Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Delaware

Medicaid and Medicare fraud cost Delaware taxpayers billions of dollars annually. Although many medical companies and drug companies are honest and work within the legal channels, some do not. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower lawyers assist healthcare workers to submit lawsuits on behalf of the government to help report this type of fraud.

The state and federal governments place a a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it counts on every day people in Delaware to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare workers in Delaware

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 scams in the industry. We know that stepping forward is challenging 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 extensive experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, and work tirelessly with you and the state of federal government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Delaware

Fraudulent Medicaid activity costs everyone in the state of Delaware. But because of the lack of government resources to combat these instances of fraud, it relies on individuals and healthcare employees who are aware of fraud to come forward with that knowledge. 

 

Under the Delaware False Claims and Reporting Act, a private individual can come forward to report Medicaid fraud with a qui tam lawsuit on behalf of the state. Under this law, these civil lawsuits can recover lost government funds and hold perpetrators of Medicaid fraud accountable while rewarding whistleblowers for their efforts. 

 

In a successful Delaware whistleblower lawsuit, the individual who brought the suit may be awarded between 15 and 25 percent of the recovery if the state chooses to enter into the suit. If the individual litigates without the state’s intervention, he or she may be awarded between 25 and 30 percent of the recovery. 

 

Under the Delaware False Claims and Reporting Act, a whistleblower is also protected from any employer retaliation that may result from their reporting fraudulent activity.

Liability of the Defendant in Delaware

The defendant in a whistleblower lawsuit in Delaware may be ordered to pay up to triple the actual damages to the state in addition to fines of between $10,957 and $21,916 for each violation. 

Statute of Limitations in Delaware

Individuals filing a qui tam lawsuit in Delaware must file their complaint within ten years of the date of the violation.

Working With an Experienced Whistleblower Attorney

Delaware relies on whistleblowers who have evidence of Medicaid fraud. If you are aware of fraud and choose to come forward, you should understand your legal rights and protections under the law. The experienced whistleblower attorneys at Khurana Law Firm, P.C. can advise and guide you in your pursuit of a whistleblower claim in Delaware. 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 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. 

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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER

If you’ve become aware of deceitful activity as it concerns Medicaid or Medicare, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is totally examined and submitted accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the government will step in, thus increasing the opportunity for a reward. Reporting Medicaid and Medicare scams is an intricate matter –  do not attempt 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 lawyers to help in your fight against Medicare and Medicaid fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam suit to report the fraud and allow you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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