Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Lewiston, Maine

Medicare and Medicaid fraud cost Maine taxpayers billions of dollars every year. While the majority of medical providers and drug companies are honest and work within the system, some don’t. When scams are perpetrated, everybody can lose. Medicaid and Medicare whistleblower lawyers can help people who work in the healthcare system to file suits on behalf of the federal or state government to help report these kinds of scams.

The state and federal government place a great deal of trust in medical and pharmaceutical service 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 Lewiston, Maine

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

With our comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, and work relentlessly with both 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 Lewiston, Maine

Among the primary functions of whistleblower laws is to fight scams and abuse in Medicaid programs in the state of Maine. When health care suppliers submit false claims or perpetrate fraud, the False Claims Act makes it possible for people who are aware of the fraudulent activity to submit a civil action on behalf of the state government to recover damages, in addition to fines. This law enables individuals to step forward to reveal fraudulent activity and protects them from retaliation by a company.

 

Because the state government has minimal resources available to fight health care scams, they may often count on people in the industry to step forward to report and file a suit against those perpetrating Medicaid scams. This allows the state to recuperate losses and penalties while the whistleblower is rewarded for their trouble.

 

In Maine, whistleblower retaliation protection is provided through the Maine Whistleblowers’ Protection Act. Unlawful retaliation against a worker can lead to payment of any back earnings, reinstatement of all benefits, repayment of court costs, and any other expenses of litigation, as well as any other possible relief ordered by the court.

Liability of the Defendant in Lewiston, 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 charges of as much as $11,000 per incorrect claim violation and extra fines and penalties. In addition to any financial penalties, the offender 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 suit are as follows:

 

The lawsuit must be filed no more than 6 years after the date of the violation, or

no greater than 3 years after the date when the offense was discovered, or ought to have reasonably been known, but not more than 10 years after the date that the offense was committed.

Working With an Experienced Whistleblower Attorney

If you have knowledge of fraudulent Medicaid activity in Lewiston, Maine, you should get immediate legal guidance from an experienced whistleblower attorney. Contact Khurana Law Firm for a completely 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 are a healthcare worker in Lewiston, 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 Lewiston, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Lewiston, Maine

When you become aware of fraud that may involve Medicare or Medicaid in Lewiston, Maine, you require the guidance of a knowledgeable whistleblower attorney, someone who can ensure that your claim is fully investigated and filed accurately and promptly. By dealing with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing the chance for a financial reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam legal representatives to help in your fight against Medicaid and Medicare fraud. We will review your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam suit to help report the scams and enable you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to to schedule a confidential consultation.

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