Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Idaho

Medicare and Medicaid fraud cost Idaho taxpayers billions of dollars annually. While most medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud occurs, everybody can lose. Medicare and Medicaid whistleblower lawyers can help people who work in the healthcare system to submit claims on behalf of the government to help report this type of fraud.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in Idaho

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 market. We know that stepping forward is challenging and many things might 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 examine your claim, diligently and 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 Idaho

Healthcare fraud costs taxpayers billions of dollars each year. While the state of Idaho does not have its own version of the federal False Claims Act, an individual who has knowledge of fraudulent Medicaid activity against the government can file a qui tam lawsuit under the federal False Claims Act. This Act imposes civil liability for false or fraudulent claims.

Under the federal False Claims Act, a private individual with information concerning fraudulent activity can bring a civil lawsuit on behalf of the government for the federal portion of the amount spent.  For this, the whistleblower may be entitled to a reward of between 15 and 30 percent of the recovery. Under the False Claims Act, the whistleblower is also afforded protection against any employer retaliation that may stem from their suit. 

If you are a Montana healthcare worker, get in touch with Montana Medicare Whistleblower attorney.

Liability of the Defendant in Idaho

Individuals, companies, or other entities that have defrauded the government may be held liable for triple the amount of damages to the government. In addition, they can be subject to substantial penalties per incident of fraud.

Statute of Limitations in Idaho

Under the federal False Claims Act, an individual bringing a qui tam lawsuit must file their complaint within ten years of the date that the violation took place.

Working With an Experienced Whistleblower Attorney

If you have evidence of fraudulent Medicaid activity in the state of Idaho, you may be able to file a whistleblower lawsuit on behalf of the government. At Khurana Law Firm, we have over 20 years of experience in complex litigation, qui tam and whistleblower law. Contact us for a confidential, no-cost consultation to discuss your rights under federal law. If you have witnessed fraud or abuse in the Medicaid system, we may be able to help you. 

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 LAWYER

If you’ve become aware of fraud that may concern Medicare or Medicaid, you require the advice of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is completely investigated and filed accurately and promptly. By dealing with a skilled lawyer you are increasing the chance that the government will step in, therefore increasing the possibility for a reward. Reporting Medicaid and Medicare scams 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 legal representatives to help in your fight against Medicare and Medicaid fraud. After you get in touch our lawyers 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 claim to report the scams and allow you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can be of help.

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