Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Portland, Maine

Medicare and Medicaid fraud cost Maine taxpayers billions of dollars every year. While most medical service providers and drug companies are ethical and work within the legal channels, some do not. When scams are perpetrated, everybody loses. Medicaid and Medicare whistleblower lawyers can help healthcare professionals to file suits on behalf of the government to report this sort of fraud.

The federal and state governments place a lot of trust in pharmaceutical and medical companies. When that trust is ill-placed, it counts on regular folks in Maine to come forward to report fraud. People like you.

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the industry. understand that stepping forward is hard and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Portland, Maine

Among the primary functions of whistleblower laws is to combat fraud and abuse in Medicaid programs in the state of Maine. When healthcare companies send incorrect claims or perpetrate fraud, the False Claims Act makes it possible for individuals who know of the fraudulent activity to submit a civil action on behalf of the government to recover damages, along with penalties. This law enables individuals to step forward to reveal deceptive activity and secures the whistleblower from retaliation by a company.

 

Since the state government has minimal resources out there to combat healthcare scams, they must often depend on individuals in the industry to come forward to report and file a suit against those engaged in Medicaid scams. This permits the state to recuperate losses and penalties 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 earnings, reinstatement of all fringe benefits, repayment of court expenses, and any other expenditures of lawsuits, as well as any other possible relief ordered by the court.

Liability of the Defendant in Portland, Maine

Under the federal False Claims Act, the accused may be responsible for damages up to 3 times the dollar amount of the fraud, with civil charges of up to $11,000 per incorrect claim offense and additional fines and charges. In addition to any monetary charges, the accused may be left out 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 lawsuit are as follows:

 

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

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

Working With an Experienced Whistleblower Lawyer

If you have knowledge of deceptive Medicaid activity in Portland, Maine, you should get immediate legal guidance from an experienced whistleblower lawyer. Contact Khurana Law Firm for a confidential, no-cost consultation to and talk about 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 Portland, 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 Portland, 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Portland, Maine

When you become aware of deceitful activity involving Medicaid or Medicare in Portland, Maine, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can guarantee that your claim is totally investigated and filed accurately and promptly. By dealing with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, thus increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is a complex 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 legal representatives to help in your fight against Medicare and Medicaid fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam claim to report the scams and enable you to collect a reward. All whistleblower work is on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can be of help.

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