Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Hawaii

Medicaid and Medicare fraud cost Hawaii taxpayers billions of dollars every year. Although many medical service providers and drug companies are ethical and work within the system, some do not. When scams are perpetrated, everybody can lose. Medicaid and Medicare whistleblower lawyers help healthcare workers to submit suits on behalf of the government to help report these kinds of scams.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that coming 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 investigate your claim, carefully prepare your case, and work relentlessly with you and the state of federal government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Hawaii

Whistleblower laws in the state of Hawaii enable individuals to come forward to report fraudulent activity against the state Medicaid program and other county programs. The state has two whistleblower laws:

 

  • The Hawaii False Claims Act allows individuals to bring a qui tam lawsuit against parties involved in fraudulent activity on behalf of the state. 
  • The False Claims to Counties Act provides for whistleblowers to file suit on behalf of counties. 

 

Under both Acts, a private individual has the ability to bring a civil lawsuit on behalf of the state or county if they are aware of individuals or entities who knowingly present fraudulent claims, misappropriate government property, fail to report a false claim discovery, or avoid payments of obligations to the state or counties. 

 

In reward for their effort, a whistleblower may be entitled to receive from 15 to 30 percent of the recovery in a successful claim. Awards may be reduced if the whistleblower took part in the fraud or their information was based on knowledge disclosed in the media or in public hearings. 

 

Both Acts also protect these individuals from retaliation by their employers.

Liability of the Defendant in Hawaii

Under both acts, the defendant may be ordered to pay up to three times the amount of harm to the state. The defendant may also be ordered to pay fines of $5,500 to $11,000 per violation. 

Statute of Limitations in Hawaii

Under both Acts, a whistleblower must file their complaint within ten years of the date on which the violation occurred. 

Working With an Experienced Whistleblower Attorney

If you have knowledge of Medicaid or other fraud in the state of Hawaii, you may have the right to file a whistleblower lawsuit holding that party accountable.  Contact Khurana Law Firm for a confidential, no-cost consultation to understand your rights and protections under Hawaii whistleblower laws.

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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY

When you become aware of potential fraud as it concerns Medicare or Medicaid, you require the advice of a skilled whistleblower attorney, someone who can ensure that your claim is completely investigated and filed accurately and immediately. By working with an experienced attorney you are increasing the chance that the government will intervene, therefore increasing your chances for a financial reward. Reporting Medicaid and Medicare scams is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam lawyers to assist in your fight against Medicaid and Medicare scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we can represent you in a qui tam claim to report the fraud and allow you to collect a financial benefit. Because all whistleblower work is on contingency, you pay nothing up until there is a settlement. Contact us today to learn how we can help.

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