Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Yuba City, California

Medicare and Medicaid fraud cost California taxpayers billions of dollars every year. While many medical companies and drug companies are honest and work within the system, there are those who don’t. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower attorneys help healthcare professionals to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

The federal and state government put a lot of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government depends on every day people in California to come forward and to report scams. People like you.

Work with

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the market. understand that stepping forward is challenging 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 substantial experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work relentlessly with both you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Yuba City, California

Medicaid scams cost taxpayers countless dollars each year in California. The California False Claims Act permits people who know 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 among just two states in the nation with a qui tam statute that attends to scams committed against private insurance companies. The California Insurance Frauds Prevention Act (“IFPA”) allows individuals to file private qui tam suits against anyone who executes insurance scams in the State.

 

Under both laws, it is a civil offense for any individual, business, or insurer to send deceptive claims, misappropriate public property, deceptively prevent monetary responsibilities, or returns of funds to the government. Whistleblowers who know of such activity can file a qui tam lawsuit to recover the harm done to the government and, in response, collect a potential financial incentive for whistleblowing.

 

If there is a recovery by the State or other subdivision of government under the California False Claims Act, the whistleblower may 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 incentives 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 Yuba City, California

Under the California False Claims Act, the offender might be ordered to pay up to three times of the harm to the government as well as fines of $5,500 to $11,000 per violation.

Statute of Limitations in Yuba City, California

In California, people submitting a whistleblower lawsuit under the California False Claims Act must normally file their grievance within 6 years of the infraction, however, there may be extensions in some instances.

Working With an Experienced Whistleblower Lawyer

If you have become aware of deceitful Medicaid activity against the state of California or fraudulent activity against a private insurer, 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 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 Yuba 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 Yuba City, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Yuba City, California

If you’ve become aware of deceptive activity involving Medicaid or Medicare in Yuba City, California, you may need the advice of a knowledgeable whistleblower attorney, someone who can ensure that your claim is completely examined and submitted accurately and immediately. By dealing with a knowledgeable attorney you are increasing the chance that the government will step in, hence increasing the chance for a financial reward. Reporting Medicare and Medicaid fraud is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam attorneys to help in your battle against Medicare and Medicaid fraud. 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 lawsuit to help report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to to schedule a confidential consultation.

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