Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Auburn, Maine

Medicare and Medicaid fraud cost Maine taxpayers billions of dollars annually. Although most medical providers and drug companies are ethical and work within the system, there are those who do not. When fraud takes place, everyone loses. Medicare and Medicaid whistleblower attorneys can help people who work in the healthcare system to file claims on behalf of the government to help report this sort of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Auburn, Maine

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and scams in the market. understand that stepping forward is difficult and numerous things might be at stake. When you come to us, your case is held in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, diligently prepare your case, and work relentlessly with you and the state of federal government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Auburn, Maine

Among the primary functions of whistleblower laws is to fight fraud and abuse in Medicaid programs in the state of Maine. When health care service providers submit incorrect claims or perpetrate fraud, the False Claims Act makes it possible for healthcare workers who know of the fraudulent activity to file a civil action on behalf of the state government to recover damages, along with fines. This makes it possible for people to step forward to disclose deceitful activity and protects the whistleblower from retaliation by a company.

 

Since the state state government has minimal resources out there to combat health care scams, they must often rely on people in the industry to come forward to report and file a suit against those perpetrating Medicaid scams. This enables the state to recuperate losses while the whistleblower is rewarded for their trouble.

 

In Maine, whistleblower retaliation protection is afforded through the Maine Whistleblowers’ Protection Act. Illegal retaliation against a worker can result in payment of any back wages, reinstatement of all fringe benefits, repayment of court expenses, and any other expenditures of litigation, as well as any other relief ordered by the court.

Liability of the Defendant in Auburn, Maine

Under the federal False Claims Act, the accused may be liable for damages up to three times the dollar amount of the fraud, with civil penalties of up to $11,000 per false claim offense and extra fines and penalties. In addition to any financial charges, the accused might be left out from any future involvement in state 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 lawsuit are as follows:

 

The complaint must be submitted no greater than 6 years after the date of the violation, or

no more than 3 years after the date when the violation was found, or must have reasonably been known, however not more than 10 years after the date that the offense was committed.

Working With an Experienced Whistleblower Attorney

If you learned of deceitful Medicaid activity in Auburn, Maine, you ought to get prompt legal guidance from an experienced whistleblower lawyer. Contact Khurana Law Firm for a completely confidential, no-cost consultation to discuss the components of your specific 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 Auburn, Maine, 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 Auburn, Maine,  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 Auburn, Maine

When you become aware of fraud that may involve Medicaid or Medicare in Auburn, Maine, you require the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is fully examined and submitted accurately and without delay. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, hence increasing the chance for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam attorneys to assist in your fight against Medicaid and Medicare fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam suit to report the scams and allow you to collect a financial benefit. Because all whistleblower work is 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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