Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Berwyn, Illinois

Medicaid and Medicare fraud cost Illinois taxpayers billions of dollars each year. Although many medical companies and drug companies are honest and work within the system, some do not. When fraud takes place, everybody can lose. Medicare and Medicaid whistleblower lawyers assist healthcare professionals to submit claims on behalf of the federal or state government to report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Berwyn, Illinois

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and fraud in the industry. We know that coming forward is difficult and many things may be at stake. When you come to us, your case is held in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, carefully prepare your case, 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 Berwyn, Illinois

When a person becomes discovers fraudulent activity against the Illinois state government Medicaid program, they may submit a civil lawsuit as whistleblowers under the Illinois False Claims Act.

 

This civil suit, on behalf of the government, holds those who carry out deceptive activity responsible for their misleading practices and recovers the financial loss to the state.

 

In addition to the Illinois False Claims Act, the Illinois Insurance Claims Fraud Prevention Act likewise enables people to come forward against fraud committed by private insurance companies.

 

State governments rely on people with awareness of scams to come forward with that knowledge in order to hold fraudulent activity in check and to penalize those who carry out those offenses. Due to the fact that states normally have restricted resources to find fraud on their own, they rely heavily on healthcare workers and will reward those individuals in return.

 

If the state takes up and prosecutes the matter, a whistleblower can be granted between 15 and 25 percent of any recovered funds. Even if the state declines and the whistleblower decides to continue by themselves, 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 Berwyn, Illinois

In the state of Illinois, the accused can be held accountable for up to three times the actual damage caused to the state and might be ordered to pay extra fines of between $5,000 and $11,000 per infraction.

Statute of Limitations in Illinois

There is a statute of constraints for the filing of a whistleblower claim by a private individual in Illinois. Plaintiffs must submit a lawsuit within 10 years of the offense date in order to be considered for a whistleblower claim.

Dealing with an Experienced Whistleblower Attorney

If you are a healthcare worker in Berwyn, Illinois and have become aware of deceitful activity against the state government, getting the legal guidance of a skilled whistleblower attorney is important. At Khurana Law Firm, P.C., we are here to assist. Contact us for a confidential, no-cost assessment 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 are a healthcare worker in Berwyn, Illinois, 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 Berwyn, Illinois,  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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WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Berwyn, Illinois

When you become aware of fraud that may concern Medicare or Medicaid in Berwyn, Illinois, you may need the guidance of a skilled whistleblower lawyer, someone who can guarantee that your claim is totally examined and submitted accurately and without delay. By working with an experienced attorney you are increasing the chance that the government will step in, hence increasing your chances for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  do not 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 legal representatives to assist in your battle against Medicare and Medicaid scams. We 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 claim to report the fraud and enable you to collect a reward. All whistleblower cases are on contingency, you pay nothing until there is a recovery. Get in touch with us today to learn how we can help.

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