Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Clinton charter township, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars every year. While the majority of medical service providers and drug companies are honest and work within the system, there are those who do not. When fraud occurs, everybody can lose. Medicare and Medicaid whistleblower attorneys assist healthcare workers to file suits on behalf of the government to help report this sort of fraud.

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

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Clinton charter township, Michigan

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the market. understand that coming forward is challenging and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Clinton charter township, Michigan

Michigan loses countless dollars each year in Medicaid scams and counts on individuals to come forward with info relating to fraudulent activity. In the state of Michigan, whistleblowers can file civil claims against companies and people who present false or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is likewise prohibited to pay or get money in exchange for referrals reimbursed by Medicaid.

 

The Act makes it possible for the whistleblower to file a qui tam claim against the parties on behalf of the government in order to recover funds lost due to scams. When the state government enters the suit, a whistleblower can get benefits in the amount of between 15 and 25 percent of the recovery to the state. If the state selects not to enter into the suit, the whistleblower might be granted between 25% and 30%  of the sum recovered.

 

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

Liability of the Defendant in Clinton charter township, Michigan

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

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower should file their complaint within ten years of the date of the violation.

Working With an Experienced Whistleblower Lawyer

While the decision to come forward can be a hard one, there is protection afforded under whistleblower laws. If you have information as it relates to Medicaid fraud in Clinton charter township, Michigan, we can offer guidance and information on what it means to be a whistleblower and how you are protected under the law. Contact the experienced whistleblower attorneys at Khurana Law Firm for a completely confidential, no-cost consultation to talk about a possible 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 Clinton charter township, 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 Clinton charter township, 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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Work With An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Clinton charter township, Michigan

If you’ve become aware of potential fraud involving Medicaid or Medicare in Clinton charter township, Michigan, you require the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is fully examined and submitted accurately and immediately. By working with a skilled lawyer you are increasing the chance that the federal or state government will step in, hence increasing the opportunity for a financial reward. Reporting Medicare and Medicaid scams is an intricate 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 attorneys to assist in your fight against Medicaid and Medicare fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and enable you to gather a reward. Because all whistleblower work is on contingency, you pay nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

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