Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Stockton, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. While the majority of medical service providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower lawyers assist healthcare workers to file claims on behalf of the government to help report this sort of fraud.

The federal and state governments put a lot of trust in pharmaceutical and medical providers. When that trust is ill-placed, it counts on every day people in California to come forward to report fraud. People like you.

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in Stockton, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the industry. We know that coming forward is difficult and many things may 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 examine your claim, carefully prepare your case, for court, and work tirelessly with both you and the state of federal government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Stockton, California

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

 

In addition, California is among just two states in the country with a qui tam statute that deals with scams carried out against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) allows people to file private qui tam suits against anyone who carries out insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurer to send deceptive claims, misuse public property, deceptively avoid monetary responsibilities, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam claim to recover the harm done to the government and, in addition, collect 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 rewards of in between 15-33% of the recovery. If the suit was litigated individually, 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 might be entitled to incentives 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 Stockton, California

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

Statute of Limitations in Stockton, California

In California, people submitting a whistleblower suit under the California False Claims Act must generally submit their complaint within six years of the offense, but, there might be extensions in some circumstances.

Working With an Experienced Whistleblower Lawyer

If you have learned of deceitful Medicaid activity against the state of California or fraudulent activity against a private insurance business, you ought to get the legal advice and assistance 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 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 Stockton, 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 Stockton, 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Stockton, California

When you become aware of fraud that may concern Medicaid or Medicare in Stockton, California, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is completely investigated and submitted accurately and quickly. By working with a skilled lawyer you are increasing the chance that the government will step in, thus increasing your chances for a financial reward. Reporting Medicare and Medicaid fraud is an intricate matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam lawyers to help in your fight against Medicare and Medicaid fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we may represent you in a qui tam lawsuit to help report the scams and enable you to collect a reward. All whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

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