Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Temecula, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars each year. While most medical providers and drug companies are honest and work within the system, some don’t. When fraud occurs, everyone loses. Medicaid and Medicare whistleblower lawyers help healthcare workers to file claims on behalf of the federal or state government to report these kinds of scams.

The federal and state governments place a great deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it relies on every day people in California to come forward to report fraud. People like you.

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the market. We know that coming forward is challenging and lots of 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 thoroughly examine your claim, diligently and carefully prepare your case, for court, and work tirelessly with you and the state of federal government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Temecula, California

Medicaid fraud cost citizens countless dollars every year in California. The California False Claims Act enables private citizens 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 one of just two states in the country with a qui tam statute that deals with scams executed against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) permits people to submit 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, company, or insurance company to submit deceptive claims, misappropriate public property, deceptively avoid financial obligations, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam claim to recuperate the damage done to the government and, in addition, collect a potential financial incentive for doing so.

 

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 suit was litigated separately, 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 might 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 step in.

Liability of the Defendant in Temecula, California

Under the California False Claims Act, the offender may 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 offense.

Statute of Limitations in Temecula, California

In California, people submitting a whistleblower claim under the California False Claims Act need to usually submit their complaint within 6 years of the offense, but, there may be extensions in some circumstances.

Working With an Experienced Whistleblower Attorney

If you have learned of deceitful Medicaid activity against the state of California or deceptive activity against a private insurer, you need to get the legal advice and assistance of a skilled whistleblower attorney. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating fraud. 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 Temecula, 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 Temecula, 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 ATTORNEY; We are proud to represent healthcare workers in Temecula, California

When you become aware of fraud involving Medicaid or Medicare in Temecula, California, you require the advice of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is completely investigated and filed accurately and immediately. By working with an experienced attorney you are increasing the chance that the federal or state government will intervene, thus increasing the possibility for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  don’t 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 battle against Medicaid and Medicare scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we may represent you in a qui tam suit to help report the fraud and allow you to gather a financial benefit. 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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