Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Des Plaines, Illinois

Medicare and Medicaid fraud cost Illinois taxpayers billions of dollars annually. Although many medical providers and drug companies are ethical and work within the system, there are those who don’t. When fraud happens, everybody can lose. Medicare and Medicaid whistleblower attorneys assist healthcare workers to file suits on behalf of the government to report this sort of fraud.

The federal and state governments place a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it depends on every day people in Illinois to come forward to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Des Plaines, Illinois

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and scams in the market. understand that coming forward is challenging and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, and work relentlessly 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 Des Plaines, Illinois

When a person becomes aware of potentially fraudulent activity against the Illinois state government Medicaid program, they can submit a civil suit as whistleblowers under the Illinois False Claims Act.

 

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

 

In addition to the Illinois False Claims Act, the Illinois Insurance Claims Fraud Prevention Act likewise allows private individuals to come forward against fraud perpetrated by private insurers.

 

State governments rely on individuals with awareness of scams to come forward with that knowledge in order to hold fraudulent activity in check and to punish those who commit those violations. Because states typically have limited resources to find fraudulent activity on their own, they rely on people and will reward those individuals in return.

 

If the state steps in and prosecutes the matter, a whistleblower can be awarded in between 15 and 25 percent of any recoveries. Even if the state opts not to step in and the whistleblower elects to proceed by themselves, that whistleblower stands to get in between 25 and 30 percent of the financial recovery as a reward for their actions.

 

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

Liability of the Defendant in Des Plaines, Illinois

In the state of Illinois, the defendant can be held liable for as much as three times the actual harm caused to the state and might 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 an individual in Illinois. Complainants need to submit a suit 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 Des Plaines, Illinois and have learned about deceitful activity against the Illinois state government, getting the legal advice of a skilled whistleblower attorney is vital. 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 are a healthcare worker in Des Plaines, 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 Des Plaines, 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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Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Des Plaines, Illinois

When you become aware of deceitful activity that may concern Medicare or Medicaid in Des Plaines, Illinois, you may need the advice of a skilled whistleblower attorney, someone who can make sure that your claim is completely investigated and submitted accurately and quickly. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, thus increasing the possibility for a reward. Reporting Medicaid and Medicare scams is an intricate matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam legal representatives to assist in your fight against Medicaid and Medicare fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you 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. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to to schedule a confidential consultation.

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