Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Bangor, Maine

Medicare and Medicaid fraud cost Maine taxpayers billions of dollars annually. While most medical service providers and drug companies are ethical and work within the legal channels, there are those who don’t. When scams are perpetrated, everyone can lose. Medicaid and Medicare whistleblower attorneys assist healthcare professionals to submit lawsuits on behalf of the federal or state government to report this type of fraud.

The state and federal government place a good deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, it depends on every day people in Maine to come forward to report scams. People like you.

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Bangor, Maine

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the industry. understand 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 examine your claim, diligently prepare your case, and work relentlessly with you and the federal or state government to assist in bringing deceptive Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Bangor, Maine

One of the main functions of whistleblower laws is to fight 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 people who know of the deceitful activity to file a civil action on behalf of the government to recover damages, as well as fines. This allows individuals to step forward to reveal fraudulent activity and protects the whistleblower from retaliation by an employer.

 

Because the state state government has minimal resources available to combat healthcare fraud, they must frequently rely on people in the industry to come forward to report and submit a suit against those engaged in Medicaid fraud. This allows the state to recover losses and penalties while the whistleblower is rewarded for their work.

 

In Maine, whistleblower retaliation protection is provided through the Maine Whistleblowers’ Protection Act. Illegal retaliation against a staff member can lead to payment of any back wages, reinstatement of all fringe benefits, repayment of court costs, and any other expenses of litigation, in addition to any other relief ordered by the court.

Liability of the Defendant in Bangor, Maine

Under the federal False Claims Act, the offender might be liable for damages up to 3 times the amount of the fraud, with civil penalties of as much as $11,000 per incorrect claim offense and additional fines and penalties. In addition to any monetary charges, the defendant might be omitted from any future participation 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 suit are as follows:

 

The lawsuit needs to be filed no greater than 6 years after the date of the offense, or

no more than 3 years after the date when the infraction was found, or should have fairly been known, but not more than 10 years after the date that the infraction was committed.

Working With an Experienced Whistleblower Lawyer

If you learned of fraudulent Medicaid activity in Bangor, Maine, you ought to get immediate legal guidance from a top rated whistleblower attorney. Contact Khurana Law Firm for a confidential, no-cost assessment to discuss the components 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 are a healthcare worker in Bangor, 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 Bangor, Maine,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Bangor, Maine

If you’ve become aware of fraud involving Medicaid or Medicare in Bangor, Maine, you may need the guidance of an experienced whistleblower lawyer, someone who can ensure that your claim is totally investigated and filed accurately and promptly. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will step in, therefore increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is a complicated matter –  do not 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 help in your fight against Medicaid and Medicare fraud. Our attorneys will review your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we can represent you in a qui tam suit to report the fraud and enable you to gather a financial benefit. All whistleblower cases are on contingency, you pay nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

Service areas