Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost California taxpayers billions of dollars every year. Although many medical providers and drug companies are honest and work within the system, some don’t. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower attorneys can help people who work in the healthcare system to file suits on behalf of the federal or state government to help report this type of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in Menifee, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and scams in the market. understand that stepping forward is difficult and lots of things may be at stake. When you come to us, your case is held in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, and work tirelessly with both you and the state of federal government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Menifee, California

Medicaid scams cost taxpayers countless dollars each year in California. The California False Claims Act permits individuals who have knowledge of Medicaid fraud the option 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 among just two states in the country with a qui tam statute that attends to fraud committed against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to submit private qui tam suits against anybody who carries out insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurer to send deceitful claims, misuse public property, deceptively prevent monetary obligations, or returns of funds to the government. Whistleblowers who know of such activity can submit a qui tam lawsuit to recuperate the harm done to the government and, in response, collect a potential reward 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 in between 15-33% of the recovery. If the lawsuit was prosecuted separately, the whistleblower’s reward potential increases to 25-50% of the 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 intervene.

Liability of the Defendant in Menifee, California

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

Statute of Limitations in Menifee, California

In California, people filing a whistleblower suit under the California False Claims Act should typically submit their complaint within six years of the offense, but, there may 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 deceptive activity against a private insurance provider, you need to get the legal guidance and assistance of a knowledgeable whistleblower lawyer. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating fraud. 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 Menifee, 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 Menifee, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Menifee, California

When you become aware of fraud involving Medicaid or Medicare in Menifee, California, you may need the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is totally examined and submitted accurately and quickly. By dealing with a skilled attorney you are increasing the chance that the government will step in, thus increasing your chances for a financial reward. Reporting Medicaid and Medicare fraud is a complex 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 lawyers to assist in your fight against Medicare and Medicaid fraud. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we may represent you in a qui tam suit to report the fraud and allow you to gather a financial benefit. All whistleblower work is on contingency, you pay nothing up until there is a recovery. Get in touch with us today to learn how we can help.

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