Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Cupertino, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars every year. While many medical service providers and drug companies are honest and work within the system, there are those who don’t. When fraud happens, everyone loses. Medicare and Medicaid whistleblower lawyers can assist healthcare professionals to submit suits on behalf of the federal or state government to report this type of fraud.

The state and federal government place a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it relies on private citizens in California to come forward to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in Cupertino, California

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is challenging and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Cupertino, California

Medicaid fraud cost citizens millions of dollars every year in California. The California False Claims Act allows private citizens who have knowledge of Medicaid scams the option 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 one of only 2 states in the country with a qui tam statute that attends to fraud executed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to file private qui tam suits against anybody who commits insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, company, or insurer to send deceptive claims, misuse public property, deceptively avoid monetary obligations, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam suit to recover the damage done to the government and, in addition, gather a potential reward for whistleblowing.

 

If there is a financial recovery by the State or other subdivision of government under the California False Claims Act, the whistleblower may be entitled to rewards of between 15-33% of the recovery. If the lawsuit was prosecuted 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 in between 30-40% of the recovery if the government steps in and 40-50% of the recovery if the government does not step in.

Liability of the Defendant in Cupertino, California

Under the California False Claims Act, the offender 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 infraction.

Statute of Limitations in Cupertino, California

In California, people submitting a whistleblower lawsuit under the California False Claims Act must usually submit their problem within 6 years of the offense, however, there might be extensions in some instances.

Working With an Experienced Whistleblower Lawyer

If you have become aware of fraudulent Medicaid activity against the state of California or fraudulent activity against a private insurer, you should 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 assessment 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 Cupertino, 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 Cupertino, 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 LAWYER; We are proud to represent healthcare workers in Cupertino, California

When you become aware of fraud involving Medicaid or Medicare in Cupertino, California, you require the advice of a knowledgeable whistleblower attorney, someone who can guarantee that your claim is fully examined and filed accurately and quickly. By dealing with an experienced attorney you are increasing the chance that the federal or state government will step in, thus increasing your chances for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam attorneys to help in your fight against Medicare and Medicaid scams. We 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 lawsuit to report the scams and enable you to collect a reward. All whistleblower work is on contingency, you pay nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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