Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Downey, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars every year. Although many medical providers and drug companies are ethical and work within the legal channels, some do not. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys can assist people who work in the healthcare system to submit suits on behalf of the federal or state government to help report these kinds of scams.

The federal and state government place a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government depends on private citizens in California to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Downey, California

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and scams in the market. understand that stepping forward is hard and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Downey, California

Medicaid scams cost taxpayers countless dollars every year in California. The California False Claims Act permits private citizens who have knowledge of Medicaid scams the ability 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 2 states in the nation with a qui tam statute that addresses scams executed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to file private qui tam suits against anyone who carries out insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance company to send fraudulent claims, misappropriate public property, deceptively avoid monetary obligations, 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 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 in between 15-33% of the recovery. If the suit was prosecuted separately, 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 Downey, California

Under the California False Claims Act, the defendant might be ordered to pay up to 3 times of the harm to the government along with fines of $5,500 to $11,000 per infraction.

Statute of Limitations in Downey, California

In California, people submitting a whistleblower lawsuit under the California False Claims Act need to usually file their problem within six years of the offense, however, there may be extensions in some circumstances.

Working With an Experienced Whistleblower Attorney

If you have learned of deceptive Medicaid activity against the state of California or deceitful activity against a private insurer, you ought to get the legal guidance 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 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 Downey, 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 Downey, 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 LAWYER; We are proud to represent healthcare workers in Downey, California

When you become aware of potential fraud as it concerns Medicare or Medicaid in Downey, California, you may need the advice of a knowledgeable whistleblower attorney, someone who can make sure that your claim is fully investigated and filed accurately and promptly. By working with a skilled attorney you are increasing the chance that the federal or state government will step in, hence increasing the chance for a financial reward. Reporting Medicaid and Medicare scams is an intricate 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 lawyers to assist in your battle against Medicaid and Medicare fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam lawsuit to help report the scams and allow you to gather a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can help.

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