Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Garden Grove, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. While the majority of medical service providers and drug companies are honest and work within the system, there are those who do not. When fraud takes place, everybody loses. Medicare and Medicaid whistleblower attorneys help people who work in the healthcare system to file suits on behalf of the government to help report this type of fraud.

The state and federal governments put a lot of trust in medical and pharmaceutical companies. When that trust is ill-placed, it counts on private citizens in California to come forward to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in Garden Grove, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the industry. understand that coming forward is not simple and numerous 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, diligently and carefully prepare your case, for court, and work relentlessly with both you and the state of federal government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Garden Grove, California

Medicaid fraud cost citizens countless dollars every year in California. The California False Claims Act allows individuals who have knowledge of Medicaid fraud the option to submit a civil complaint on behalf of the state, county, municipality, public school, or any government agency that has been defrauded.

 

In addition, California is among only 2 states in the country with a qui tam statute that attends to scams carried out against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) permits people to submit private qui tam suits against anyone who carries out insurance fraud in the State.

 

Under both laws, it is a civil offense for any individual, company, or insurer to submit fraudulent claims, misuse public property, deceptively prevent financial obligations, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam claim to recover the damage done to the government and, in response, collect a potential financial incentive for whistleblowing.

 

If there is a financial 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 separately, 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 rewards 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 Garden Grove, California

Under the California False Claims Act, the accused may be mandated to pay up to 3 times of the harm to the government in addition to fines of $5,500 to $11,000 per violation.

Statute of Limitations in Garden Grove, California

In California, people submitting a whistleblower claim under the California False Claims Act need to normally submit their grievance within six years of the offense, however, there might be extensions in some instances.

Working With an Experienced Whistleblower Lawyer

If you have learned of deceitful Medicaid activity against the state of California or deceitful activity against a private insurance business, you ought to get the legal guidance and guidance of a knowledgeable whistleblower lawyer. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating scams. 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 Garden Grove, 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 Garden Grove, 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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WORKING WITH An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Garden Grove, California

If you’ve become aware of fraud involving Medicare or Medicaid in Garden Grove, California, you may need the advice of a knowledgeable whistleblower attorney, someone who can ensure that your claim is totally examined and submitted accurately and immediately. By working with a knowledgeable attorney you are increasing the chance that the government will intervene, hence increasing the chance for a 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 have years of prior experience as national qui tam attorneys to help in your battle against Medicare and Medicaid fraud. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we can represent you in a qui tam claim to help report the fraud and enable you to collect a reward. All whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

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