Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost California taxpayers billions of dollars every year. Although most medical service providers and drug companies are ethical and work within the legal channels, some don’t. When fraud occurs, everybody loses. Medicare and Medicaid whistleblower lawyers can help people who work in the healthcare system to file suits on behalf of the federal or state government to report these kinds of scams.

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

Work with

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the industry. We know that coming forward is difficult and many things may 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 examine your claim, diligently and carefully prepare your case, and work tirelessly with you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in El Monte, California

Medicaid fraud cost citizens countless dollars each year in California. The California False Claims Act enables individuals who know of Medicaid fraud 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 one of only two states in the nation with a qui tam statute that addresses fraud executed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) permits individuals to file private qui tam suits against anyone 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 avoid financial obligations, or returns of funds to the government. Whistleblowers who are aware of such activity can submit a qui tam claim to recuperate the harm done to the government and, in addition, 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 incentives of in between 15-33% of the recovery. If the lawsuit was litigated independently, the whistleblower’s reward potential increases to 25-50% of the financial recovery.

 

If there is a recovery by the state under the IFPA, the whistleblower might 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 step in.

Liability of the Defendant in El Monte, California

Under the California False Claims Act, the accused might be mandated to pay up to 3 times the amount of damage to the government along with fines of $5,500 to $11,000 per violation.

Statute of Limitations in El Monte, California

In California, people filing a whistleblower claim under the California False Claims Act need to usually file their problem within six years of the offense, but, there may 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 deceitful activity against a private insurer, you should get the legal guidance and assistance of an experienced whistleblower lawyer. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating scams. Contact us for a completely 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 El Monte, 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 El Monte, 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 El Monte, California

If you’ve become aware of potential fraud involving Medicare or Medicaid in El Monte, California, you may need the advice of a knowledgeable whistleblower attorney, someone who can make sure that your claim is completely investigated and filed accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the federal or state government will step in, hence increasing the opportunity for a financial reward. Reporting Medicare and Medicaid fraud is an intricate matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam legal representatives to assist in your fight against Medicare and Medicaid fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and allow you to gather a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to to schedule a confidential consultation.

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