Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Illinois taxpayers billions of dollars every year. Although most medical companies and drug companies are ethical and work within the system, some do not. When fraud happens, everybody can lose. Medicare and Medicaid whistleblower attorneys can help people who work in the healthcare system to file lawsuits on behalf of the government to help report these kinds of scams.

The state and federal government place a great deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government relies on regular folks in Illinois to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare workers in Hoffman Estates, Illinois

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the industry. We know that coming forward is hard 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 thoroughly examine your claim, carefully prepare your case, for court, and work tirelessly with both you and the federal or state government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Hoffman Estates, Illinois

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

 

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

 

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

 

State governments rely on individuals with knowledge of scams to come forward with that knowledge in order to hold fraudulent activity in check and to punish those who carry out those infractions. Due to the fact that states typically have limited resources to find fraud on their own, they rely heavily on healthcare workers and will reward them in return.

 

If the state steps in and prosecutes the matter, a whistleblower can be awarded between 15 and 25 percent of any recoveries. Even if the state opts not to step in and the whistleblower chooses to proceed by themselves, 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 filed a claim against their company.

Liability of the Defendant in Hoffman Estates, Illinois

In the state of Illinois, the offender can be held responsible for up to 3 times the actual harm caused to the state and may be required to pay extra fines of in 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 a private individual in Illinois. Plaintiffs should submit a suit 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 Hoffman Estates, Illinois and have become aware of fraudulent activity against the government, getting the legal recommendations of a skilled whistleblower attorney is crucial. At Khurana Law Firm, P.C., we are here to help. 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 Hoffman Estates, 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 Hoffman Estates, 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 Hoffman Estates, Illinois

If you’ve become aware of potential fraud that may concern Medicare or Medicaid in Hoffman Estates, Illinois, you need the advice of a knowledgeable whistleblower attorney, someone who can guarantee that your claim is completely investigated and submitted accurately and immediately. By working with an experienced attorney you are increasing the chance that the federal or state government will intervene, thus increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is a complex 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 legal representatives to assist in your battle against Medicare and Medicaid fraud. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we may represent you in a qui tam lawsuit to help report the scams and enable you to collect a reward. Because all whistleblower work is 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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