Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Wilmington, Delaware

Medicaid and Medicare fraud cost Delaware taxpayers billions of dollars each year. Although most medical service providers and drug companies are honest and work within the system, there are those who do not. When fraud happens, everyone loses. Medicaid and Medicare whistleblower attorneys can help people who work in the healthcare system to file suits on behalf of the government to report this sort of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Wilmington, Delaware

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and fraud in the market. understand that coming forward is difficult and numerous 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 completely examine your claim, diligently prepare your case, and work tirelessly with you and the state of federal government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Wilmington, Delaware

Deceitful Medicaid activity costs everyone in the state of Delaware. Because of the shortage of government resources to fight these instances of fraud, the government relies on private citizens and healthcare staff members who know of fraud to come forward with this information.

 

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

 

In a successful Delaware whistleblower claim, the individual who brought the lawsuit might be awarded between 15 and 25 percent of the recuperation if the state elects to participate in the lawsuit. If the private citizen litigates without the state’s intervention, he or she might be granted in between 25 and 30 percent of the financial recovery.

 

Under the Delaware False Claims and Reporting Act, a whistleblower is likewise safeguarded from any company retaliation that might arise from their reporting deceptive activity.

Liability of the Defendant in Wilmington, 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 Wilmington, Delaware

Individuals filing a qui tam claim in Delaware need to submit their complaint within ten years of the date of the offense.

Working With an Experienced Whistleblower Lawyer

Delaware relies on whistleblowers who have proof of Medicaid scams. If you know of scams in Wilmington, Delaware and pick to come forward, you need to understand your legal rights and protections under the law. The skilled 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 are a healthcare worker in Wilmington, Delaware, 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 Wilmington, Delaware,  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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Wilmington, Delaware

If you’ve become aware of fraud that may involve Medicare or Medicaid in Wilmington, Delaware, you require the guidance of a skilled whistleblower lawyer, someone who can guarantee that your claim is completely investigated and filed accurately and without delay. By working with an experienced attorney you are increasing the chance that the government will intervene, 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 bring years of experience as national qui tam lawyers to help in your fight against Medicare and Medicaid fraud. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we believe you have a valid claim, we can represent you in a qui tam lawsuit to help report the scams and enable you to gather a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to learn how we can be of help.

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