Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in East Honolulu, Hawaii

Medicare and Medicaid fraud cost Hawaii taxpayers billions of dollars annually. While many medical service providers and drug companies are ethical and work within the system, some do not. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower lawyers can assist healthcare professionals to submit claims on behalf of the government to help report these kinds of scams.

The state and federal government put a good deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it relies on regular folks in Hawaii to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in East Honolulu, Hawaii

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the market. We know that stepping forward is hard and lots of 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 thoroughly investigate your claim, diligently prepare your case, for court, and work relentlessly with both you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in East Honolulu, Hawaii

Whistleblower statutes in Hawaii allow 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 permits private citizens to bring a qui tam claim against parties involved in deceptive activity on behalf of the state of Hawaii.

 

The False Claims to Counties Act provides for whistleblowers to file a lawsuit on behalf of counties in Hawaii.

 

Under both Acts, a private citizen has the capability to bring a civil suit on behalf of the state or county if they know of people or business entities who intentionally present fraudulent claims, abuse government property, neglect to report a false claim discovery, or avoid repayments of obligations to the state or counties.

 

In reward for their initiative, a whistleblower can be entitled to get from 15 to 30 percent of the recovered funds in a successful claim. Awards might be reduced if the whistleblower took part in the fraud or their info was based upon knowledge revealed in the media or in public hearings.

 

Both Acts likewise safeguard these individuals from retaliation by their companies.

Liability of the Defendant in East Honolulu, Hawaii

Under both acts, the defendant may be required to pay up to 3 times the quantity of damage to the state. The defendant might likewise be ordered to pay fines of $5,500 to $11,000 per offense.

Statute of Limitations in East Honolulu, Hawaii

Under both Acts, a whistleblower needs to submit their complaint within 10 years of the date on which the infraction occurred.

Working With an Experienced Whistleblower Lawyer

If you have knowledge of Medicaid or other fraud in East Honolulu, Hawaii, you may deserve to file a whistleblower lawsuit holding that party responsible. Contact Khurana Law Firm for a completely 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 are a healthcare worker in East Honolulu, Hawaii, 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 East Honolulu, Hawaii,  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 East Honolulu, Hawaii

If you’ve become aware of fraud as it concerns Medicare or Medicaid in East Honolulu, Hawaii, you require the advice of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is totally investigated and filed accurately and immediately. By dealing with an experienced attorney you are increasing the chance that the government will intervene, therefore increasing your chances for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam lawyers to help in your battle against Medicare and Medicaid scams. Our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam suit to help report the fraud and allow you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can be of help.

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