Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Elgin, Illinois

Medicaid and Medicare fraud cost Illinois taxpayers billions of dollars every year. Although the majority of medical companies and drug companies are ethical and work within the system, there are those who don’t. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower attorneys assist healthcare professionals to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

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

Work with

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

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

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

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Whistleblower Laws in Elgin, Illinois

When a person becomes learns of potentially 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 civil lawsuit, filed on behalf of the government, holds those who perform fraudulent activity responsible 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 allows people to come forward against scams committed by private insurance companies.

 

State governments count on individuals with knowledge of scams to come forward with that information in order to hold fraudulent activity in check and to penalize those who carry out those infractions. Since states typically 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 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 between 25 and 30 percent of the recovery as a reward.

 

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

Liability of the Defendant in Elgin, Illinois

In the state of Illinois, the defendant can be held responsible for approximately 3 times the actual damage inflicted to the state and may be required to pay additional fines of between $5,000 and $11,000 per offense.

Statute of Limitations in Illinois

There is a statute of constraints for the filing of a whistleblower claim by an individual in Illinois. Plaintiffs should submit a complaint 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 Elgin, Illinois and have become aware of deceptive activity against the state government, getting the legal advice of an experienced 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 Elgin, 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 Elgin, 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 ATTORNEY; We are proud to represent healthcare workers in Elgin, Illinois

When you become aware of fraud that may involve Medicaid or Medicare in Elgin, Illinois, you may need the advice of an experienced whistleblower attorney, someone who can ensure that your claim is fully examined and filed accurately and immediately. By working with a skilled attorney you are increasing the chance that the federal or state government will intervene, hence increasing your chances for a reward. Reporting Medicaid and Medicare scams is an intricate matter –  do not attempt 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 lawyers to assist in your battle against Medicare and Medicaid fraud. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we can represent you in a qui tam lawsuit to report the fraud and enable you to collect a reward. All whistleblower work is on contingency, you pay nothing up until there is a settlement. Contact us today to learn how we can be of help.

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