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Medicaid and Medicare fraud cost NY State taxpayers billions of dollars every year. Although many medical companies and drug companies are ethical and work within the system, some do not. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower attorneys assist healthcare professionals to file claims on behalf of the government to report this sort of fraud.
The state and federal government put a lot of trust in pharmaceutical and medical providers. When that trust is ill-placed, it relies on every day people in New York to come forward and to report scams. People like you.
At Khurana Law Firm, P.C., as knowledgeable 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 easy and lots of things may 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, for court, and work relentlessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.
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:
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
Coders are directed to add codes based on other information in the chart.
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.
The MA provider reviews charts to add additional diagnosis codes.
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.
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 Troy, New York, get in touch with us here.
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.
Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.
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.
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.
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.
The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity.
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.
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 Troy, New York to report Medicare fraud, contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation.
When you become aware of potential fraud as it concerns Medicare or Medicaid in Troy, New York, you need the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is totally investigated and submitted accurately and without delay. By dealing with a skilled attorney you are increasing the chance that the government will step in, therefore increasing your chances for a reward. Reporting Medicare and Medicaid scams is a complex matter – do not 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 attorneys to help in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we can represent you in a qui tam lawsuit to report the fraud and enable you to collect a reward. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can help.
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