Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. While many medical service providers and drug companies are honest and work within the legal channels, there are those who don’t. When scams are perpetrated, everybody loses. Medicare and Medicaid whistleblower attorneys help healthcare professionals to submit lawsuits on behalf of the federal or state government to help report these kinds of scams.

The federal and state governments put a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it relies on private citizens in California to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Palmdale, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and fraud in the market. understand that coming forward is hard and numerous things might be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Palmdale, California

Medicaid fraud cost taxpayers countless dollars each year in California. The California False Claims Act allows people who know of Medicaid scams the option to file 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 one of only 2 states in the country with a qui tam statute that deals with scams executed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) permits individuals to submit private qui tam suits against anybody who executes insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, company, or insurer to send fraudulent claims, misuse 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, 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 incentives of between 15-33% of the recovery. If the lawsuit was prosecuted independently, the whistleblower’s reward potential increases to 25-50% of the funds recovered.

 

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 steps in and 40-50% of the recovery if the government does not step in.

Liability of the Defendant in Palmdale, California

Under the California False Claims Act, the accused might 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 Palmdale, California

In California, individuals filing a whistleblower claim under the California False Claims Act should normally file their grievance within six years of the offense, but, there might be extensions in some circumstances.

Working With an Experienced Whistleblower Lawyer

If you have become aware of deceitful Medicaid activity against the state of California or fraudulent activity against a private insurer, you should get the legal guidance and guidance of a knowledgeable 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 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 Palmdale, 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 Palmdale, 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Palmdale, California

If you’ve become aware of fraudulent activity that may concern Medicaid or Medicare in Palmdale, California, you may need the guidance of a knowledgeable whistleblower attorney, someone who can ensure that your claim is totally investigated and filed accurately and immediately. By working with a knowledgeable lawyer you are increasing the chance that the government will intervene, thus increasing the chance for a financial reward. Reporting Medicaid and Medicare scams is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam legal representatives to help in your battle against Medicaid and Medicare fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe that you have a legitimate 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 work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can be of help.

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