Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in South Gate, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. Although the majority of medical companies and drug companies are honest and work within the system, there are those who don’t. When fraud occurs, everyone can lose. Medicare and Medicaid whistleblower attorneys help healthcare workers to submit lawsuits on behalf of the government to report this type of fraud.

The state and federal government place a good 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 healthcare employees in South Gate, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that stepping forward is not easy and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in South Gate, California

Medicaid scams cost citizens millions of dollars each year in California. The California False Claims Act allows individuals who know 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 just 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”) permits individuals 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 private citizen, business, or insurer to submit fraudulent claims, abuse public property, deceptively prevent financial obligations, or returns of funds to the government. Whistleblowers who know of such activity can file a qui tam lawsuit to recover the harm done to the government and, in response, gather a potential financial incentive for whistleblowing.

 

If there is a recovery by the State or other subdivision of government under the California False Claims Act, the whistleblower might be entitled to incentives of in between 15-33% of the recovery. If the lawsuit was prosecuted independently, the whistleblower’s reward potential increases to 25-50% of the 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 intervenes and 40-50% of the recovery if the government does not intervene.

Liability of the Defendant in South Gate, California

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

Statute of Limitations in South Gate, California

In California, people filing a whistleblower suit under the California False Claims Act need to usually file their grievance within 6 years of the violation, however, there might be extensions in some circumstances.

Working With an Experienced Whistleblower Lawyer

If you have become aware 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 skilled 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 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 South Gate, 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 South Gate, 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 South Gate, California

When you become aware of fraud involving Medicare or Medicaid in South Gate, California, you require the guidance of a skilled whistleblower attorney, someone who can guarantee that your claim is totally investigated and submitted accurately and immediately. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, hence increasing your chances for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  don’t try to do this alone, we are here to help.

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

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