Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Oakland, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars every year. Although many medical service providers and drug companies are ethical and work within the system, some do not. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower attorneys can help people who work in the healthcare system to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and scams in the market. We know that stepping forward is difficult and numerous 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 and carefully prepare your case, for court, and work relentlessly with both you and the federal or state government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Oakland, California

Medicaid scams cost citizens countless dollars every year in California. The California False Claims Act allows private citizens who know of Medicaid scams the ability 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 only 2 states in the country with a qui tam statute that deals with fraud carried out against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to file private qui tam suits against anyone who carries out insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, company, or insurance provider to send deceitful claims, abuse public property, deceptively avoid financial commitments, or returns of funds to the government. Whistleblowers who know of such activity can submit a qui tam lawsuit 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 may be entitled to incentives of between 15-33% of the recovery. If the suit was litigated individually, 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 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 Oakland, California

Under the California False Claims Act, the accused might be mandated to pay up to 3 times of damage to the government in addition to fines of $5,500 to $11,000 per infraction.

Statute of Limitations in Oakland, California

In California, individuals filing a whistleblower lawsuit under the California False Claims Act need to typically file their complaint within six years of the violation, but, there might be extensions in some instances.

Working With an Experienced Whistleblower Attorney

If you have learned of deceitful Medicaid activity against the state of California or deceptive activity against a private insurance provider, you should get the legal advice and guidance of an experienced 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 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 Oakland, 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 Oakland, 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 Oakland, California

When you become aware of fraudulent activity as it concerns Medicare or Medicaid in Oakland, California, you may need the advice of a knowledgeable whistleblower attorney, someone who can make sure that your claim is fully examined and submitted accurately and without delay. By dealing 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 try 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 lawyers to help in your battle against Medicare and Medicaid scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we may represent you in a qui tam lawsuit to report the scams and enable you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to learn how we can help.

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