Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Idaho Falls, Idaho

Medicare and Medicaid fraud cost Idaho taxpayers billions of dollars annually. Although most medical providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower attorneys can assist people who work in the healthcare system to submit suits on behalf of the government to report these kinds of scams.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Idaho Falls, Idaho

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is not easy and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, and work relentlessly with both you and the federal or state government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Idaho Falls, Idaho

Health care fraud costs Idaho taxpayers billions of dollars each year. While the state of Idaho does not have its own type of the federal False Claims Act, an individual who knows of deceptive Medicaid activity against the government can file a qui tam suit under the federal False Claims Act. This Act enforces civil liability for misleading or deceitful claims.

 

Under the federal False Claims Act, a private individual who has info concerning fraudulent activity can bring a civil lawsuit on behalf of the government for the federal part of the amount invested. 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 also provided shield against any company retaliation that might originate from their case.

Liability of the Defendant in Idaho Falls, Idaho

Individuals, companies, or other entities that have defrauded the federal government might be held responsible for triple the amount of damages to the government. In addition, they may be subject to considerable penalties per occurrence of scams.

Statute of Limitations in Idaho Falls, Idaho

Under the federal False Claims Act, a private citizen bringing a qui tam suit must submit their complaint within 10 years of the date that the infraction took place.

Working With an Experienced Whistleblower Attorney

If you have evidence of fraudulent Medicaid activity in Idaho Falls, Idaho, you might be able to file a whistleblower lawsuit on behalf of the government. At Khurana Law Firm, we have more than 20 years of experience in complex lawsuits, qui tam, and whistleblower law. Contact us for a confidential, no-cost assessment to discuss your rights under federal law. If you have experienced scams or abuse in the Medicaid system, we might 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 are a healthcare worker in Idaho Falls, 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 Idaho Falls, 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Idaho Falls, Idaho

If you’ve become aware of fraudulent activity that may concern Medicare or Medicaid in Idaho Falls, Idaho, you may need the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and immediately. By working with an experienced attorney you are increasing the chance that the government will step in, hence increasing your chances for a financial reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam attorneys to assist in your fight against Medicare and Medicaid fraud. Our attorneys will review your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam lawsuit to report the fraud and enable you to collect a reward. All whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to learn how we can be of help.

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