Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Camarillo, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. While many medical providers and drug companies are honest and work within the system, there are those who do not. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower lawyers assist healthcare professionals to file lawsuits on behalf of the government to report this sort of fraud.

The federal and state governments put a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it counts on every day people in California to come forward to report scams. People like you.

Work with

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the industry. We know that coming forward is difficult and lots of things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, carefully prepare your case, for court, and work relentlessly with you and the federal or state government to assist in bringing deceitful Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Camarillo, California

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

 

In addition, California is among just 2 states in the country with a qui tam statute that addresses fraud executed against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) allows people to submit private qui tam suits against anybody who executes insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, company, or insurance company to submit deceptive claims, misappropriate public property, deceptively prevent financial responsibilities, or returns of funds to the government. Whistleblowers who know of such activity can submit a qui tam suit to recuperate the harm done to the government and, in response, collect 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 might be entitled to incentives of in between 15-33% of the recovery. If the suit was litigated independently, the whistleblower’s reward potential increases to 25-50% of the recovery.

 

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

Liability of the Defendant in Camarillo, California

Under the California False Claims Act, the offender may be mandated to pay up to three times the amount of the harm to the government along with fines of $5,500 to $11,000 per offense.

Statute of Limitations in Camarillo, California

In California, individuals filing a whistleblower claim under the California False Claims Act should generally submit their problem within 6 years of the offense, however, there might be extensions in some circumstances.

Working With an Experienced Whistleblower Attorney

If you have become aware of fraudulent Medicaid activity against the state of California or deceptive activity against a private insurance provider, you ought to get the legal advice and assistance of a knowledgeable whistleblower attorney. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating fraud. 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 are a healthcare worker in Camarillo, 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 Camarillo, California,  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
Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Camarillo, California

When you become aware of fraudulent activity that may involve Medicaid or Medicare in Camarillo, California, you may need the guidance of a knowledgeable whistleblower attorney, someone who can ensure that your claim is totally examined and submitted accurately and promptly. By working with an experienced attorney you are increasing the chance that the government will intervene, hence increasing the chance for a reward. Reporting Medicaid and Medicare fraud 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 experience as national qui tam attorneys to help in your battle against Medicare and Medicaid fraud. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we can represent you in a qui tam claim to help report the scams and enable you to collect a reward. All whistleblower work is on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can be of help.

Service areas