Medicare and Medicaid fraud cost Florida taxpayers billions of dollars each year. While most medical companies and drug companies are ethical and work within the legal channels, some don’t. When scams are perpetrated, everyone can lose. Medicare and Medicaid whistleblower lawyers can help healthcare professionals to submit suits on behalf of the government to report these kinds of scams.
The federal and state government place a good deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government counts on regular folks in Florida to come forward and to report scams. People like you.
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 challenging 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 extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, and work relentlessly with you and the federal or state government to help bring deceitful Medicare or Medicaid activity to justice.
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:
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
Coders are directed to add codes based on other information in the chart.
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
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 Spring Hill, Florida, get in touch with us here.
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.
Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.
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.
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.
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.
The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity.
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.
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 Spring Hill, Florida, you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation.
When you become aware of fraudulent activity involving Medicare or Medicaid in Spring Hill, Florida, you need the advice of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is fully examined and filed accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the government will intervene, thus increasing the possibility for a financial reward. Reporting Medicare and Medicaid scams is a complicated matter – don’t try 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 fight against Medicaid and Medicare scams. We will review your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we may represent you in a qui tam claim to help report the scams and allow you to gather a financial benefit. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to to schedule a confidential consultation.
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