Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Macomb, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars every year. Although most medical companies and drug companies are ethical and work within the legal channels, some do not. When scams are perpetrated, everyone loses. Medicaid and Medicare whistleblower lawyers can help people who work in the healthcare system to submit lawsuits on behalf of the federal or state government to help report this sort of fraud.

The federal and state governments place a great deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it counts on every day people in Michigan to come forward to report scams. People like you.

Work with

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the industry. We know that stepping forward is not simple and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

schedule a
confidential consultation

Whistleblower Laws in Macomb, Michigan

Michigan loses millions of dollars each year in Medicaid scams and counts on private citizens to step forward with info concerning deceptive activity. In the state of Michigan, whistleblowers can file civil claims against businesses and individuals who provide incorrect or deceptive claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also prohibited to pay or get funds in exchange for recommendations reimbursed by Medicaid.

 

The Act enables the whistleblower to submit a qui tam claim against the parties on behalf of the state government in order to recuperate funds lost due to fraud. When the state government enters the lawsuit, a whistleblower can get benefits in the amount of in between 15 and 25 percent of the recovery to the state. If the state elects not to get into the suit, the whistleblower may be awarded between 25 and 30 percent  of the financial recovery.

 

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

Liability of the Defendant in Macomb, Michigan

If an offender 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 between $5,000 and $10,000 per private offense.

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower should file their grievance within 10 years of the date of the infraction.

Working With an Experienced Whistleblower Attorney

While the decision to come forward can be a tough one, there is defense afforded under whistleblower laws. If you have information regarding Medicaid scams in Macomb, Michigan, we can provide guidance and information on what it means to be a whistleblower and how you are safeguarded under the law. Contact the knowledgeable whistleblower lawyers at Khurana Law Firm for a completely confidential, no-cost consultation to go over a prospective 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 Macomb, 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 Macomb, Michigan,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
Work With An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Macomb, Michigan

If you’ve become aware of fraudulent activity that may involve Medicaid or Medicare in Macomb, Michigan, you require the guidance of a skilled whistleblower lawyer, someone who can guarantee that your claim is fully investigated and submitted accurately and promptly. By working with a skilled attorney you are increasing the chance that the government will step in, thus increasing the possibility for a reward. Reporting Medicaid and Medicare scams is an intricate matter –  do not 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 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 feel that you may have a legitimate claim, we may represent you in a qui tam suit to report the fraud and enable you to gather a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can help.

Service areas