Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Arizona

Medicaid and Medicare fraud cost Arizona taxpayers billions of dollars every year. Although the majority of medical providers and drug companies are honest and work within the system, there are those who do not. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower attorneys assist healthcare workers to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

The state and federal governments place a a lot of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government relies on every day people in Arizona to come forward and to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care workers in Arizona.

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the market. We know that stepping forward is difficult and numerous things might be at stake. When you come to us, your case is held 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 tirelessly with you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Arizona

While Arizona does not have a state False Claims Act, an individual who has knowledge of Medicaid fraud in the state of Arizona may pursue a whistleblower claim under the federal False Claims Act. The Act empowers private individuals to come forward with a civil lawsuit on behalf of the government to hold those who commit fraud accountable. 

The government relies on private individuals and employees to come forward when they are aware of fraudulent Medicaid activity. The federal False Claims Act allows an employee or individual to bring forth a qui tam lawsuit on behalf of the government and enables them to receive a reward for their efforts. 

Under the federal Act, a private individual or employee who brings a whistleblower claim on behalf of the government may be entitled to a reward of between 15 percent and 25 percent of the recovery in the suit. If the government chooses not to intervene, the whistleblower may receive a reward of between 25 and 30 percent of the recovery. 

In addition to a reward, employees in Arizona are protected against retaliation, discharge, or discrimination by an employer because of a whistleblower lawsuit.

If you are a Utah healthcare worker, get in touch with Utah Medicare Whistleblower attorney.

Liability of the Defendant in Arizona

In a whistleblower lawsuit under the False Claims Act, the defendant may be liable for up to triple the harm to the government as well as additional penalties of $5,500 to $11,000 per violation.

Statute of Limitations in Arizona

Under the federal False Claims Act, a whistleblower must file a complaint within 10 years of the violation.

Working With an Experienced Whistleblower Attorney

Those who have evidence or information concerning fraudulent Medicaid activity in Arizona should understand their rights and what to expect if they are considering a whistleblower lawsuit. Getting experienced legal guidance from a whistleblower attorney is essential. At Khurana Law Firm, P.C., we will help you understand the procedure as well as your rights and options under the False Claims Act. Contact us for a confidential, no-cost consultation to discuss your case.

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 can report it 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. To report Medicare fraud, contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY

If you’ve become aware of fraud that may involve Medicare or Medicaid, you may need the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is completely investigated and submitted accurately and promptly. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, hence increasing the chance for a financial reward. Reporting Medicaid and Medicare fraud is a complicated 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 lawyers to help in your fight against Medicare and Medicaid fraud. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we may represent you in a qui tam suit to help report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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