Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost California taxpayers billions of dollars every year. While the majority of medical service providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower lawyers assist healthcare professionals to file lawsuits on behalf of the government to help report this type of fraud.

The federal and state government put a great deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government relies on every day people in California to come forward to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Walnut Creek, 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 market. We know that coming forward is challenging and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our extensive experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, for court, and work tirelessly with both you and the federal or state government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Walnut Creek, California

Medicaid fraud cost taxpayers millions of dollars every year in California. The California False Claims Act allows people who know of Medicaid scams the ability 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 only 2 states in the country with a qui tam statute that deals with fraud committed against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) allows people to submit private qui tam suits against anybody who executes insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurance company to submit deceptive claims, misappropriate public property, deceptively avoid financial commitments, 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 response, gather 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 prosecuted separately, 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 may be entitled to rewards of in 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 Walnut Creek, California

Under the California False Claims Act, the accused may be mandated to pay up to three times the amount of the harm to the government in addition to fines of $5,500 to $11,000 per violation.

Statute of Limitations in Walnut Creek, California

In California, individuals submitting a whistleblower lawsuit under the California False Claims Act need to typically file their grievance within 6 years of the infraction, but, there might be extensions in some instances.

Working With an Experienced Whistleblower Lawyer

If you have become aware of deceptive Medicaid activity against the state of California or deceitful activity against a private insurance business, you should 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 scams. Contact us for a completely confidential, no-cost assessment 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 Walnut Creek, 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 Walnut Creek, 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 Walnut Creek, California

When you become aware of potential fraud that may concern Medicaid or Medicare in Walnut Creek, California, you require the advice of a knowledgeable whistleblower attorney, someone who can make sure that your claim is totally examined and filed accurately and without delay. By working with an experienced lawyer you are increasing the chance that the federal or state government will step in, hence increasing the chance 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 bring years of practical experience as national qui tam legal representatives to assist 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 that you may have a legitimate claim, we may represent you in a qui tam lawsuit to help report the scams and allow you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to to schedule a confidential consultation.

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