Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Dearborn Heights, Michigan

Medicaid and Medicare fraud cost Michigan taxpayers billions of dollars each year. Although most medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud happens, everyone can lose. Medicare and Medicaid whistleblower lawyers help healthcare workers to submit lawsuits on behalf of the government to report this sort of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Dearborn Heights, Michigan

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the market. We know that coming forward is difficult and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, and work tirelessly with both 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 Dearborn Heights, Michigan

Michigan loses millions of dollars each year in Medicaid scams and depends on private citizens to step forward with details concerning deceptive activity. In the state of Michigan, whistleblowers can submit civil claims against businesses and individuals who provide false or deceptive claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also prohibited to pay or receive money in exchange for recommendations paid by Medicaid.

 

The Act makes it possible for the whistleblower to submit a qui tam claim against the parties on behalf of the government so as to recuperate funds lost due to scams. When the government enters the lawsuit, 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 participate in the suit, the whistleblower might be granted between 25% and 30%  of the sum recovered.

 

Under whistleblower laws, the whistleblower is also safeguarded from any employer retaliation against them in producing a lawsuit.

Liability of the Defendant in Dearborn Heights, Michigan

If an offender is found guilty of defrauding the state, they might be ordered by the court to pay up to triple the amount of real harm that they caused, in addition to fines of in between $5,000 and $10,000 per specific violation.

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower must submit their problem within 10 years of the date of the offense.

Working With an Experienced Whistleblower Lawyer

While the choice to come forward can be a challenging one, there is protection afforded under whistleblower laws. If you have information regarding Medicaid scams in Dearborn Heights, Michigan, we can provide guidance and helpful information on what it means to be a whistleblower and how you are secured under the law. Contact the skilled whistleblower attorneys at Khurana Law Firm for a completely confidential, no-cost consultation to talk about 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 Dearborn Heights, 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 Dearborn Heights, 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 ATTORNEY; We are proud to represent healthcare workers in Dearborn Heights, Michigan

When you become aware of fraud that may concern Medicaid or Medicare in Dearborn Heights, Michigan, you need the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is fully examined and filed accurately and promptly. By working with an experienced lawyer you are increasing the chance that the government will intervene, thus increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not try 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 attorneys to assist in your battle against Medicaid and Medicare fraud. After you get in touch our lawyers will examine 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 lawsuit to help report the scams and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to learn how we can be of help.

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