Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Riverside, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. Although many medical companies and drug companies are honest and work within the system, some don’t. When fraud happens, everyone can lose. Medicaid and Medicare whistleblower lawyers help healthcare professionals to file lawsuits on behalf of the federal or state government to help report this sort of fraud.

The federal and state government place a great deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, it relies on every day people in California to come forward and to report fraud. People like you.

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and fraud in the industry. understand that coming forward is difficult and many things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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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 Riverside, 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. 

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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. 

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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 Riverside, 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 ATTORNEY; We are proud to represent healthcare workers in Riverside, California

If you’ve become aware of potential fraud as it concerns Medicaid or Medicare in Riverside, California, you may need the guidance of a skilled whistleblower lawyer, someone who can guarantee that your claim is fully examined and submitted accurately and promptly. By working with a skilled attorney you are increasing the chance that the federal or state government will step in, thus increasing the opportunity for a financial reward. Reporting Medicare and Medicaid fraud is an intricate matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam attorneys to help in your fight against Medicare and Medicaid fraud. We will review your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we may represent you in a qui tam claim to report the fraud and enable you to collect a financial benefit. 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 be of help.

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