Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Ann Arbor city, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars every year. While the majority of 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 lawyers can assist people who work in the healthcare system to file suits on behalf of the government to report these kinds of scams.

The federal and state government place a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it counts on every day people in Michigan to come forward to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Ann Arbor city, Michigan

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the market. We know that stepping forward is hard and lots of things may be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Ann Arbor city, Michigan

Michigan loses countless dollars each year in Medicaid fraud and depends on private citizens to step forward with details concerning deceitful activity. In the state of Michigan, whistleblowers can file civil lawsuits against companies and people who provide incorrect or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also unlawful to pay or receive funds in exchange for referrals paid by Medicaid.

 

The Act allows the whistleblower to file a qui tam lawsuit against the parties on behalf of the government so as to recuperate funds lost due to fraud. When the government joins the suit, a whistleblower can receive benefits in the amount of between 15 and 25 percent of the funds recovered to the state. If the state elects not to enter into the suit, the whistleblower might be awarded between 25 and 30 percent  of the financial recovery.

 

Under whistleblower laws, the whistleblower is likewise protected from any company retaliation against them in producing a lawsuit.

Liability of the Defendant in Ann Arbor city, Michigan

If an accused is found guilty of defrauding the state, they may be ordered to pay up to triple the dollar amount of actual damage that they caused, in addition to fines of in between $5,000 and $10,000 per private infraction.

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower needs to submit their problem within 10 years of the date of the violation.

Working With an Experienced Whistleblower Attorney

While the decision to come forward can be a hard one, there is protection afforded under whistleblower laws. If you have information concerning Medicaid fraud in Ann Arbor city, Michigan, we can provide guidance and helpful information on what it means to be a whistleblower and how you are safeguarded under the law. Contact the skilled whistleblower attorneys at Khurana Law Firm for a confidential, no-cost consultation and to go over a prospective whistleblower claim.

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 Ann Arbor city, Michigan, 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 Ann Arbor city, Michigan,  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 Ann Arbor city, Michigan

If you’ve become aware of potential fraud that may involve Medicare or Medicaid in Ann Arbor city, Michigan, you need the advice of a skilled whistleblower attorney, someone who can guarantee that your claim is totally investigated and filed accurately and promptly. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, thus increasing the chance for a reward. Reporting Medicare and Medicaid fraud is an intricate matter –  do not 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 help in your battle against Medicaid and Medicare fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we can represent you in a qui tam suit to help report the scams and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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