Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Whittier, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. Although the majority of medical companies and drug companies are ethical and work within the legal channels, there are those who do not. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower lawyers help healthcare professionals to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

The federal and state governments put a good deal of trust in medical and pharmaceutical 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.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Whittier, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is hard and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Whittier, California

Medicaid scams cost taxpayers countless dollars every year in California. The California False Claims Act permits individuals who have knowledge of Medicaid scams the option to file a civil complaint on behalf of the state, county, town, public school, or any government agency that has been defrauded.

 

In addition, California is one of only two states in the nation with a qui tam statute that deals with scams carried out against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to file private qui tam suits against anyone who carries out insurance fraud in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurance provider to submit fraudulent claims, abuse public property, deceptively avoid monetary responsibilities, or returns of funds to the government. Whistleblowers who are aware of such activity can submit a qui tam lawsuit to recover the harm done to the government and, in addition, gather a potential reward 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 individually, 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 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 Whittier, California

Under the California False Claims Act, the offender may be ordered to pay up to three 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 Whittier, California

In California, people filing a whistleblower claim under the California False Claims Act should typically submit their grievance within six years of the violation, but, there may be extensions in some circumstances.

Working With an Experienced Whistleblower Lawyer

If you have become aware of deceitful Medicaid activity against the state of California or deceptive activity against a private insurance company, you should get the legal guidance and guidance of a knowledgeable whistleblower lawyer. At Khurana Law Firm, P.C., we have dedicated our practice to whistleblowers and combating scams. Contact us for a 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 Whittier, 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 Whittier, 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 Whittier, California

If you’ve become aware of fraud as it concerns Medicaid or Medicare in Whittier, California, you require the guidance of an experienced whistleblower attorney, someone who can guarantee that your claim is totally investigated and filed accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the federal or state government will intervene, hence increasing the opportunity for a reward. Reporting Medicaid and Medicare 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 Medicare and Medicaid fraud. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we may represent you in a qui tam claim to report the fraud and allow you to gather a reward. 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 help.

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