Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Union City, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are ethical and work within the legal channels, some don’t. When scams are perpetrated, everybody loses. Medicaid and Medicare whistleblower attorneys can assist healthcare professionals to submit claims on behalf of the federal or state government to help report these kinds of scams.

The state and federal governments put a good deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government counts on private citizens in California to come forward and to report scams. People like you.

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in Union City, California

At Khurana Law Firm, P.C., as experienced 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 challenging and many things might be at stake. When you come to us, your case is held in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, for court, and work tirelessly with both you and the state of federal government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Union City, California

Medicaid scams cost taxpayers countless dollars each year in California. The California False Claims Act permits private citizens who have knowledge of Medicaid fraud the ability to submit a civil complaint on behalf of the state, county, municipality, public school, or any government agency that has been defrauded.

 

In addition, California is among only 2 states in the nation with a qui tam statute that deals with fraud carried out against private insurance providers. The California Insurance Frauds Prevention Act (“IFPA”) allows people to submit private qui tam suits against anyone who executes insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurer to submit fraudulent claims, misappropriate public property, deceptively prevent monetary obligations, or returns of funds to the government. Whistleblowers who know of such activity can submit a qui tam lawsuit to recover the damage done to the government and, in response, collect a potential financial incentive 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 might be entitled to incentives of between 15-33% of the recovery. If the lawsuit was prosecuted independently, 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 rewards 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 Union City, California

Under the California False Claims Act, the accused might be mandated 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 infraction.

Statute of Limitations in Union City, California

In California, individuals filing a whistleblower lawsuit under the California False Claims Act need to normally file their grievance within 6 years of the offense, but, there may be extensions in some instances.

Working With an Experienced Whistleblower Attorney

If you have become aware of fraudulent Medicaid activity against the state of California or deceitful activity against a private insurance business, you need to get the legal guidance and assistance of a skilled 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 consultation 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 Union City, 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 Union City, 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
WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Union City, California

When you become aware of deceptive activity that may concern Medicare or Medicaid in Union City, California, you require the guidance of an experienced whistleblower attorney, someone who can ensure that your claim is completely examined and submitted accurately and promptly. By dealing with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, thus increasing your chances for a financial reward. Reporting Medicaid and Medicare scams is a complicated matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam legal representatives to assist in your fight against Medicare and Medicaid scams. Our attorneys will review your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam suit to report the scams and allow you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can be of help.

Service areas