Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in La Habra, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. While the majority of medical companies and drug companies are honest and work within the legal channels, some do not. When fraud occurs, everyone can lose. Medicaid and Medicare whistleblower lawyers can assist healthcare professionals to file claims on behalf of the federal or state government to report these kinds of scams.

The federal and state governments put a great deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government depends on every day people in California to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in La Habra, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and scams in the industry. We know that coming forward is difficult and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in La Habra, California

Medicaid fraud cost taxpayers millions of dollars each year in California. The California False Claims Act permits people who have knowledge of Medicaid scams the ability to file 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 country with a qui tam statute that deals with fraud committed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) permits people to submit private qui tam suits against anyone who executes insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurer to send fraudulent claims, misappropriate public property, deceptively prevent financial commitments, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam claim to recover the harm done to the government and, in addition, gather a potential financial incentive for whistleblowing.

 

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 rewards of in between 15-33% of the recovery. If the lawsuit was prosecuted 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 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 La Habra, California

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

Statute of Limitations in La Habra, California

In California, individuals filing a whistleblower claim under the California False Claims Act must generally submit their problem within six years of the violation, 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 insurance company, you need to get the legal advice and assistance of a skilled 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 La Habra, 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 La Habra, 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 ATTORNEY; We are proud to represent healthcare workers in La Habra, California

If you’ve become aware of deceptive activity as it concerns Medicaid or Medicare in La Habra, California, you may need the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and quickly. By dealing with a knowledgeable lawyer you are increasing the chance that the federal or state government will step in, thus increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is a complicated matter –  don’t 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 legal representatives to assist in your battle against Medicaid and Medicare fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we believe you have a valid claim, we can represent you in a qui tam claim to report the fraud and enable you to gather a reward. All whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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