Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Hanford, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars annually. While most medical service providers and drug companies are honest and work within the legal channels, there are those who do not. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower lawyers can assist healthcare workers to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

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

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing health care workers in Hanford, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the market. We know that coming 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 comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, and work tirelessly with you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Hanford, California

Medicaid scams cost citizens countless dollars every year in California. The California False Claims Act enables people who know of Medicaid scams the option to file 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 only 2 states in the country with a qui tam statute that attends to scams executed against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) permits individuals to submit private qui tam suits against anyone who commits insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, company, or insurer to send deceptive claims, misappropriate public property, deceptively prevent financial obligations, or returns of funds to the government. Whistleblowers who know of such activity can submit a qui tam suit to recuperate the damage done to the government and, in response, collect a potential financial incentive for doing so.

 

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 prosecuted 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 intervenes and 40-50% of the recovery if the government does not step in.

Liability of the Defendant in Hanford, California

Under the California False Claims Act, the defendant might be ordered to pay up to 3 times of damage to the government as well as fines of $5,500 to $11,000 per violation.

Statute of Limitations in Hanford, California

In California, people submitting a whistleblower claim under the California False Claims Act must typically submit their problem within 6 years of the offense, but, there may be extensions in some instances.

Working With an Experienced Whistleblower Lawyer

If you have learned of fraudulent Medicaid activity against the state of California or fraudulent activity against a private insurer, you need 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 assessment 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 Hanford, 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 Hanford, 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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Report Medical fraud
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WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Hanford, California

When you become aware of potential fraud that may involve Medicare or Medicaid in Hanford, California, you may need the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the government will step in, therefore increasing the opportunity for a financial reward. Reporting Medicaid and Medicare scams 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 practical experience as national qui tam legal representatives to assist in your battle against Medicaid and Medicare scams. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we may represent you in a qui tam lawsuit to help report the scams and enable you to collect a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

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