Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Hoover, Alabama

Medicare and Medicaid fraud cost Alabama taxpayers billions of dollars each year. Although many medical companies and drug companies are honest and work within the legal channels, there are those who don’t. When fraud takes place, everyone loses. Medicare and Medicaid whistleblower lawyers help healthcare professionals to submit lawsuits on behalf of the government to help report this sort of fraud.

The federal and state governments put a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, it counts on every day people in Alabama to come forward to report scams. People like you.

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Hoover, Alabama

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that coming forward is not simple and lots of 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 examine your claim, diligently and carefully prepare your case, and work tirelessly with both 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 Hoover, Alabama

Medicaid scams in the state of Alabama costs residents of the state millions each year. The Alabama Medicaid Fraud Control Unit examines numerous reports of fraud and abuse yearly. Medicaid scams can lead to serious criminal charges and civil judgments. A number of the monetary recoveries from businesses and people that defraud the state result from whistleblowers and healthcare professionals who report knowledge of the fraudulent activity.

 

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

 

Furthermore, the whistleblower who reports an infraction under the False Claims Act is safeguarded from any company retaliation as an outcome of their reporting.

Liability of the Defendant in Hoover, Alabama

Under the federal False Claims Act, the offender might be ordered to pay up to 3 times the amount of harm 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 lawsuit is six years from the date of the offense or three years after the state government learned or need to have known about the fact, however not more than 10 years after the infraction.

Working With an Experienced Whistleblower Lawyer

If you have become aware of Medicaid scams in Hoover, Alabama, you need to get experienced legal counsel to advise you of your rights and protections under the False Claims Act, as well as guide you if you choose to carry out a whistleblower claim. 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 Hoover, 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 Hoover, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Hoover, Alabama

When you become aware of potential fraud that may involve Medicaid or Medicare in Hoover, Alabama, you need the guidance of a skilled whistleblower lawyer, someone who can make sure that your claim is totally investigated and filed accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the government will intervene, therefore increasing the chance for a financial reward. Reporting Medicaid and Medicare scams 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 prior experience as national qui tam lawyers to help in your fight against Medicaid and Medicare fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we may represent you in a qui tam suit to help report the scams and enable you to gather a financial benefit. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can be of help.

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