Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Murrieta, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars every year. While many medical service providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud happens, everyone loses. Medicare and Medicaid whistleblower lawyers can help healthcare professionals to submit claims on behalf of the government to report these kinds of scams.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Murrieta, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and scams in the market. understand that stepping forward is challenging and numerous 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 examine your claim, diligently and carefully prepare your case, for court, and work tirelessly with you and the state of federal government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Murrieta, California

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

 

In addition, California is among just 2 states in the country with a qui tam statute that addresses fraud committed against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) permits people to submit private qui tam suits against anybody who executes insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, company, or insurer to send deceptive claims, misuse public property, deceptively prevent monetary responsibilities, or returns of funds to the government. Whistleblowers who are aware 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 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 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 step in.

Liability of the Defendant in Murrieta, California

Under the California False Claims Act, the offender may be ordered to pay up to three times the amount of the harm to the government along with fines of $5,500 to $11,000 per offense.

Statute of Limitations in Murrieta, California

In California, individuals filing a whistleblower claim under the California False Claims Act should typically file their complaint within six years of the offense, but, there may be extensions in some instances.

Working With an Experienced Whistleblower Attorney

If you have learned of deceptive Medicaid activity against the state of California or fraudulent activity against a private insurance company, you need to get the legal advice and assistance of a skilled whistleblower attorney. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating scams. 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 Murrieta, 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 Murrieta, 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 Murrieta, California

If you’ve become aware of potential fraud involving Medicare or Medicaid in Murrieta, California, you need the advice of a skilled whistleblower attorney, someone who can make sure that your claim is totally examined and submitted accurately and promptly. By working with an experienced lawyer you are increasing the chance that the federal or state government will step in, hence increasing your chances for a financial reward. Reporting Medicare and Medicaid fraud is an intricate matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam legal representatives to assist in your battle against Medicare and Medicaid scams. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we feel that you have a legitimate claim, we can represent you in a qui tam suit to report the scams and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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