Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in Delano, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. Although most medical providers and drug companies are honest and work within the legal channels, some don’t. When fraud happens, everybody loses. Medicare and Medicaid whistleblower lawyers can assist healthcare workers to file claims on behalf of the federal or state government to report these kinds of scams.

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

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Delano, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and fraud in the industry. understand that stepping forward is hard and lots of things may be at stake. When you come to us, your case is held in the strictest confidence .

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

schedule a
confidential consultation

Whistleblower Laws in Delano, California

Medicaid scams cost taxpayers millions of dollars each year in California. The California False Claims Act permits people who know of Medicaid scams the ability to submit a civil complaint on behalf of the state, county, town, public school, or any government agency that may have been defrauded.

 

In addition, California is among only two 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 commits insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurer to submit deceitful claims, misuse public property, deceptively avoid monetary obligations, or returns of funds to the government. Whistleblowers who know of such activity can file a qui tam claim to recover 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 might be entitled to rewards of between 15-33% of the recovery. If the suit was litigated 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 incentives of between 30-40% of the recovery if the government steps in and 40-50% of the recovery if the government does not intervene.

Liability of the Defendant in Delano, California

Under the California False Claims Act, the defendant might be mandated to pay up to three times of damage to the government along with fines of $5,500 to $11,000 per violation.

Statute of Limitations in Delano, California

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

Working With an Experienced Whistleblower Attorney

If you have learned of fraudulent Medicaid activity against the state of California or deceitful activity against a private insurer, you ought to get the legal advice and guidance 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 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 Delano, 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 Delano, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Delano, California

When you become aware of fraudulent activity that may concern Medicaid or Medicare in Delano, California, you require the advice of a skilled whistleblower attorney, someone who can make sure that your claim is completely examined and submitted accurately and without delay. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, thus increasing your chances for a reward. Reporting Medicaid and Medicare fraud is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam legal representatives to help in your fight against Medicaid and Medicare fraud. We will examine 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 suit to report the scams and enable you to gather a reward. Because all whistleblower cases are on contingency, you pay nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

Service areas