Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Downers Grove, Illinois

Medicaid and Medicare fraud cost Illinois taxpayers billions of dollars every year. Although many medical companies and drug companies are ethical and work within the legal channels, there are those who do not. When scams are perpetrated, everybody loses. Medicare and Medicaid whistleblower attorneys assist healthcare workers to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

The federal and state government place a lot of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government relies on every day people in Illinois to come forward to report scams. People like you.

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the industry. We know that coming forward is not simple and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Downers Grove, Illinois

When a person becomes learns of fraudulent activity against the Illinois state government Medicaid program, they have the right to submit a civil suit as whistleblowers under the Illinois False Claims Act.

 

This civil lawsuit, on behalf of the government, holds those who carry out deceptive activity liable for their misleading practices and helps recover the loss to the state.

 

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

 

State governments depend on individuals with knowledge of scams to come forward with that knowledge in order to hold fraudulent activity in check and to penalize those who carry out those infractions. Since states generally have restricted resources to find fraudulent activity on their own, they rely on healthcare workers and will reward them in return.

 

If the state takes up and prosecutes the matter, a whistleblower can be granted in between 15 and 25 percent of any recoveries. Even if the state opts not to step in and the whistleblower chooses to continue on their own, that whistleblower stands to get in between 25 and 30 percent of the recovery as a reward for their actions.

 

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

Liability of the Defendant in Downers Grove, Illinois

In the state of Illinois, the accused can be held responsible for up to three times the actual harm caused to the state and might be required to pay extra fines of between $5,000 and $11,000 per offense.

Statute of Limitations in Illinois

There is a statute of restrictions for the filing of a whistleblower claim by an individual in Illinois. Plaintiffs should submit a complaint within 10 years of the infraction date in order to be considered for a whistleblower claim.

Working With an Experienced Whistleblower Attorney

If you are a healthcare worker in Downers Grove, Illinois and have learned about deceptive activity against the Illinois state government, getting the legal advice of a knowledgeable whistleblower attorney is crucial. At Khurana Law Firm, P.C., we are here to assist. 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 Downers Grove, 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 Downers Grove, 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 Downers Grove, Illinois

If you’ve become aware of potential fraud as it concerns Medicare or Medicaid in Downers Grove, Illinois, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is totally examined and submitted accurately and quickly. By dealing with a knowledgeable lawyer you are increasing the chance that the government will intervene, therefore increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam attorneys to help in your battle against Medicare and Medicaid scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam lawsuit to report the fraud and enable you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can be of help.

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