Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Farmington Hills, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars each year. Although most medical service providers and drug companies are ethical and work within the system, some do not. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower attorneys assist people who work in the healthcare system to submit claims on behalf of the federal or state government to report this sort of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Farmington Hills, Michigan

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the industry. We know that coming forward is challenging and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently and carefully prepare your case, and work relentlessly with both 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 Farmington Hills, Michigan

Michigan loses millions of dollars each year in Medicaid fraud and depends on individuals to come forward with details regarding fraudulent activity. In the state of Michigan, whistleblowers can submit civil lawsuits against companies and individuals who present false or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also illegal to pay or get money in exchange for referrals reimbursed by Medicaid.

 

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

 

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

Liability of the Defendant in Farmington Hills, Michigan

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

Statute of Limitations in Michigan

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

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 regarding Medicaid scams in Farmington Hills, Michigan, we can offer guidance and helpful information on what it means to be a whistleblower and how you are safeguarded under the law. Contact the experienced whistleblower lawyers at Khurana Law Firm for a confidential, no-cost consultation and to go over 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 Farmington Hills, 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 Farmington Hills, 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 Farmington Hills, Michigan

If you’ve become aware of deceitful activity that may concern Medicare or Medicaid in Farmington Hills, Michigan, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can guarantee that your claim is completely investigated and submitted accurately and without delay. By dealing with a knowledgeable attorney you are increasing the chance that the government will step in, hence increasing the opportunity for a 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 have years of practical experience as national qui tam attorneys to assist in your battle against Medicaid and Medicare scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam claim to help report the fraud and enable you to gather a reward. All whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to learn how we can help.

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