Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Redding, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are honest and work within the legal channels, some do not. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower lawyers can assist people who work in the healthcare system to file suits on behalf of the federal or state government to help report these kinds of scams.

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

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing health care workers in Redding, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the market. We know that coming forward is challenging and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, and work relentlessly with both you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Redding, California

Medicaid fraud cost taxpayers countless dollars every year in California. The California False Claims Act allows private citizens 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 has been defrauded.

 

In addition, California is among only 2 states in the country with a qui tam statute that addresses fraud carried out against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to file private qui tam suits against anyone who commits insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance company to submit deceptive claims, misappropriate public property, deceptively avoid financial responsibilities, or returns of funds to the government. Whistleblowers who know of such activity can submit a qui tam lawsuit to recuperate the harm 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 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 intervenes and 40-50% of the recovery if the government does not intervene.

Liability of the Defendant in Redding, California

Under the California False Claims Act, the defendant 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 Redding, California

In California, people submitting a whistleblower suit under the California False Claims Act should generally file their grievance within 6 years of the violation, but, there might be extensions in some instances.

Working With an Experienced Whistleblower Attorney

If you have learned of fraudulent Medicaid activity against the state of California or deceptive activity against a private insurance company, you ought to get the legal guidance and assistance of an experienced 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 in order 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 Redding, 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 Redding, 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 Redding, California

If you’ve become aware of deceitful activity as it concerns Medicare or Medicaid in Redding, California, you may need the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is completely examined and filed accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the federal or state government will intervene, thus increasing your chances for a reward. Reporting Medicare and Medicaid fraud is a complex matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam attorneys to help in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam lawsuit to report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can be of help.

Service areas