Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. While most medical companies and drug companies are ethical and work within the legal channels, some don’t. When fraud happens, everyone loses. Medicare and Medicaid whistleblower attorneys can assist healthcare workers to file lawsuits on behalf of the federal or state government to help report these kinds of scams.
The state and federal government place a great deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government depends on every day people in California to come forward to report scams. People like you.
At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic 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 investigate your claim, diligently and carefully prepare your case, and work tirelessly with you and the state of federal government to help bring fraudulent Medicare or Medicaid activity to justice.
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:
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
Coders are directed to add codes based on other information in the chart.
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
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 Tustin, California, get in touch with us here.
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.
Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.
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.
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.
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.
The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity.
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.
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 Tustin, California, you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation.
If you’ve become aware of deceitful activity as it concerns Medicare or Medicaid in Tustin, California, you may need the guidance of a knowledgeable whistleblower attorney, someone who can guarantee that your claim is totally investigated and submitted accurately and without delay. By working with a knowledgeable attorney you are increasing the chance that the government will step in, hence increasing the opportunity 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 have years of practical experience as national qui tam attorneys to help in your battle against Medicare and Medicaid fraud. We will review your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we can represent you in a qui tam lawsuit to help report the scams and allow you to collect a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to learn how we can be of help.
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