Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Oak Park, Illinois

Medicare and Medicaid fraud cost Illinois taxpayers billions of dollars annually. Although many medical service providers and drug companies are honest and work within the system, there are those who do not. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to submit suits on behalf of the government to help report these kinds of scams.

The federal and state governments put a great deal of trust in medical and pharmaceutical 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.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Oak Park, Illinois

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and scams in the industry. We know that stepping forward is not easy and lots of things may 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 investigate your claim, diligently and carefully prepare your case, and work relentlessly with you and the state of federal government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Oak Park, Illinois

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

 

This civil suit, filed on behalf of the state government, holds those who perform fraudulent activity accountable 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 individuals to come forward against fraud perpetrated by private insurance providers.

 

State governments depend on people 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 violations. Since states normally have restricted 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 granted in 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 receive 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 submitted a claim against their employer.

Liability of the Defendant in Oak Park, Illinois

In the state of Illinois, the accused can be held accountable for approximately three times the actual harm caused to the state and may be ordered to pay extra fines of in between $5,000 and $11,000 per offense.

Statute of Limitations in Illinois

There is a statute of restrictions for the filing of a whistleblower claim by a private individual in Illinois. Plaintiffs should 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 Oak Park, Illinois and have become aware of deceptive activity against the state government, getting the legal advice of a knowledgeable whistleblower lawyer is important. At Khurana Law Firm, P.C., we are here to assist. 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 Oak Park, 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 Park, 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 Park, Illinois

If you’ve become aware of deceitful activity that may involve Medicaid or Medicare in Oak Park, 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 promptly. By dealing with an experienced attorney you are increasing the chance that the government will intervene, therefore increasing the chance for a reward. Reporting Medicare and Medicaid fraud is an intricate matter –  don’t try 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 help in your fight against Medicare and Medicaid fraud. Our attorneys will review your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we can represent you in a qui tam lawsuit to report the scams and enable you to gather a reward. All whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to learn how we can be of help.

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