Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars annually. Although many medical providers and drug companies are honest and work within the system, some do not. When scams are perpetrated, everyone can lose. Medicaid and Medicare whistleblower attorneys assist healthcare workers to submit lawsuits on behalf of the government to help report this type of fraud.

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

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Kalamazoo city, Michigan

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that coming forward is not simple and many 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 thoroughly investigate your claim, diligently prepare your case, and work relentlessly with you and the federal or state government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Kalamazoo city, Michigan

Michigan loses countless dollars each year in Medicaid scams and counts on individuals to come forward with information regarding deceitful activity. In the state of Michigan, whistleblowers can submit civil lawsuits against businesses and people who present incorrect or fraudulent claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is likewise unlawful to pay or receive money in exchange for referrals reimbursed 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 scams. When the government joins the suit, a whistleblower can get rewards in the amount of in between 15 and 25 percent of the funds recovered to the state. If the state selects not to get into the suit, the whistleblower might be awarded between 25 and 30 percent  of the sum recovered.

 

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

Liability of the Defendant in Kalamazoo city, Michigan

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

Statute of Limitations in Michigan

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

Working With an Experienced Whistleblower Lawyer

While the decision to come forward can be a tough one, there is defense afforded under whistleblower laws. If you have information relating to Medicaid fraud in Kalamazoo city, Michigan, we can provide guidance and 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 discuss 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 Kalamazoo 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 Kalamazoo 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 Kalamazoo city, Michigan

If you’ve become aware of fraud as it concerns Medicare or Medicaid in Kalamazoo city, Michigan, you need the guidance of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is fully examined and filed accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the federal or state government will intervene, therefore increasing your chances for a financial reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam lawyers to assist in your battle against Medicaid and Medicare fraud. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we can represent you in a qui tam lawsuit to report the scams and enable you to collect a reward. 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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