Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Pearl City, Hawaii

Medicaid and Medicare fraud cost Hawaii taxpayers billions of dollars each year. Although the majority of medical service providers and drug companies are ethical and work within the system, there are those who don’t. When fraud occurs, everybody loses. Medicare and Medicaid whistleblower lawyers can assist people who work in the healthcare system to file claims on behalf of the federal or state government to report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Pearl City, Hawaii

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the industry. understand that coming forward is not easy and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, for court, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Pearl City, Hawaii

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

 

The Hawaii False Claims Act allows individuals to bring a qui tam suit against parties involved in deceptive activity on behalf of the state of Hawaii.

 

The False Claims to Counties Act allows for whistleblowers to file a suit on behalf of counties.

 

Under both Acts, a private individual has the capability to bring a civil claim on behalf of the state or county if they are aware of people or business entities who knowingly present deceitful claims, misappropriate 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 an effective claim. Awards might be decreased if the whistleblower participated in the fraud or their info was based on knowledge revealed in the media or in public hearings.

 

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

Liability of the Defendant in Pearl City, Hawaii

Under both acts, the offender might be required to pay up to 3 times the quantity 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 Pearl City, Hawaii

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

Working With an Experienced Whistleblower Lawyer

If you know of Medicaid or other fraud in Pearl City, Hawaii, you may can file a whistleblower suit 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 Pearl City, 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 Pearl City, 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 ATTORNEY; We are proud to represent healthcare workers in Pearl City, Hawaii

When you become aware of potential fraud that may concern Medicare or Medicaid in Pearl City, Hawaii, you require the advice of an experienced whistleblower lawyer, someone who can guarantee that your claim is completely examined and filed accurately and immediately. By working with an experienced 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 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 prior experience as national qui tam lawyers to help in your battle against Medicaid and Medicare fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we may represent you in a qui tam suit to help report the scams and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to learn how we can be of help.

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