Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Livonia, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars each year. While many medical providers and drug companies are honest and work within the legal channels, some don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys help people who work in the healthcare system to submit suits on behalf of the government to help report this sort of fraud.

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

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare workers in Livonia, Michigan

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the industry. understand that coming forward is challenging and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Livonia, Michigan

Michigan loses millions of dollars each year in Medicaid scams and counts on people to come forward with info regarding deceptive activity. In the state of Michigan, whistleblowers can file civil suits against businesses and people who provide false or deceptive claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also unlawful to pay or receive funds in exchange for referrals 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 recover funds lost due to fraud. When the state government enters the suit, a whistleblower can get benefits in the amount of in between 15 and 25 percent of the recovery to the state. If the state picks not to get into the suit, the whistleblower may be awarded between 25 and 30 percent  of the recovery.

 

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

Liability of the Defendant in Livonia, Michigan

If a defendant is found guilty of defrauding the state, they may be ordered by the court to pay up to triple the dollar amount of real damage that they caused, in addition to fines of between $5,000 and $10,000 per individual offense.

Statute of Limitations in Michigan

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

Working With an Experienced Whistleblower Lawyer

While the decision to come forward can be a challenging one, there is protection afforded under whistleblower laws. If you have information regarding Medicaid fraud in Livonia, 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 attorneys at Khurana Law Firm for a confidential, no-cost consultation and 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 Livonia, 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 Livonia, 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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Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Livonia, Michigan

When you become aware of fraud that may concern Medicare or Medicaid in Livonia, Michigan, you may need the guidance of an experienced whistleblower lawyer, someone who can guarantee that your claim is fully investigated and submitted accurately and promptly. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing the possibility for a reward. Reporting Medicaid and Medicare fraud is a complicated matter –  don’t attempt 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 help in your battle against Medicaid and Medicare scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam lawsuit to report the scams and allow you to collect a reward. All whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to to schedule a confidential consultation.

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