Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Lewiston, Idaho

Medicaid and Medicare fraud cost Idaho taxpayers billions of dollars each year. Although most medical providers and drug companies are honest and work within the system, there are those who don’t. When fraud happens, everybody loses. Medicare and Medicaid whistleblower attorneys help people who work in the healthcare system to file claims on behalf of the federal or state government to help report these kinds of scams.

The state and federal government put a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it counts 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 workers in Lewiston, Idaho

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and scams in the industry. We know that coming forward is difficult and numerous things might be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Lewiston, Idaho

Health care fraud costs 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 person who has learned of fraudulent Medicaid activity against the government can submit a qui tam lawsuit under the federal False Claims Act. This Act establishes civil liability for false or deceitful claims.

 

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

Liability of the Defendant in Lewiston, Idaho

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

Statute of Limitations in Lewiston, Idaho

Under the federal False Claims Act, a private citizen bringing a qui tam claim should file their complaint within ten years of the date that the infraction occurred.

Working With an Experienced Whistleblower Attorney

If you have proof of deceitful Medicaid activity in Lewiston, Idaho, you may be able to submit a whistleblower lawsuit on behalf of the federal government. At Khurana Law Firm, we have over 20 years of experience in complex litigation, qui tam, and whistleblower law. Contact us for a personal, no-cost consultation to discuss your rights under federal law. If you have actually seen fraud 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 Lewiston, 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 Lewiston, 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 Lewiston, Idaho

When you become aware of fraud that may involve Medicare or Medicaid in Lewiston, Idaho, you may need the advice of a knowledgeable whistleblower attorney, someone who can guarantee that your claim is fully investigated and filed accurately and promptly. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will intervene, thus increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not attempt 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 lawyers to assist in your battle against Medicaid and Medicare fraud. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we may represent you in a qui tam lawsuit to report the scams and enable you to gather a reward. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can be of help.

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