Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Escondido, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. While many medical companies and drug companies are ethical and work within the system, some don’t. When scams are perpetrated, everybody loses. Medicare and Medicaid whistleblower lawyers can assist people who work in the healthcare system to file claims on behalf of the government to help report this sort of fraud.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the market. understand that coming forward is difficult and many things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Escondido, California

Medicaid scams cost citizens millions of dollars every year in California. The California False Claims Act permits private citizens who have knowledge of Medicaid scams the ability to file a civil complaint on behalf of the state, county, municipality, public school, or any government agency that has been defrauded.

 

In addition, California is one of just 2 states in the country with a qui tam statute that deals with scams committed against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to file private qui tam suits against anybody who executes insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance company to submit deceitful claims, abuse public property, deceptively avoid monetary responsibilities, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam lawsuit to recover the damage 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 between 15-33% of the recovery. If the suit was litigated individually, 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 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 Escondido, California

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

Statute of Limitations in Escondido, California

In California, individuals filing a whistleblower suit under the California False Claims Act must usually submit their complaint within six years of the infraction, but, there may be extensions in some circumstances.

Working With an Experienced Whistleblower Lawyer

If you have learned of deceptive Medicaid activity against the state of California or fraudulent activity against a private insurance business, you should 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 scams. Contact us for a confidential, no-cost assessment 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 Escondido, 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 Escondido, 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 Escondido, California

When you become aware of deceitful activity as it concerns Medicare or Medicaid in Escondido, California, you may need the advice of a skilled whistleblower lawyer, someone who can ensure that your claim is completely investigated and filed accurately and without delay. By dealing with an experienced lawyer you are increasing the chance that the government will intervene, therefore increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is a complex matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam attorneys to assist in your battle against Medicaid and Medicare scams. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam suit to help report the scams and enable you to gather a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to learn how we can be of help.

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