Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Illinois

Medicaid and Medicare fraud cost Illinois taxpayers billions of dollars every year. While most medical companies and drug companies are ethical and work within the legal channels, there are those who do not. When fraud occurs, everyone loses. Medicaid and Medicare whistleblower lawyers help people who work in the healthcare system to file suits on behalf of the federal or state government to help report this type of fraud.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in Illinois.

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the market. We know that coming forward is challenging and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently prepare your case, for court, and work tirelessly 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 Illinois

When an individual becomes aware of fraudulent activity against the Illinois state government Medicaid program, they have the right to file a civil lawsuit as whistleblowers under the Illinois False Claims Act. 

 

This is a civil suit on behalf of the government that holds those who conduct fraudulent activity accountable for their deceptive practices and recovers the loss to the state. 

 

In addition to the Illinoi False Claims Act, the Illinois Insurance Claims Fraud Prevention Act also allows individuals to come forward against fraud perpetrated by private insurance companies. 

 

State governments rely on individuals with knowledge of fraud to come forward with that knowledge to hold this activity in check and to punish those who commit those violations. Because states typically have limited resources to do this on their own, they rely heavily on individuals and will reward them in return. 

 

If the state takes up and prosecutes the matter, a whistleblower can be awarded between 15 and 25 percent of any recoveries. Even if the state declines and the whistleblower decides to proceed on their own, that whistleblower stands to receive between 25 and 30 percent of the recovery as a reward.

 

The Illinois False Claims Act also protects the whistleblower against retaliation when they have filed a claim against their employer.

Liability of the Defendant in Illinois

In the state of Illinois, the defendant can be held liable for up to three times the actual harm caused to the state and may be required to pay additional fines of between $5,000 and $11,000 per violation.

Statute of Limitations in Illinois

There is a statute of limitations for the filing of a whistleblower claim by an individual in Illinois. Plaintiffs must file a complaint within 10 years of the violation date in order to be considered for a whistleblower claim.

Working With an Experienced Whistleblower Attorney

If you have become aware of fraudulent activity against the government, getting the legal advice of an experienced whistleblower attorney is critical. At Khurana Law Firm, P.C., we are here to help. Contact us for a confidential, no-cost consultation to discuss your case.

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 An Experienced WHISTLEBLOWER LAWYER

If you’ve become aware of potential fraud as it concerns Medicare or Medicaid, you may need the advice of a skilled whistleblower attorney, someone who can ensure that your claim is fully examined and submitted accurately and without delay. By working with an experienced attorney you are increasing the chance that the federal or state government will intervene, thus increasing the possibility for a financial reward. Reporting Medicare and Medicaid 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 experience as national qui tam lawyers to assist in your battle against Medicaid and Medicare scams. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we feel 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 financial benefit. All whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

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