Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Redondo Beach, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. While the majority of medical service providers and drug companies are honest and work within the system, there are those who don’t. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare workers to file suits on behalf of the federal or state government to report this sort of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in Redondo Beach, California

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

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

schedule a
confidential consultation

Whistleblower Laws in Redondo Beach, California

Medicaid fraud cost citizens countless dollars every year in California. The California False Claims Act permits people who know of Medicaid scams the option to file a civil complaint on behalf of the state, county, town, public school, or any government agency that may have been defrauded.

 

In addition, California is among only two states in the nation with a qui tam statute that attends to scams committed against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) permits people to submit private qui tam suits against anyone who carries out insurance fraud in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurance provider to submit deceptive claims, misappropriate public property, deceptively prevent monetary commitments, or returns of funds to the government. Whistleblowers who know of such activity can file a qui tam claim to recuperate the harm done to the government and, in addition, collect a potential financial incentive for doing so.

 

If there is a recovery by the State or other subdivision of government under the California False Claims Act, the whistleblower may be entitled to rewards of between 15-33% of the recovery. If the lawsuit was litigated 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 incentives 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 Redondo Beach, California

Under the California False Claims Act, the defendant might be mandated to pay up to three times the amount of damage to the government as well as fines of $5,500 to $11,000 per offense.

Statute of Limitations in Redondo Beach, California

In California, people filing a whistleblower lawsuit under the California False Claims Act need to usually submit their grievance within six years of the offense, however, 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 insurer, you should get the legal advice and guidance of a knowledgeable whistleblower attorney. 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 Redondo Beach, 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 Redondo Beach, 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
Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Redondo Beach, California

If you’ve become aware of potential fraud involving Medicare or Medicaid in Redondo Beach, California, you require the advice of an experienced whistleblower attorney, someone who can guarantee that your claim is fully investigated and filed accurately and promptly. By working with a skilled lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity for a financial reward. Reporting Medicare and Medicaid scams is a complicated matter –  do not try 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 fight against Medicaid and Medicare scams. We will examine 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 enable you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

Service areas