Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Springfield, 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 legal channels, there are those who don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys can assist healthcare professionals to submit claims on behalf of the federal or state government to help report these kinds of scams.

The federal and state governments put a great deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government relies on every day people in Illinois to come forward to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Springfield, Illinois

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic choice to come forward to report abuse and scams in the industry. We know that coming forward is hard and numerous things might be at stake. When you come to us, your case is held in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Springfield, Illinois

When a healthcare worker becomes discovers 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 lawsuit, on behalf of the government, holds those who perform deceitful activity accountable for their deceptive practices and helps recover the loss to the state.

 

In addition to the Illinois False Claims Act, the Illinois Insurance Claims Fraud Prevention Act likewise permits private individuals to come forward against scams committed by private insurance companies.

 

State governments count on people with knowledge of fraud to come forward with that knowledge in order to hold fraudulent activity in check and to penalize those who commit those infractions. Because states usually have restricted resources to find fraudulent activity on their own, the state rely on individuals and will reward those individuals in return.

 

If the state takes up and prosecutes the matter, a whistleblower can be awarded between 15 and 25 percent of any recoveries. Even if the state declines and the whistleblower elects to continue by themselves, that whistleblower stands to receive in between 25 and 30 percent of the recovery as a reward.

 

The Illinois False Claims Act likewise safeguards the whistleblower against retaliation when they have submitted a claim against their company.

Liability of the Defendant in Springfield, Illinois

In the state of Illinois, the accused can be held responsible for as much as three times the actual damage inflicted to the state and might be required to pay additional fines of in between $5,000 and $11,000 per infraction.

Statute of Limitations in Illinois

There is a statute of limitations for the filing of a whistleblower claim by a private individual in Illinois. Complainants 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 Springfield, Illinois and have learned about deceitful activity against the state government, getting the legal recommendations of a skilled whistleblower attorney is critical. At Khurana Law Firm, P.C., we are here to assist. 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 Springfield, 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 Springfield, 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Springfield, Illinois

If you’ve become aware of deceitful activity that may involve Medicare or Medicaid in Springfield, Illinois, you may need the advice of a skilled whistleblower attorney, someone who can guarantee that your claim is fully investigated and filed accurately and quickly. By dealing with a knowledgeable attorney you are increasing the chance that the government will step in, therefore increasing your chances for a reward. Reporting Medicaid and Medicare fraud is a complex 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 battle against Medicare and Medicaid fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we can represent you in a qui tam suit to report the fraud and allow you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can be of help.

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