Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Roseville, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. While the majority of medical providers and drug companies are honest and work within the legal channels, some do not. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower attorneys can assist healthcare professionals to submit lawsuits on behalf of the government to help report this sort of fraud.

The state and federal government put a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it relies on private citizens in California to come forward and to report fraud. People like you.

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Roseville, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that stepping forward is challenging and lots of things might be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Roseville, California

Medicaid fraud cost taxpayers millions of dollars each year in California. The California False Claims Act permits individuals who have knowledge of Medicaid scams the ability to submit 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 one of just two states in the nation with a qui tam statute that deals with scams carried out against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) permits individuals to submit private qui tam suits against anyone who commits insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance provider to submit deceptive claims, misuse public property, deceptively prevent monetary commitments, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam lawsuit to recover the damage 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 may be entitled to rewards of between 15-33% of the recovery. If the suit was litigated independently, 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 may 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 step in.

Liability of the Defendant in Roseville, California

Under the California False Claims Act, the accused might be mandated to pay up to three times the amount of the harm to the government along with fines of $5,500 to $11,000 per infraction.

Statute of Limitations in Roseville, California

In California, individuals submitting a whistleblower lawsuit under the California False Claims Act should usually submit their complaint within six years of the violation, however, 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 fraudulent activity against a private insurance provider, you should get the legal guidance and assistance of a skilled whistleblower attorney. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating scams. Contact us for a 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 Roseville, 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 Roseville, 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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Report Medical fraud
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WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Roseville, California

If you’ve become aware of fraud as it concerns Medicaid or Medicare in Roseville, California, you may need the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is totally investigated and submitted accurately and immediately. By dealing with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  don’t try 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 help in your battle against Medicare and Medicaid fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we can represent you in a qui tam claim to help report the fraud and enable you to collect a reward. All whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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