Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Illinois taxpayers billions of dollars annually. Although the majority of medical service providers and drug companies are ethical and work within the legal channels, some do not. When fraud happens, everyone can lose. Medicare and Medicaid whistleblower attorneys can help people who work in the healthcare system to submit suits on behalf of the federal or state government to help report this type of fraud.

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

Work with

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the industry. We know that stepping forward is difficult and numerous things may 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, and work relentlessly with you and the federal or state government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Peoria, Illinois

When a healthcare worker becomes discovers fraudulent activity against the Illinois state government Medicaid program, they have the right to submit a civil suit as whistleblowers under the Illinois False Claims Act.

 

This civil suit, on behalf of the government, holds those who perform fraudulent activity responsible 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 likewise allows people to come forward against scams perpetrated by private insurers.

 

State governments depend on individuals with awareness 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 usually have restricted resources to find fraudulent activity on their own, they rely on healthcare workers and will reward those individuals in return.

 

If the state takes up and prosecutes the matter, a whistleblower can be granted between 15 and 25 percent of any recovered funds. Even if the state opts not to step in and the whistleblower decides to continue by themselves, that whistleblower stands to receive in 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 Peoria, Illinois

In the state of Illinois, the defendant can be held responsible for approximately 3 times the actual harm inflicted to the state and may be ordered 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 file a suit within 10 years of the infraction date in order to be considered for a whistleblower claim.

Working With an Experienced Whistleblower Attorney

If you are a healthcare worker in Peoria, Illinois and have learned about deceitful activity against the Illinois state government, getting the legal advice of a skilled whistleblower lawyer is vital. At Khurana Law Firm, P.C., we are here to help. Contact us for a 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 Peoria, 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 Peoria, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Peoria, Illinois

If you’ve become aware of deceptive activity as it concerns Medicare or Medicaid in Peoria, Illinois, you may need the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is fully examined and filed accurately and promptly. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, therefore increasing the possibility for a reward. Reporting Medicare and Medicaid scams is a complex matter –  don’t 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 lawyers to assist in your battle against Medicaid and Medicare fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam claim to report the fraud and enable you to collect 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 be of help.

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