Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid scams in Connecticut

Medicaid and Medicare fraud cost Connecticut taxpayers billions of dollars annually. While the majority of medical companies and drug companies are honest and work within the system, some don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys can help healthcare professionals to file suits on behalf of the federal or state government to report this type of fraud.

The state and federal governments put a great deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it depends on regular folks in Connecticut to come forward to report scams. People like you.

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Connecticut.

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic choice to come forward to report abuse and fraud in the industry. understand that coming forward is not easy and many things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

schedule a
confidential consultation

Whistleblower Laws in the State of Connecticut

People who may have learned of Medicare fraud in Connecticut can come forward with a whistleblower claim submitted under the Connecticut False Claims Act. The Connecticut False Claims Act holds anybody who may have intentionally submitted false claims to Medicare or to Connecticut Health and Human Services liable and responsible for their deceitful actions.

What Does the Connecticut False Claims Act Say?

Sec. 4-275 of the Connecticut False Claims Act defines the types of deceptive activity that are forbidden under the Act. 

 

Sec. 4-277 says that anybody with awareness of the prohibited fraudulent activity can submit a civil action in the Supreme court in the name of the State of Connecticut.

Penalties in a Whistleblower Claim in Connecticut

The defendant in a whistleblower claim may be mandated by the court to pay up to three times the damage to the State of Connecticut in addition to fines of between $10,957 and $21,916  per incorrect claim.

 

Whistleblower Awards Under the Connecticut False Claims Act

An individual who comes forward as a whistleblower with information about Medicare fraud and who files a successful claim may be able to collect a reward of between 15 and 25 percent of the recovery if the government chooses to enter into the claim and  between 25 to 30 percent of the recovery if the government declines.

Whistleblower Protections in Connecticut

In the State of Connecticut, any whistleblower is protected against retaliation by an employer when they have pursued a qui tam claim on behalf of the government.

Statute of Limitations in a Qui Tam Claim in Connecticut

Under the Connecticut False Claims Act, a whistleblower must file a claim within ten years of the date of the violation.

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 can report it 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. To report Medicare fraud, contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY

When you become aware of fraud involving Medicaid or Medicare, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can guarantee that your claim is fully examined and submitted accurately and immediately. By dealing with an experienced attorney you are increasing the chance that the government will intervene, therefore increasing the opportunity for a reward. Reporting Medicaid and Medicare scams 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 help in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we may represent you in a qui tam claim to help report the scams and allow you to collect a financial benefit. Because 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 be of help.

Service areas