Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Sacramento, 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, there are those who do not. When fraud takes place, everyone loses. Medicare and Medicaid whistleblower attorneys help healthcare workers to submit suits on behalf of the government to help report this type of fraud.

The state and federal government put a great 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 Medicaid and Medicare whistleblower attorneys; representing health care workers in Sacramento, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and fraud in the market. understand that stepping forward is difficult and lots of things might be at stake. When you come to us, your case is held in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we completely investigate your claim, carefully prepare your case, for court, and work tirelessly with both you and the federal or state government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Sacramento, California

Medicaid fraud cost citizens countless dollars each year in California. The California False Claims Act permits people who have knowledge 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 one of only two states in the nation with a qui tam statute that addresses fraud carried out against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to submit private qui tam suits against anyone who carries out insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance company to submit deceitful claims, misappropriate public property, deceptively prevent monetary obligations, or returns of funds to the government. Whistleblowers who are aware of such activity can submit a qui tam lawsuit to recover the damage done to the government and, in response, gather a potential financial incentive 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 between 15-33% of the recovery. If the suit was prosecuted 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 steps in and 40-50% of the recovery if the government does not step in.

Liability of the Defendant in Sacramento, California

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

Statute of Limitations in Sacramento, California

In California, individuals filing a whistleblower lawsuit under the California False Claims Act must generally submit their grievance within six years of the offense, but, there may be extensions in some circumstances.

Working With an Experienced Whistleblower Attorney

If you have learned of deceitful Medicaid activity against the state of California or deceptive activity against a private insurer, you need to get the legal guidance and guidance 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 completely 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 Sacramento, 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 Sacramento, 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 Sacramento, California

If you’ve become aware of deceitful activity as it concerns Medicaid or Medicare in Sacramento, California, you need the guidance of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is fully investigated and submitted accurately and quickly. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, thus increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam lawyers to help in your fight against Medicaid and Medicare fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam suit to help report the fraud and enable you to collect a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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