Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Hawaii taxpayers billions of dollars annually. Although many medical providers and drug companies are honest and work within the system, there are those who don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower lawyers can assist people who work in the healthcare system to file suits on behalf of the federal or state government to report this sort of fraud.

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

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

At Khurana Law Firm, P.C., as skilled 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 may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently prepare your case, for court, and work tirelessly with both you and the state of federal government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Hilo, Hawaii

Whistleblower statutes in Hawaii make it possible for private citizens to come forward to report fraudulent activity against the state Medicaid program and other county programs. The state of Hawaii has 2 whistleblower laws:

 

The Hawaii False Claims Act permits individuals to bring a qui tam claim against parties associated with 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 lawsuit on behalf of the state or county if they know of people or business entities who intentionally 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 initiative, a whistleblower may be entitled to get from 15 to 30 percent of the recovery in an effective claim. Awards may be decreased if the whistleblower participated in the scams or their information was based on knowledge divulged in the media or in public hearings.

 

Both Acts likewise secure these individuals from retaliation by their employers.

Liability of the Defendant in Hilo, Hawaii

Under both acts, the offender might be required to pay up to three times the amount of damage to the state. The accused may also be ordered to pay fines of $5,500 to $11,000 per violation.

Statute of Limitations in Hilo, Hawaii

Under both Acts, a whistleblower must submit their complaint within 10 years of the date on which the offense took place.

Working With an Experienced Whistleblower Lawyer

If you have knowledge of Medicaid or other scams in Hilo, Hawaii, you may can file a whistleblower claim holding that party accountable. Contact Khurana Law Firm for a confidential, no-cost assessment 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 Hilo, 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 Hilo, 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Hilo, Hawaii

When you become aware of fraud that may involve Medicare or Medicaid in Hilo, Hawaii, you may need the advice of a skilled whistleblower attorney, someone who can guarantee that your claim is totally investigated and submitted accurately and quickly. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, therefore increasing your chances for a reward. Reporting Medicaid and Medicare scams is an intricate matter –  do not try 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 legal representatives to help in your fight against Medicaid and Medicare fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and enable you to collect a reward. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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