Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Palatine, Illinois

Medicare and Medicaid fraud cost Illinois taxpayers billions of dollars each year. While most medical service providers and drug companies are ethical and work within the legal channels, some don’t. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower lawyers can assist people who work in the healthcare system to file claims on behalf of the federal or state government to help report these kinds of scams.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic choice to come forward to report abuse and scams in the market. We know that stepping forward is not easy and many things may 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 thoroughly examine your claim, carefully prepare your case, and work tirelessly with both you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Palatine, Illinois

When a person becomes discovers 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 recovers the financial 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 fraud committed by private insurers.

 

State governments depend on individuals with knowledge of fraud to come forward with that information in order to hold fraudulent activity in check and to punish those who carry out those violations. Because states typically have limited resources to find fraudulent activity on their own, they rely heavily on people 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 recovered funds. Even if the state declines and the whistleblower decides to continue on their own, that whistleblower stands to receive in between 25 and 30 percent of the recovery as a reward for their actions.

 

The Illinois False Claims Act likewise secures the whistleblower against retaliation when they have filed a claim against their employer.

Liability of the Defendant in Palatine, Illinois

In the state of Illinois, the accused can be held responsible for approximately three times the actual damage caused to the state and might be required to pay extra 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 an individual in Illinois. Plaintiffs should submit a suit within 10 years of the infraction date in order to be considered for a whistleblower claim.

Dealing with an Experienced Whistleblower Attorney

If you are a healthcare worker in Palatine, Illinois and have learned about deceptive activity against the Illinois state government, getting the legal advice of a knowledgeable whistleblower lawyer is vital. 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 Palatine, 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 Palatine, 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Palatine, Illinois

When you become aware of fraud as it concerns Medicare or Medicaid in Palatine, Illinois, you need the advice of an experienced whistleblower lawyer, someone who can make sure that your claim is fully investigated and filed accurately and quickly. By dealing with a skilled attorney you are increasing the chance that the federal or state government will step in, hence increasing the chance for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam lawyers to help in your fight against Medicare and Medicaid fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we may represent you in a qui tam claim to help report the scams and enable you to gather a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to learn how we can be of help.

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