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.
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.
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:
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
Coders are directed to add codes based on other information in the chart.
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
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.
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.
Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.
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.
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.
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.
The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity.
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.
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.
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.
Disclaimer: This website is attorney advertisement. The hiring of a lawyer is an important decision that should not be based solely upon advertisements. The materials contained within this website provide general information about the firm, and do not constitute legal advice and are intended for informational purposes only. All rights reserved. By BSP Legal Marketing.