Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Yucaipa, California

Medicaid and Medicare fraud cost California taxpayers billions of dollars each year. While the majority of medical companies and drug companies are ethical and work within the legal channels, there are those who do not. When scams are perpetrated, everyone can lose. Medicare and Medicaid whistleblower lawyers help healthcare workers to submit suits on behalf of the government to help report this sort of fraud.

The state and federal government place a great deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government depends on regular folks in California to come forward to report fraud. People like you.

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Yucaipa, California

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that coming forward is hard and numerous things might be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Yucaipa, California

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

 

In addition, California is among just two states in the nation with a qui tam statute that deals with scams executed against private insurers. The California Insurance Frauds Prevention Act (“IFPA”) permits people to file private qui tam suits against anyone who carries out insurance scams in the State.

 

Under both laws, it is a civil offense for any private citizen, business, or insurer to send deceptive claims, abuse public property, deceptively avoid financial responsibilities, or returns of funds to the government. Whistleblowers who are aware of such activity can file a qui tam lawsuit to recover the damage done to the government and, in addition, gather a potential reward for whistleblowing.

 

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 rewards 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 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 step in.

Liability of the Defendant in Yucaipa, California

Under the California False Claims Act, the offender might be mandated to pay up to 3 times the amount of damage to the government in addition to fines of $5,500 to $11,000 per violation.

Statute of Limitations in Yucaipa, California

In California, people submitting a whistleblower suit under the California False Claims Act should generally submit their problem within six years of the infraction, 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 company, you should get the legal guidance and guidance of an experienced whistleblower attorney. 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 Yucaipa, 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 Yucaipa, 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 ATTORNEY; We are proud to represent healthcare workers in Yucaipa, California

If you’ve become aware of potential fraud that may involve Medicare or Medicaid in Yucaipa, California, you need the advice of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is fully investigated and submitted accurately and quickly. By working with an experienced attorney you are increasing the chance that the federal or state government will step in, therefore increasing the chance for a financial reward. Reporting Medicare and Medicaid scams is a complicated 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 lawyers to help in your battle against Medicare and Medicaid fraud. Our attorneys will review your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam lawsuit to help report the fraud and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay nothing up until there is a recovery. Get in touch with us today to learn how we can help.

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