost Alabama taxpayers billions of dollars every year. Although most medical companies and drug companies are honest and work within the legal channels, there are those who don’t. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower lawyers assist healthcare workers to file suits on behalf of the federal or state government to report this type of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in Dothan, Alabama

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the market. We know that coming forward is hard and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Dothan, Alabama

Medicaid scams in the state of Alabama costs taxpayers millions each year. The Alabama Medicaid Fraud Control Unit investigates hundreds of reports of fraud and abuse each year. Medicaid fraud can result in major criminal charges and civil judgments. Much of the monetary recoveries from businesses and individuals that defraud the state result from whistleblowers and healthcare workers who report knowledge of scams.

 

Although Alabama does not have a state false claims act, a private individual with awareness or evidence of Medicaid fraud in Alabama may file a qui tam suit 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 proof of scams can seek recovery on behalf of the state government. The state government can select to enter the litigation or not. A whistleblower can get in between 15-25% of the recovery when the government enters into the lawsuit and 25-30% if litigated without the government.

 

Furthermore, the whistleblower who reports an offense under the False Claims Act is protected from any employer retaliation as an outcome of their reporting.

Liability of the Defendant in Dothan, Alabama

Under the federal False Claims Act, the offender might be ordered to pay up to 3 times the amount of damage to the government. The defendant may 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 offense or 3 years after the state government knew or ought to have known about the fact, however not more than 10 years after the infraction.

Working With an Experienced Whistleblower Lawyer

If you have learned about Medicaid scams in Dothan, Alabama, you need to get skilled legal counsel to advise you of your rights and protections under the False Claims Act, as well as guide you if you elect to carry out a whistleblower claim. Contact Khurana Law Firm for a confidential, no-cost assessment.

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 Dothan, 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 Dothan, 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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WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Dothan, Alabama

When you become aware of potential fraud as it concerns Medicare or Medicaid in Dothan, Alabama, you may need the advice of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is totally investigated and filed accurately and promptly. By working with an experienced lawyer you are increasing the chance that the government will intervene, therefore increasing the chance for a reward. Reporting Medicaid and Medicare scams is a complex matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam attorneys to assist in your fight against Medicaid and Medicare scams. We will evaluate your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

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