Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Carmichael, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars each year. Although most medical service providers and drug companies are honest and work within the legal channels, some don’t. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower attorneys can help healthcare professionals to submit lawsuits on behalf of the federal or state government to help report this type of fraud.

The federal and state governments place a lot of trust in pharmaceutical and medical companies. When that trust is ill-placed, it counts on regular folks in California to come forward to report scams. People like you.

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Carmichael, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the industry. We know that stepping forward is hard and many things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Carmichael, California

Medicaid fraud cost citizens millions of dollars every year in California. The California False Claims Act allows individuals who know of Medicaid fraud the option to file a civil complaint on behalf of the state, county, municipality, public school, or any government agency that may have been defrauded.

 

In addition, California is one of just two states in the nation with a qui tam statute that deals with scams 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 scams in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurance company to submit deceitful claims, misuse public property, deceptively prevent financial commitments, 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 addition, collect a potential financial incentive for doing so.

 

If there is a financial recovery by the State or other subdivision of government under the California False Claims Act, the whistleblower might be entitled to rewards 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 may 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 Carmichael, California

Under the California False Claims Act, the accused may be ordered to pay up to 3 times the amount of damage to the government in addition to fines of $5,500 to $11,000 per violation.

Statute of Limitations in Carmichael, California

In California, people submitting a whistleblower lawsuit under the California False Claims Act should usually submit their complaint within six years of the violation, but, there may be extensions in some instances.

Working With an Experienced Whistleblower Attorney

If you have learned of deceptive Medicaid activity against the state of California or fraudulent activity against a private insurer, you need to get the legal guidance and assistance of an experienced whistleblower attorney. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating fraud. Contact us for a completely 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 Carmichael, 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 Carmichael, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Carmichael, California

If you’ve become aware of fraud as it concerns Medicaid or Medicare in Carmichael, California, you may need the guidance of a skilled whistleblower lawyer, someone who can guarantee that your claim is totally examined and filed accurately and quickly. By dealing with a skilled attorney you are increasing the chance that the government will intervene, hence increasing the possibility for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  do not 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 attorneys to assist in your fight against Medicare and Medicaid scams. We will examine your case on a confidential, no-obligation basis. If we feel that you have a legitimate claim, we may represent you in a qui tam lawsuit to report the scams and allow you to collect a reward. Because all whistleblower work is on contingency, you pay nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

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