Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in San Tan Valley, Arizona

Medicare and Medicaid fraud cost Arizona taxpayers billions of dollars every year. While many medical providers and drug companies are honest and work within the system, there are those who don’t. When fraud occurs, everyone loses. Medicaid and Medicare whistleblower lawyers help people who work in the healthcare system to file suits on behalf of the government to help report this sort of fraud.

The federal and state governments place a great deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government relies on private citizens in Arizona to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in San Tan Valley, Arizona

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the market. We know that stepping forward is not simple 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 thoroughly examine your claim, diligently prepare your case, and work tirelessly with you and the state of federal government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in San Tan Valley, Arizona

While Arizona does not have a state False Claims Act, a person who knows 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 carry out scams accountable.

 

The government depends on citizens and healthcare workers to come forward when they are aware of fraudulent Medicaid activity. The federal False Claims Act enables an employee or a private citizen to bring a qui tam claim on behalf of the government and enables them to get a financial reward for their efforts.

 

Under the federal Act, a private individual or healthcare worker who brings a whistleblower claim on behalf of the government might be entitled to a reward of between 15 percent and 25 percent of the financial recovery in the lawsuit. If the government selects not to intervene, the whistleblower may get a reward of between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in San Tan Valley, Arizona

In a whistleblower suit under the False Claims Act, the defendant might be liable for up to triple the damage 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 should file a complaint within 10 years of the offense.

Working With an Experienced Whistleblower Attorney

Those who have proof or information concerning deceitful Medicaid activity in San Tan Valley, Arizona ought to understand their rights and what to expect if they are considering a whistleblower suit. Getting experienced legal guidance from a whistleblower lawyer is essential. At Khurana Law Firm, P.C., we will help you understand the complaint process along with your rights and choices 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 San Tan Valley, 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 San Tan Valley, 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 San Tan Valley, Arizona

When you become aware of fraud involving Medicaid or Medicare in San Tan Valley, Arizona, you need the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is fully investigated and filed accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the federal or state government will intervene, thus increasing the opportunity for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  do not try 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 legal representatives to assist in your battle against Medicare and Medicaid fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we can represent you in a qui tam claim to help report the scams and enable you to gather a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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