Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Santa Clarita, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. Although many medical service providers and drug companies are honest and work within the system, there are those who do not. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower lawyers help people who work in the healthcare system to submit lawsuits on behalf of the federal or state government to report this type of fraud.

The federal and state governments put a great deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government counts on every day people in California to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Santa Clarita, California

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is not simple and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Santa Clarita, California

Medicaid fraud cost citizens millions of dollars every year in California. The California False Claims Act enables individuals who know of Medicaid fraud the ability to file a civil complaint on behalf of the state, county, town, public school, or any government agency that has been defrauded.

 

In addition, California is among only two states in the nation with a qui tam statute that addresses scams executed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) allows people to file private qui tam suits against anyone who executes insurance fraud in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurance provider to submit fraudulent claims, misappropriate public property, deceptively avoid monetary responsibilities, or returns of funds to the government. Whistleblowers who know of such activity can file a qui tam claim to recuperate the harm done to the government and, in addition, collect a potential financial incentive for whistleblowing.

 

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 in between 15-33% of the recovery. If the lawsuit was prosecuted separately, the whistleblower’s reward potential increases to 25-50% of the funds recovered.

 

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 steps in and 40-50% of the recovery if the government does not intervene.

Liability of the Defendant in Santa Clarita, California

Under the California False Claims Act, the offender might be ordered to pay up to 3 times the amount of the harm to the government as well as fines of $5,500 to $11,000 per violation.

Statute of Limitations in Santa Clarita, California

In California, individuals filing a whistleblower suit under the California False Claims Act must normally submit their grievance within six years of the infraction, but, there might be extensions in some circumstances.

Working With an Experienced Whistleblower Attorney

If you have become aware of deceitful Medicaid activity against the state of California or fraudulent activity against a private insurer, you ought to get the legal guidance and guidance of a skilled whistleblower lawyer. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating scams. 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 Santa Clarita, 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 Santa Clarita, 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 Santa Clarita, California

When you become aware of fraud involving Medicaid or Medicare in Santa Clarita, California, you need the guidance of a skilled whistleblower lawyer, someone who can make sure that your claim is totally investigated and submitted accurately and promptly. By dealing with a skilled lawyer you are increasing the chance that the government will step in, thus increasing the chance for a reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam lawyers to assist in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we can represent you in a qui tam lawsuit to report the fraud and allow you to gather a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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