Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Montgomery, Alabama

Medicare and Medicaid fraud cost Alabama taxpayers billions of dollars annually. While the majority of medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud happens, everyone can lose. Medicaid and Medicare whistleblower attorneys assist healthcare workers to submit lawsuits on behalf of the federal or state government to help report this type of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Montgomery, Alabama

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and fraud in the industry. We know that stepping forward is not simple and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

schedule a
confidential consultation

Whistleblower Laws in Montgomery, Alabama

Medicaid scams in the state of Alabama costs taxpayers millions each year. The Alabama Medicaid Fraud Control Unit investigates numerous reports of fraud and abuse yearly. Medicaid fraud can lead to serious criminal charges and civil judgments. Much of the financial recoveries from companies and individuals that defraud the state result from whistleblowers and healthcare professionals who report their knowledge of scams.

 

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

 

Under the federal False Claims Act, a whistleblower with proof of fraud can seek financial recovery on behalf of the state government. The state government can choose to go into the lawsuit or not. A whistleblower can get between 15-25% of the recovery when the government participates in the lawsuit and 25-30% if litigated without the government.

 

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

Liability of the Defendant in Montgomery, Alabama

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

Statute of Limitations in Alabama

The statute of limitations for a qui tam claim is six years from the date of the offense or three years after the state government learned or ought to have learnt about the fact, but not more than 10 years after the offense.

Working With an Experienced Whistleblower Lawyer

If you have learned about Medicaid scams in Montgomery, Alabama, you ought 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 Montgomery, 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 Montgomery, Alabama,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
WORKING WITH An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Montgomery, Alabama

If you’ve become aware of fraud that may involve Medicare or Medicaid in Montgomery, Alabama, you need the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is fully examined and submitted accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the government will step in, thus increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is a complicated 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 help in your battle against Medicare and Medicaid scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we may represent you in a qui tam suit to report the scams and allow you to collect a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can help.

Service areas