Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Grand Rapids city, Michigan

Medicaid and Medicare fraud cost Michigan taxpayers billions of dollars each year. While the majority of medical service providers and drug companies are honest and work within the legal channels, some do not. When fraud happens, everybody loses. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to submit suits on behalf of the federal or state government to help report these kinds of scams.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Grand Rapids city, Michigan

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that stepping forward is not simple and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Grand Rapids city, Michigan

Michigan loses countless dollars each year in Medicaid scams and depends on private citizens to come forward with information regarding fraudulent activity. In the state of Michigan, whistleblowers can submit civil claims against companies and individuals 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 allows the whistleblower to submit a qui tam suit against the parties on behalf of the state 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 selects not to enter into the suit, the whistleblower might be granted between 25 and 30 percent  of the sum recovered.

 

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

Liability of the Defendant in Grand Rapids city, Michigan

If a defendant is found guilty of defrauding the state, they may be ordered to pay up to triple the amount of actual damage that they created, in addition to fines of in between $5,000 and $10,000 per specific offense.

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower needs to 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 difficult one, there is protection afforded under whistleblower laws. If you have information relating to Medicaid scams in Grand Rapids city, Michigan, we can offer guidance and information on what it means to be a whistleblower and how you are secured under the law. Contact the knowledgeable whistleblower attorneys at Khurana Law Firm for a completely confidential, no-cost consultation and to go over 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 Grand Rapids 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 Grand Rapids 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Grand Rapids city, Michigan

When you become aware of potential fraud that may involve Medicare or Medicaid in Grand Rapids city, Michigan, you require the advice of an experienced whistleblower lawyer, someone who can make sure that your claim is fully investigated and filed accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the government will intervene, thus increasing the chance for a financial reward. Reporting Medicare and Medicaid fraud is an intricate matter –  don’t attempt 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 legal representatives to help in your fight against Medicare and Medicaid scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you have a legitimate claim, we may represent you in a qui tam claim to help report the scams and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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