Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost California taxpayers billions of dollars annually. While many medical providers and drug companies are honest and work within the system, some do not. When fraud happens, everybody loses. Medicaid and Medicare whistleblower lawyers can help healthcare professionals to file suits on behalf of the federal or state government to report this type of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in San Mateo, California

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the market. We know that coming forward is difficult and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

schedule a
confidential consultation

Whistleblower Laws in San Mateo, California

Medicaid scams cost taxpayers countless dollars every year in California. The California False Claims Act permits people who have knowledge of Medicaid fraud the option to file 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 one of only two states in the nation with a qui tam statute that attends to scams committed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) allows people to submit private qui tam suits against anyone who executes insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurance provider to submit deceitful claims, misappropriate public property, deceptively prevent financial obligations, or returns of funds to the government. Whistleblowers who are aware of such activity can submit a qui tam claim to recover the harm done to the government and, in response, collect a potential reward for whistleblowing.

 

If there is a recovery by the State or other subdivision of government under the California False Claims Act, the whistleblower may be entitled to incentives of in between 15-33% of the recovery. If the lawsuit was prosecuted individually, 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 rewards 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 San Mateo, California

Under the California False Claims Act, the accused may be mandated to pay up to 3 times the amount of damage to the government in addition to fines of $5,500 to $11,000 per offense.

Statute of Limitations in San Mateo, California

In California, individuals filing a whistleblower claim under the California False Claims Act need to usually file their grievance within six years of the offense, but, there might be extensions in some instances.

Working With an Experienced Whistleblower Lawyer

If you have learned of deceptive Medicaid activity against the state of California or deceitful activity against a private insurance provider, you ought to get the legal advice and guidance of a knowledgeable whistleblower attorney. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating fraud. Contact us for a completely 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 Mateo, 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 Mateo, California,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in San Mateo, California

When you become aware of fraudulent activity as it concerns Medicaid or Medicare in San Mateo, California, you require the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is totally investigated and filed accurately and immediately. By dealing with a skilled lawyer you are increasing the chance that the government will intervene, therefore increasing your chances for a reward. Reporting Medicaid and Medicare fraud is an intricate 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 lawyers to help in your battle against Medicaid and Medicare fraud. We will evaluate your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we may represent you in a qui tam claim to help report the scams and enable you to collect a reward. All whistleblower work is on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can help.

Service areas