Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost California taxpayers billions of dollars every year. While most medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower attorneys assist people who work in the healthcare system to submit suits on behalf of the federal or state government to report this sort of fraud.

The federal and state government put a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government counts on regular folks in California to come forward and to report fraud. People like you.

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Pittsburg, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the market. understand that stepping forward is not easy and many 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 examine your claim, carefully prepare your case, and work tirelessly with both you and the state of federal government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Pittsburg, California

Medicaid scams cost citizens countless dollars every year in California. The California False Claims Act enables people who have knowledge 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 two states in the country with a qui tam statute that addresses fraud committed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) permits people to file private qui tam suits against anyone who executes insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance provider to send fraudulent claims, misuse public property, deceptively avoid financial responsibilities, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam claim to recover the harm done to the government and, in response, collect a potential reward 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 might be entitled to rewards of between 15-33% of the recovery. If the lawsuit was prosecuted separately, the whistleblower’s reward potential increases to 25-50% of the financial recovery.

 

If there is a recovery by the state under the IFPA, the whistleblower might be entitled to rewards of 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 Pittsburg, California

Under the California False Claims Act, the defendant may be mandated to pay up to 3 times of the harm to the government as well as fines of $5,500 to $11,000 per violation.

Statute of Limitations in Pittsburg, California

In California, individuals submitting a whistleblower claim under the California False Claims Act need to normally file their problem within six years of the infraction, but, there may be extensions in some circumstances.

Working With an Experienced Whistleblower Lawyer

If you have learned of deceitful Medicaid activity against the state of California or fraudulent activity against a private insurance company, you should get the legal guidance and guidance of an experienced 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 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 Pittsburg, 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 Pittsburg, California,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Pittsburg, California

When you become aware of fraud that may concern Medicaid or Medicare in Pittsburg, California, you need the advice of a knowledgeable whistleblower attorney, someone who can make sure that your claim is completely investigated and submitted accurately and immediately. By working with a skilled attorney you are increasing the chance that the federal or state government will intervene, therefore increasing the possibility for a financial reward. Reporting Medicare and Medicaid scams is an intricate 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 legal representatives to help in your battle against Medicare and Medicaid scams. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam claim to report the scams and allow you to collect a reward. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

Service areas