Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in South Whittier, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. While many medical service providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud happens, everybody can lose. Medicare and Medicaid whistleblower lawyers can assist healthcare workers to file claims on behalf of the government to report these kinds of scams.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in South Whittier, California

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams 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 substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently prepare your case, and work tirelessly with both you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in South Whittier, California

Medicaid fraud cost taxpayers millions of dollars each year in California. The California False Claims Act enables individuals who know of Medicaid scams the option to submit 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 among just two states in the nation with a qui tam statute that attends to fraud 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 scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance company to send fraudulent claims, abuse public property, deceptively prevent monetary responsibilities, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam lawsuit to recuperate the damage 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 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 intervenes and 40-50% of the recovery if the government does not step in.

Liability of the Defendant in South Whittier, California

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

Statute of Limitations in South Whittier, California

In California, individuals submitting a whistleblower suit under the California False Claims Act must generally file their complaint within six years of the offense, but, there may be extensions in some instances.

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 insurance business, you should get the legal advice 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 assessment 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 Whittier, 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 Whittier, 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 ATTORNEY; We are proud to represent healthcare workers in South Whittier, California

When you become aware of fraud that may concern Medicaid or Medicare in South Whittier, California, you require the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is totally investigated and filed accurately and immediately. By dealing with a knowledgeable lawyer you are increasing the chance that the government will intervene, thus increasing the chance for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam attorneys to help in your fight against Medicare and Medicaid fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we can represent you in a qui tam suit to help report the fraud and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay nothing until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

Service areas