Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Commerce City, Colorado

Medicare and Medicaid fraud cost Colorado taxpayers billions of dollars each year. While many 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. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to file lawsuits on behalf of the federal or state government to help report this sort of fraud.

The federal and state government put a good deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, the government depends on regular folks in Colorado to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Commerce City, Colorado

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the market. We know that coming forward is difficult and lots of 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 thoroughly investigate your claim, diligently and carefully prepare your case, and work tirelessly with both you and the federal or state government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Commerce City, Colorado

Medicaid scams may cost taxpayers millions of dollars each year. In the state of Colorado, the Medicaid False Claims Act permits people and healthcare workers who have proof of Medicaid fraud the ability to submit a civil whistleblower lawsuit on behalf of the government.

It is an offense for a person or entity to send deceptive claims or otherwise defraud the state government in Colorado Under the state’s Medicaid False Claims Act, an individual with the knowledge of deceptive activity can come forward as whistleblowers and file a qui tam claim, possibly gathering a substantial financial reward for their efforts. If the state chooses to intervene in the suit, a whistleblower can collect between 15 and 25 percent of the recovery. If the whistleblower pursues litigation independently, she or he may be awarded between 25 and 30 percent of the financial recovery.

Colorado’s Medicaid False Claims Act further protects a whistleblower from company retaliation should such retaliation take place as a result of their reporting the fraudulent activity.

Liability of the Defendant in Commerce City, Colorado

The defendant in a qui tam lawsuit in Colorado might be purchased to pay the federal government as much as 3 times the quantity of the monetary loss to the state along with fines of $5,000 to $10,000 per violation.

Statute of Limitations in Colorado

In the state of Colorado, individuals submitting a whistleblower claim need to file their complaint within ten years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

If you have knowledge of fraudulent Medicaid activity in Commerce City, Colorado, you might choose to come forward with a whistleblower suit. In this case, you must understand your legal rights and protections under Colorado whistleblower law. The knowledgeable whistleblower attorneys at Khurana Law Firm, P.C. can help. Contact us for a confidential, no-cost consultation 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 Commerce City, Colorado, 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 Commerce City, Colorado,  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 Commerce City, Colorado

When you become aware of potential fraud as it concerns Medicare or Medicaid in Commerce City, Colorado, you require the guidance of an experienced whistleblower attorney, someone who can ensure that your claim is fully examined and submitted accurately and without delay. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing the opportunity for a financial reward. Reporting Medicare and Medicaid fraud is a complicated matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam attorneys to assist in your battle against Medicare and Medicaid scams. We will evaluate your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam suit to report the fraud and enable you to collect a reward. All whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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