Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Dearborn, Michigan

Medicaid and Medicare fraud cost Michigan taxpayers billions of dollars every year. While many medical companies and drug companies are ethical and work within the system, there are those who do not. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower lawyers can assist healthcare workers to file claims on behalf of the federal or state government to help report this type of fraud.

The federal and state governments put a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it depends on regular folks in Michigan to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Dearborn, 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 fraud in the market. understand that stepping forward is challenging 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 examine your claim, diligently prepare your case, for court, and work relentlessly with you and the state of federal government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Dearborn, Michigan

Michigan loses countless dollars each year in Medicaid fraud and depends on individuals to step forward with information regarding fraudulent activity. In the state of Michigan, whistleblowers can submit civil suits against companies and people who provide false or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also illegal to pay or receive funds in exchange for referrals paid by Medicaid.

 

The Act enables the whistleblower to submit a qui tam suit against the parties on behalf of the state government in order to recover funds lost due to fraud. When the government joins the lawsuit, a whistleblower can receive rewards in the amount of between 15 and 25 percent of the recovery to the state. If the state picks not to get into the suit, the whistleblower might be granted between 25% and 30%  of the recovery.

 

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

Liability of the Defendant in Dearborn, Michigan

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

Statute of Limitations in Michigan

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

Working With an Experienced Whistleblower Attorney

While the choice to come forward can be a hard one, there is protection afforded under whistleblower laws. If you have information relating to Medicaid scams in Dearborn, Michigan, we can provide guidance and information on what it means to be a whistleblower and how you are protected under the law. Contact the knowledgeable whistleblower lawyers at Khurana Law Firm for a completely confidential, no-cost consultation to talk about a potential 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, 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, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Dearborn, Michigan

When you become aware of fraud that may involve Medicaid or Medicare in Dearborn, Michigan, you need the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is totally examined and submitted accurately and quickly. By working with a skilled attorney you are increasing the chance that the government will intervene, therefore increasing your chances for a financial reward. Reporting Medicare and Medicaid scams is a complicated matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam attorneys to assist in your battle against Medicaid and Medicare scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we can represent you in a qui tam suit to report the fraud and enable you to collect a reward. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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