Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Coeur d'Alene, Idaho

Medicaid and Medicare fraud cost Idaho taxpayers billions of dollars every year. While most medical service providers and drug companies are ethical and work within the legal channels, some do not. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower attorneys can help healthcare workers to file suits on behalf of the government to report this sort of fraud.

The state and federal governments place a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it depends on private citizens in Idaho to come forward and to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Coeur d'Alene, Idaho

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the industry. We know that coming forward is hard and numerous 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, for court, and work tirelessly with both you and the state of federal government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Coeur d'Alene, Idaho

Healthcare fraud costs Idaho taxpayers billions of dollars each and every year. While the state of Idaho does not have its own type of the federal False Claims Act, a private citizen who has learned of fraudulent Medicaid activity against the government can file a qui tam claim under the federal False Claims Act. This Act enforces civil liability for false or deceptive claims.

 

Under the federal False Claims Act, a private individual who has information pertaining to fraudulent activity can bring a civil claim on behalf of the government for the federal portion of the amount spent. For this, the whistleblower may be entitled to a benefit of in between 15 and 30 percent of the recuperation. Under the False Claims Act, the whistleblower is likewise provided protection against any company retaliation that may come from their lawsuit.

Liability of the Defendant in Coeur d'Alene, Idaho

People, companies, or other entities that may have defrauded the federal government may be held responsible for triple the damages to the federal government. In addition, they may be subject to considerable charges per incident of scams.

Statute of Limitations in Coeur d'Alene, Idaho

Under the federal False Claims Act, an individual bringing a qui tam suit needs to file their complaint within 10 years of the date that the violation happened.

Working With an Experienced Whistleblower Attorney

If you have evidence of fraudulent Medicaid activity in Coeur d’Alene, Idaho, you may be able to file a whistleblower suit on behalf of the government. At Khurana Law Firm, we have more than 20 years of experience in intricate lawsuits, qui tam, and whistleblower law. Contact us for a confidential, no-cost consultation to discuss your rights under federal law. If you have actually seen scams or abuse in the Medicaid system, we may be able to assist 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 are a healthcare worker in Coeur d’Alene, Idaho, 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 Coeur d’Alene, Idaho,  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 Coeur d'Alene, Idaho

When you become aware of fraud that may involve Medicaid or Medicare in Coeur d’Alene, Idaho, you need the advice of a skilled whistleblower attorney, someone who can guarantee that your claim is totally examined and filed accurately and without delay. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, hence increasing the opportunity for a financial reward. Reporting Medicare and Medicaid scams is a complex matter –  don’t attempt to do this alone, we are here to help.

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

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