Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Maryland

Medicare and Medicaid fraud cost Maryland taxpayers billions of dollars every year. Although the majority of medical providers and drug companies are ethical and work within the system, there are those who do not. When fraud happens, everybody loses. Medicare and Medicaid whistleblower lawyers can assist healthcare professionals to file lawsuits on behalf of the government to report this type of fraud.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Maryland.

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that stepping forward is difficult and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Maryland

The Maryland False Health Claims Act makes persons who present false claims related to Maryland state health plans or programs, including Medicaid,k liable for their actions. In 2015, the Maryland False Claims Act was enacted to expand the scope of the False Health Claims Act to allow individuals who have knowledge of fraud against the government outside of the healthcare context the ability to come forward with a qui tam lawsuit.  

 

A whistleblower lawsuit is a civil lawsuit brought by an individual on behalf of the state to collect from parties that knowingly present false claims or otherwise defraud state programs for their own gain.

 

In a qui tam lawsuit, a whistleblower acts as the claimant to hold these parties accountable for their actions. Maryland law requires that the suit also be entered into by the government in order for it to go forward. This allows the government the ability to recover funds that it lost as a result of the fraudulent activity as well as penalties and fines.

Whistleblower Protection in Maryland

Under whistleblower laws, the person reporting the fraudulent activity is protected from retaliation by an employer. The whistleblower may also be awarded a reward of between 15 and 25 percent of the amount of the recovery.

Liability of the Defendant in Maryland

Under the Maryland False Claims Act as well as Maryland’s False Health Claims Act, a defendant can be ordered to pay the government damages in the amount of up to three times the amount of harm to the state. The defendant can also be ordered to pay fines of up to $10,000 per violation.

Statute of Limitations in Maryland

In Maryland, a plaintiff must file a whistleblower claim within ten years of the violation.

Working With an Experienced Whistleblower Attorney

If you have knowledge of fraud against the state of Maryland, contact the experienced whistleblower attorneys at Khurana Law Firm for a confidential, no-cost consultation to discuss your case. You may be entitled to a substantial reward for your efforts.

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 fraudulent activity that may concern Medicaid or Medicare, you need the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is totally examined and filed accurately and promptly. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, therefore increasing the chance for a reward. Reporting Medicare and Medicaid scams 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 lawyers to assist in your battle against Medicare and Medicaid fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and enable you to collect a financial benefit. All whistleblower work is on contingency, you pay nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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