Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Redwood City, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. While most medical service providers and drug companies are ethical and work within the system, there are those who don’t. When fraud happens, everyone loses. Medicare and Medicaid whistleblower attorneys can help people who work in the healthcare system to file claims on behalf of the federal or state government to report this sort of fraud.

The state and federal government put a good 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 scams. People like you.

Work with

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and fraud in the market. We know that stepping forward is not simple and many things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, diligently prepare your case, and work tirelessly with you and the state of federal government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Redwood City, California

Medicaid scams cost citizens millions of dollars every year in California. The California False Claims Act allows individuals 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 one of just 2 states in the country with a qui tam statute that attends to fraud committed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) allows people to submit private qui tam suits against anybody who commits insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurer to submit deceptive claims, misuse public property, deceptively prevent monetary commitments, or returns of funds to the government. Whistleblowers who know of such activity can file a qui tam suit to recover the harm done to the government and, in response, gather 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 in between 15-33% of the recovery. If the suit was prosecuted separately, 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 may be entitled to rewards of between 30-40% of the recovery if the government intervenes and 40-50% of the recovery if the government does not step in.

Liability of the Defendant in Redwood City, California

Under the California False Claims Act, the accused may be mandated 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 Redwood City, California

In California, individuals filing a whistleblower lawsuit under the California False Claims Act must usually submit their grievance within 6 years of the infraction, but, there might be extensions in some instances.

Working With an Experienced Whistleblower Lawyer

If you have become aware of fraudulent Medicaid activity against the state of California or fraudulent activity against a private insurance company, you ought to get the legal guidance 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 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 Redwood City, 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 Redwood City, 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 Redwood City, California

When you become aware of fraud involving Medicaid or Medicare in Redwood City, California, you may need the advice of a skilled whistleblower attorney, someone who can make sure that your claim is completely investigated and submitted accurately and without delay. By working with a knowledgeable lawyer you are increasing the chance that the government will intervene, hence increasing your chances for a 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 bring years of practical experience as national qui tam attorneys to assist in your fight against Medicare and Medicaid scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam lawsuit to report the fraud and allow you to collect a reward. All whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to to schedule a confidential consultation.

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