Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Phoenix, Arizona

Medicaid and Medicare fraud cost Arizona taxpayers billions of dollars annually. While the majority of medical companies and drug companies are ethical and work within the legal channels, there are those who don’t. When scams are perpetrated, everyone can lose. Medicaid and Medicare whistleblower lawyers help healthcare professionals to submit suits on behalf of the government to report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in Phoenix, Arizona

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the market. We know that coming forward is not easy and lots of things may be at stake. When you come to us, your case is held in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently and carefully prepare your case, and work tirelessly with you and the state of federal government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Phoenix, Arizona

While Arizona does not have a state False Claims Act, a person who has knowledge of Medicaid scams 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 perpetrate scams accountable.

 

The government counts on citizens and employees to come forward when they learn of deceitful Medicaid activity. The federal False Claims Act permits a worker or individual to bring a qui tam claim on behalf of the government and allows them to receive a reward for their efforts.

 

Under the federal Act, a private individual or healthcare worker 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 lawsuit. If the government selects not to step in, the whistleblower might get a benefit of between 25 and 30 percent of the recovery.

 

In addition to a reward, staff members in Arizona are protected from retaliation, discharge, or discrimination by an employer due to the fact that of a whistleblower claim.

Liability of the Defendant in Phoenix, Arizona

In a whistleblower claim under the False Claims Act, the accused might be accountable for up to triple the damage to the government as well as extra penalties of $5,500 to $11,000 per violation.

Statute of Limitations in Arizona

Under the federal False Claims Act, a whistleblower should submit a complaint within 10 years of the offense.

Working With an Experienced Whistleblower Attorney

Healthcare workers who have proof or information concerning deceitful Medicaid activity in Phoenix, Arizona should understand their rights and what to anticipate if they are considering a whistleblower claim. Getting experienced legal assistance from a whistleblower attorney is important. At Khurana Law Firm, P.C., we will help you understand the complaint process as well as your rights and options under the False Claims Act. Contact us for a completely 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 are a healthcare worker in Phoenix, Arizona, 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 Phoenix, Arizona,  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 ATTORNEY; We are proud to represent healthcare workers in Phoenix, Arizona

If you’ve become aware of deceptive activity as it concerns Medicare or Medicaid in Phoenix, Arizona, you may need the advice of an experienced whistleblower lawyer, someone who can make sure that your claim is totally investigated and submitted accurately and promptly. By working with a skilled attorney you are increasing the chance that the government will step in, hence increasing the chance for a financial reward. Reporting Medicare and Medicaid scams is an intricate matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam legal representatives to help in your battle against Medicare and Medicaid fraud. We will evaluate your case on a confidential, no-obligation basis. If we believe you have a valid claim, we can represent you in a qui tam claim to report the fraud and allow you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to learn how we can be of help.

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