Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Monterey Park, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are ethical and work within the system, some don’t. When fraud happens, everybody loses. Medicaid and Medicare whistleblower lawyers assist healthcare workers to file suits on behalf of the federal or state government to help report these kinds of scams.

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

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare workers in Monterey Park, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that coming forward is hard and many 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, 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 Monterey Park, California

Medicaid fraud cost taxpayers millions of dollars every year in California. The California False Claims Act allows private citizens who know of Medicaid fraud 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 among just two states in the country with a qui tam statute that attends to fraud executed against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) permits people to submit private qui tam suits against anyone who commits insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurance provider to submit deceptive claims, misappropriate public property, deceptively prevent monetary obligations, or returns of funds to the government. Whistleblowers who know of such activity can file a qui tam lawsuit to recover the harm done to the government and, in addition, 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 may be entitled to incentives of in between 15-33% of the recovery. If the suit was prosecuted independently, 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 may be entitled to rewards of in between 30-40% of the recovery if the government intervenes and 40-50% of the recovery if the government does not intervene.

Liability of the Defendant in Monterey Park, California

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

Statute of Limitations in Monterey Park, California

In California, people submitting a whistleblower suit under the California False Claims Act must generally file their problem within 6 years of the infraction, however, there might be extensions in some instances.

Working With an Experienced Whistleblower Attorney

If you have become aware of fraudulent Medicaid activity against the state of California or deceptive activity against a private insurance provider, you need to get the legal guidance and guidance 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 Monterey Park, 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 Monterey Park, 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 ATTORNEY; We are proud to represent healthcare workers in Monterey Park, California

When you become aware of fraud involving Medicare or Medicaid in Monterey Park, California, you need the advice of an experienced whistleblower attorney, someone who can ensure that your claim is completely investigated and filed accurately and promptly. By working with an experienced attorney you are increasing the chance that the government will intervene, hence increasing the possibility for a reward. Reporting Medicaid and Medicare scams is an intricate 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 legal representatives to help in your battle against Medicaid and Medicare fraud. We will review your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we can represent you in a qui tam suit to help report the fraud and allow you to gather a reward. Because all whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to learn how we can be of help.

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