Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Mount Prospect, Illinois

Medicaid and Medicare fraud cost Illinois taxpayers billions of dollars every year. Although most medical service providers and drug companies are honest and work within the system, there are those who don’t. When fraud happens, everyone loses. Medicare and Medicaid whistleblower lawyers assist healthcare workers to submit suits on behalf of the federal or state government to help report this sort of fraud.

The federal and state governments put a good deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, the government depends on private citizens in Illinois to come forward and to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Mount Prospect, Illinois

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the market. We know that stepping forward is not easy 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 substantial experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, and work relentlessly with both you and the state of federal government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Mount Prospect, Illinois

When an individual becomes discovers fraudulent activity against the Illinois state government Medicaid program, they can file a civil claim as whistleblowers under the Illinois False Claims Act.

 

This civil lawsuit, on behalf of the state government, holds those who carry out deceptive activity liable 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 also permits individuals to come forward against scams perpetrated by private insurance providers.

 

State governments depend on people with knowledge of fraud to come forward with that information in order to hold fraudulent activity in check and to penalize those who commit those infractions. Due to the fact that states normally have limited resources to find fraudulent activity on their own, they rely heavily on people 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 recovered funds. Even if the state declines and the whistleblower decides to continue on their own, that whistleblower stands to receive between 25 and 30 percent of the 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 Mount Prospect, Illinois

In the state of Illinois, the accused can be held liable for up to three times the actual damage inflicted to the state and may 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 limitations for the filing of a whistleblower claim by a private individual in Illinois. Plaintiffs need to file a lawsuit 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 Mount Prospect, Illinois and have learned about fraudulent activity against the state government, getting the legal recommendations of a skilled whistleblower lawyer is critical. At Khurana Law Firm, P.C., we are here to assist. Contact us for a 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 Mount Prospect, 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 Mount Prospect, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Mount Prospect, Illinois

If you’ve become aware of deceitful activity that may concern Medicare or Medicaid in Mount Prospect, Illinois, you require the advice of an experienced whistleblower lawyer, someone who can guarantee that your claim is fully examined and filed accurately and immediately. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing your chances for a financial reward. Reporting Medicare and Medicaid scams is a complicated 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 legal representatives to assist in your fight against Medicare and Medicaid scams. We will review your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we may represent you in a qui tam suit to report the scams and enable you to gather a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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