Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in San Bernardino, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars every year. Although the majority of medical providers and drug companies are ethical and work within the system, some don’t. When fraud happens, everybody can lose. Medicaid and Medicare whistleblower attorneys can help healthcare professionals to submit suits on behalf of the federal or state government to help report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in San Bernardino, California

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the industry. We know that stepping forward is hard 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 thoroughly investigate your claim, diligently and carefully prepare your case, for court, and work tirelessly with both you and the federal or state government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in San Bernardino, California

Medicaid fraud cost taxpayers countless dollars each year in California. The California False Claims Act enables individuals who have knowledge of Medicaid fraud the ability to file a civil complaint on behalf of the state, county, municipality, public school, or any government agency that has been defrauded.

 

In addition, California is among just 2 states in the nation with a qui tam statute that attends to fraud executed against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) permits people to submit private qui tam suits against anyone who carries out insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, company, or insurance provider to send fraudulent claims, abuse public property, deceptively prevent financial obligations, or returns of funds to the government. Whistleblowers who know of such activity can submit a qui tam claim to recuperate the harm done to the government and, in response, collect 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 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 San Bernardino, California

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

Statute of Limitations in San Bernardino, California

In California, individuals filing a whistleblower lawsuit under the California False Claims Act must normally submit their complaint within six years of the violation, but, there may 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 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 confidential, no-cost consultation 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 San Bernardino, 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 San Bernardino, 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 San Bernardino, California

If you’ve become aware of potential fraud as it concerns Medicaid or Medicare in San Bernardino, California, you need the guidance of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is fully examined and submitted accurately and without delay. By dealing with a skilled attorney you are increasing the chance that the government will step in, therefore increasing the possibility for a financial reward. Reporting Medicare and Medicaid 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 attorneys to assist in your fight against Medicare and Medicaid scams. We will examine your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we may represent you in a qui tam lawsuit to report the scams and allow you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can be of help.

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