Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in Maine

Medicare and Medicaid fraud cost Maine taxpayers billions of dollars annually. While the majority of medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys can help healthcare professionals to file lawsuits on behalf of the federal or state government to help report these kinds of scams.

The state and federal governments place a a good deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government relies on private citizens in Maine to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Maine.

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and fraud in the market. understand that coming forward is difficult and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, and work tirelessly with both you and the federal or state government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Maine

One of the main purposes of whistleblower laws is to combat fraud and abuse in Medicaid programs in the state of Maine. When healthcare providers submit false claims or perpetrate fraud, the False Claims Act makes it possible for individuals who are aware of the fraudulent activity to file a civil action on behalf of the government to recover damages as well as penalties. This enables individuals to come forward to disclose fraudulent activity and protects them from retaliation by an employer. 

Because the state government has minimal resources available to combat healthcare fraud, they must often rely on individuals in the industry to come forward to report and file suit against Medicaid fraud. This allows the state to recover losses and penalties while the whistleblower is rewarded for their trouble.

In Maine, whistleblower retaliation protection is afforded through the Maine Whistleblowers’ Protection Act. Unlawful retaliation against an employee can result in 

  • Payment of any back wages
  • Reinstatement of all fringe benefits
  • Court costs and any other expenses of litigation
  • Any other possible relief ordered by the court.

If you are a New Hampshire healthcare worker, get in touch with New Hampshire Medicare Whistleblower attorney.

Liability of the Defendant in Maine

Under the federal False Claims Act, the defendant may be liable for damages up to three times the amount of the fraud, with civil penalties of up to $11,000 per false claim violation and additional fines and penalties. In addition to any monetary penalties, the defendant may be excluded from any future participation in government programs such as Medicaid.

Statute of Limitations in Maine

Under the federal False Claims Act, the statute of limitations for filing a qui tam suit are as follows:

 

  • The complaint must be filed no more than 6 years after the date of the violation, or
  • No more than 3 years after the date when the violation was discovered, or should have reasonably been known, but not more than 10 years after the date that the violation was committed.

Working With an Experienced Whistleblower Attorney

If you have knowledge of fraudulent Medicaid activity in the state of Maine, you should get immediate legal guidance from a professional whistleblower attorney. Contact Khurana Law Firm for a confidential, no-cost consultation to discuss the elements of 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 can report it 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. To report Medicare fraud, 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

When you become aware of fraud involving Medicare or Medicaid, you need the guidance of a skilled whistleblower lawyer, someone who can ensure that your claim is completely investigated and filed accurately and promptly. By working with a skilled lawyer you are increasing the chance that the government will intervene, thus increasing the possibility for a financial reward. Reporting Medicare and Medicaid 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. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we believe that you have a legitimate claim, we can represent you in a qui tam suit to report the fraud and enable you to gather a financial benefit. Because all whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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