Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Evanston, Illinois

Medicare and Medicaid fraud cost Illinois taxpayers billions of dollars every year. While many medical companies and drug companies are ethical and work within the legal channels, some don’t. When fraud occurs, everyone can lose. Medicaid and Medicare whistleblower attorneys assist people who work in the healthcare system to file claims on behalf of the government to help report these kinds of scams.

The federal and state government put a great deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, it depends on every day people in Illinois to come forward and to report scams. People like you.

Work with

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

At Khurana Law Firm, P.C., as skilled 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 not simple and numerous things may 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 thoroughly investigate your claim, carefully prepare your case, and work relentlessly with both you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Evanston, Illinois

When a healthcare worker becomes aware of potentially fraudulent activity against the Illinois state government Medicaid program, they may file a civil claim as whistleblowers under the Illinois False Claims Act.

 

This civil suit, filed on behalf of the state government, holds those who carry out deceitful 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 permits people to come forward against scams committed by private insurers.

 

State governments count 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 commit those violations. Due to the fact that states usually have limited resources to find fraudulent activity on their own, the state rely heavily on individuals and will reward them in return.

 

If the state takes up and prosecutes the matter, a whistleblower can be awarded in 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 financial recovery as a reward.

 

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

Liability of the Defendant in Evanston, Illinois

In the state of Illinois, the accused can be held responsible for as much as 3 times the actual harm caused to the state and might be required to pay additional fines of in between $5,000 and $11,000 per infraction.

Statute of Limitations in Illinois

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

Working With an Experienced Whistleblower Attorney

If you are a healthcare worker in Evanston, Illinois and have become aware of deceptive activity against the government, getting the legal guidance of a knowledgeable whistleblower attorney is critical. At Khurana Law Firm, P.C., we are here to assist. Contact us for a completely 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 Evanston, 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 Evanston, 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 LAWYER; We are proud to represent healthcare workers in Evanston, Illinois

If you’ve become aware of potential fraud that may concern Medicare or Medicaid in Evanston, Illinois, you require the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is fully investigated and filed accurately and promptly. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, therefore increasing your chances for a reward. Reporting Medicare and Medicaid scams 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 practical experience as national qui tam lawyers to assist in your battle against Medicaid and Medicare fraud. Our attorneys will review your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we can represent you in a qui tam suit to help report the scams and enable you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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