Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. Although the majority of medical companies and drug companies are honest and work within the legal channels, there are those who don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower lawyers help healthcare workers to submit claims on behalf of the government to report these kinds of scams.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Richmond, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and fraud in the market. We know that stepping forward is hard 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 substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently and carefully prepare your case, for court, and work relentlessly with both you and the federal or state government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Richmond, California

Medicaid fraud cost taxpayers countless dollars every year in California. The California False Claims Act permits private citizens 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 just two states in the country with a qui tam statute that attends to fraud carried out against private insurance providers. 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 insurance company to send deceitful claims, misappropriate 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 lawsuit to recuperate the harm done to the government and, in addition, collect a potential reward for doing so.

 

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 rewards of in between 15-33% of the recovery. If the suit was litigated 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 might 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 intervene.

Liability of the Defendant in Richmond, California

Under the California False Claims Act, the offender might 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 Richmond, California

In California, people submitting a whistleblower lawsuit under the California False Claims Act need to typically file their complaint within six years of the violation, but, there may be extensions in some circumstances.

Working With an Experienced Whistleblower Lawyer

If you have learned of fraudulent Medicaid activity against the state of California or deceitful activity against a private insurance business, you ought to get the legal guidance and assistance of a knowledgeable 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 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 Richmond, 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 Richmond, 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 LAWYER; We are proud to represent healthcare workers in Richmond, California

If you’ve become aware of fraud as it concerns Medicaid or Medicare in Richmond, California, you require the guidance of an experienced whistleblower lawyer, someone who can ensure that your claim is totally examined and filed accurately and quickly. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam legal representatives to assist in your battle against Medicaid and Medicare scams. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we may represent you in a qui tam lawsuit to help report the fraud and allow you to gather a reward. Because all whistleblower cases are on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can help.

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