Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Illinois taxpayers billions of dollars annually. Although the majority of medical companies and drug companies are honest and work within the legal channels, there are those who don’t. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower attorneys can assist healthcare professionals to submit claims on behalf of the government to report this sort of fraud.

The state and federal governments put a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government depends on regular folks in Illinois to come forward and to report scams. People like you.

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare employees in Oak Lawn, Illinois

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and fraud in the market. We know that coming forward is not simple and lots of things might be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, and work relentlessly with you and the state of federal government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Oak Lawn, Illinois

When a person becomes aware of potentially fraudulent activity against the Illinois state government Medicaid program, they have the right to submit 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 fraudulent activity accountable for their deceptive practices and recovers the financial loss to the state.

 

In addition to the Illinois False Claims Act, the Illinois Insurance Claims Fraud Prevention Act likewise permits people to come forward against fraud perpetrated by private insurance providers.

 

State governments rely 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 carry out those offenses. Due to the fact that states usually have limited resources to find fraudulent activity on their own, they rely heavily on healthcare workers and will reward those individuals in return.

 

If the state steps in 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 elects to proceed 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 protects the whistleblower against retaliation when they have filed a claim against their employer.

Liability of the Defendant in Oak Lawn, Illinois

In the state of Illinois, the offender can be held responsible for approximately three times the actual damage inflicted to the state and might be ordered to pay extra fines of between $5,000 and $11,000 per offense.

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 offense date in order to be considered for a whistleblower claim.

Dealing with an Experienced Whistleblower Attorney

If you are a healthcare worker in Oak Lawn, Illinois and have become aware of deceptive activity against the government, getting the legal guidance of a knowledgeable whistleblower lawyer is critical. At Khurana Law Firm, P.C., we are here to help. 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 Oak Lawn, 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 Oak Lawn, 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 Oak Lawn, Illinois

If you’ve become aware of fraud that may concern Medicaid or Medicare in Oak Lawn, Illinois, you may need the guidance of a skilled whistleblower lawyer, someone who can make sure that your claim is totally investigated and submitted accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the government will intervene, therefore increasing the chance for a reward. Reporting Medicare and Medicaid 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 prior experience as national qui tam attorneys to help in your battle against Medicaid and Medicare fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam claim to report the scams and enable you to gather a reward. 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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