Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Anaheim, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. While many medical service providers and drug companies are ethical and work within the legal channels, some don’t. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower lawyers assist healthcare workers to file claims on behalf of the federal or state government to help report these kinds of scams.

The state and federal governments put a good deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government counts on regular folks in California to come forward to report fraud. People like you.

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Anaheim, California

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 scams in the market. We know that stepping forward is hard 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 relentlessly with both you and the state of federal government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Anaheim, California

Medicaid scams cost taxpayers millions of dollars every year in California. The California False Claims Act enables individuals who know of Medicaid scams the option to submit a civil complaint on behalf of the state, county, town, public school, or any government agency that has been defrauded.

 

In addition, California is one of just two states in the country with a qui tam statute that deals with fraud carried out against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to file private qui tam suits against anyone who executes insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, company, or insurance company to send deceitful claims, misuse public property, deceptively prevent financial responsibilities, or returns of funds to the government. Whistleblowers who know of such activity can submit a qui tam claim to recuperate the damage done to the government and, in response, gather a potential financial incentive for doing so.

 

If there is a recovery by the State or other subdivision of government under the California False Claims Act, the whistleblower may be entitled to incentives of in between 15-33% of the recovery. If the lawsuit was prosecuted independently, the whistleblower’s reward potential increases to 25-50% of the funds recovered.

 

If there is a recovery by the state under the IFPA, the whistleblower might be entitled to rewards of in between 30-40% of the recovery if the government intervenes and 40-50% of the recovery if the government does not step in.

Liability of the Defendant in Anaheim, California

Under the California False Claims Act, the defendant might be mandated to pay up to 3 times the amount of damage to the government as well as fines of $5,500 to $11,000 per violation.

Statute of Limitations in Anaheim, California

In California, individuals filing a whistleblower lawsuit under the California False Claims Act should normally submit their problem within six years of the violation, but, there might be extensions in some instances.

Working With an Experienced Whistleblower Attorney

If you have become aware of fraudulent Medicaid activity against the state of California or fraudulent activity against a private insurance provider, you should get the legal guidance and assistance of a knowledgeable whistleblower lawyer. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating fraud. Contact us for a confidential, no-cost consultation in order 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 Anaheim, California, 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 Anaheim, California,  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 Anaheim, California

If you’ve become aware of potential fraud that may concern Medicare or Medicaid in Anaheim, California, you require the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is fully investigated and submitted accurately and without delay. By working with a skilled attorney you are increasing the chance that the federal or state government will step in, thus increasing the opportunity for a reward. Reporting Medicare and Medicaid scams is a complex matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam lawyers to assist in your battle against Medicare and Medicaid scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we may represent you in a qui tam suit to help report the scams and enable you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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