Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Bloomington, Illinois

Medicare and Medicaid fraud cost Illinois taxpayers billions of dollars every year. Although many medical service providers and drug companies are ethical and work within the legal channels, some do not. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower lawyers can help healthcare workers to file suits on behalf of the federal or state government to report this type of fraud.

The state and federal government place a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, it depends on private citizens in Illinois to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in Bloomington, Illinois

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the industry. understand that coming forward is difficult and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work tirelessly with both you and the state of federal government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Bloomington, Illinois

When a healthcare worker becomes learns of fraudulent activity against the Illinois state government Medicaid program, they can file a civil suit as whistleblowers under the Illinois False Claims Act.

 

This civil suit, filed on behalf of the state government, holds those who carry out fraudulent activity accountable for their deceptive practices and helps recover the loss to the state.

 

In addition to the Illinois False Claims Act, the Illinois Insurance Claims Fraud Prevention Act likewise permits people to come forward against fraud perpetrated by private insurance providers.

 

State governments count on individuals with awareness of fraud to come forward with that knowledge in order to hold fraudulent activity in check and to penalize those who carry out those infractions. Because states normally have restricted resources to find fraud on their own, they rely on people and will reward them in return.

 

If the state steps in and prosecutes the matter, a whistleblower can be granted in between 15 and 25 percent of any recoveries. Even if the state declines and the whistleblower elects to proceed by themselves, that whistleblower stands to get in between 25 and 30 percent of the recovery as a reward.

 

The Illinois False Claims Act likewise protects the whistleblower against retaliation when they have sued against their company.

Liability of the Defendant in Bloomington, Illinois

In the state of Illinois, the offender can be held accountable for as much as 3 times the actual damage caused to the state and may be ordered to pay additional fines of in between $5,000 and $11,000 per violation.

Statute of Limitations in Illinois

There is a statute of constraints for the filing of a whistleblower claim by a private individual in Illinois. Complainants should file a complaint within 10 years of the violation date in order to be considered for a whistleblower claim.

Dealing with an Experienced Whistleblower Attorney

If you are a healthcare worker in Bloomington, Illinois and have become aware of deceitful activity against the state government, getting the legal guidance of an experienced whistleblower attorney is vital. At Khurana Law Firm, P.C., we are here to assist. Contact us for a completely 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 Bloomington, 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 Bloomington, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Bloomington, Illinois

When you become aware of potential fraud involving Medicaid or Medicare in Bloomington, Illinois, you may need the advice of a knowledgeable whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and immediately. By dealing with an experienced attorney you are increasing the chance that the federal or state government will step in, hence 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 practical experience as national qui tam attorneys to assist in your fight against Medicare and Medicaid fraud. We will examine your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam claim to help report the fraud and enable you to collect 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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