Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Novi city, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars annually. While many medical providers and drug companies are honest and work within the legal channels, there are those who don’t. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower attorneys can help people who work in the healthcare system to submit suits on behalf of the federal or state government to report this type of fraud.

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

Work with

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the market. understand that stepping forward is hard 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 thoroughly examine your claim, diligently prepare your case, for court, and work relentlessly with you and the state of federal government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Novi city, Michigan

Michigan loses countless dollars each year in Medicaid scams and relies on individuals to step forward with details regarding deceptive activity. In the state of Michigan, whistleblowers can file civil lawsuits against companies and people who present incorrect or fraudulent 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 reimbursed by Medicaid.

 

The Act makes it possible for the whistleblower to file a qui tam lawsuit against the parties on behalf of the government in order to recover funds lost due to scams. When the state government enters the suit, a whistleblower can receive rewards in the amount of in between 15 and 25 percent of the funds recovered to the state. If the state chooses not to participate in the suit, the whistleblower might be awarded between 25 and 30 percent  of the sum recovered.

 

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

Liability of the Defendant in Novi city, Michigan

If a defendant 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 offense.

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower needs to file their complaint within 10 years of the date of the violation.

Working With an Experienced Whistleblower Lawyer

While the choice to come forward can be a hard one, there is defense afforded under whistleblower laws. If you have information relating to Medicaid scams in Novi city, Michigan, we can offer guidance and helpful 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 completely 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 Novi 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 Novi 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 ATTORNEY; We are proud to represent healthcare workers in Novi city, Michigan

If you’ve become aware of potential fraud as it concerns Medicaid or Medicare in Novi city, Michigan, you need the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is fully investigated and filed accurately and quickly. By dealing with a skilled lawyer you are increasing the chance that the government will step in, thus increasing your chances for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not try 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 legal representatives to help in your fight against Medicare and Medicaid scams. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam lawsuit to report the fraud and allow you to gather a reward. All whistleblower work is on contingency, you pay nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

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