Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Tracy, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars every year. While many medical providers and drug companies are honest and work within the legal channels, there are those who don’t. When fraud takes place, everybody loses. Medicare and Medicaid whistleblower attorneys assist healthcare workers to file claims on behalf of the government to report this type of fraud.

The federal and state government put a good deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government depends on regular folks in California to come forward and to report fraud. People like you.

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Tracy, California

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and scams in the industry. understand that coming forward is hard 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 comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Tracy, California

Medicaid fraud cost citizens millions of dollars every year in California. The California False Claims Act enables people who have knowledge 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 among just 2 states in the nation with a qui tam statute that attends to fraud carried out against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to submit private qui tam suits against anybody who carries out insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance provider to submit fraudulent claims, misappropriate public property, deceptively avoid financial commitments, or returns of funds to the government. Whistleblowers who know of such activity can file a qui tam suit to recover the harm done to the government and, in response, gather 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 between 15-33% of the recovery. If the lawsuit was prosecuted individually, 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 in 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 Tracy, California

Under the California False Claims Act, the defendant might be mandated to pay up to 3 times the amount of the harm to the government in addition to fines of $5,500 to $11,000 per offense.

Statute of Limitations in Tracy, California

In California, people submitting a whistleblower lawsuit under the California False Claims Act must typically submit their problem within six years of the offense, but, 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 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 completely confidential, no-cost assessment 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 Tracy, 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 Tracy, 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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WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Tracy, California

If you’ve become aware of fraud that may concern Medicaid or Medicare in Tracy, California, you require the advice of a skilled whistleblower attorney, someone who can make sure that your claim is completely investigated and filed accurately and without delay. By dealing with an experienced lawyer you are increasing the chance that the government will step in, hence increasing the chance for a reward. Reporting Medicaid and Medicare scams 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 practical experience as national qui tam legal representatives to assist in your battle against Medicare and Medicaid scams. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we can represent you in a qui tam claim to help report the scams and allow you to gather a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

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