Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Waipahu, Hawaii

Medicare and Medicaid fraud cost Hawaii taxpayers billions of dollars annually. While many medical providers and drug companies are honest and work within the system, there are those who do not. When fraud occurs, everyone loses. Medicaid and Medicare 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 federal and state governments place a lot of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government relies on every day people in Hawaii to come forward and to report scams. People like you.

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the industry. We know that stepping forward is challenging 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 substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently and carefully prepare your case, for court, and work tirelessly with you and the state of federal government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Waipahu, Hawaii

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

 

The Hawaii False Claims Act permits private citizens to bring a qui tam lawsuit against parties associated with 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 citizen has the capability to bring a civil suit on behalf of the state or county if they know of people or entities who purposefully present deceptive claims, abuse government property, neglect to report an incorrect claim discovery, or avoid payments of obligations to the state or counties.

 

In reward for their initiative, a whistleblower can be entitled to receive from 15 to 30 percent of the recovery in a successful claim. Awards may be minimized if the whistleblower took part in the scams or their information was based upon knowledge revealed in the media or in public hearings.

 

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

Liability of the Defendant in Waipahu, Hawaii

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

Statute of Limitations in Waipahu, Hawaii

Under both Acts, a whistleblower should submit their complaint within 10 years of the date on which the violation occurred.

Working With an Experienced Whistleblower Attorney

If you know of Medicaid or other scams in Waipahu, Hawaii, you might have the right to file a whistleblower claim holding that party responsible. Contact Khurana Law Firm for a completely 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 Waipahu, 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 Waipahu, 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 ATTORNEY; We are proud to represent healthcare workers in Waipahu, Hawaii

When you become aware of potential fraud involving Medicare or Medicaid in Waipahu, Hawaii, you need the guidance of a skilled whistleblower attorney, someone who can guarantee that your claim is fully investigated and filed accurately and quickly. By working with an experienced attorney you are increasing the chance that the federal or state government will intervene, thus increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is an intricate matter –  don’t 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 assist in your fight against Medicare and Medicaid scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we may represent you in a qui tam lawsuit to report the scams and allow you to gather a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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