Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Pontiac, Michigan

Medicaid and Medicare fraud cost Michigan taxpayers billions of dollars every year. While most medical companies and drug companies are ethical and work within the system, there are those who don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys assist people who work in the healthcare system to submit lawsuits on behalf of the government to help report these kinds of scams.

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

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Pontiac, Michigan

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and fraud in the market. understand that coming forward is hard 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 completely investigate your claim, diligently and carefully prepare your case, and work tirelessly with both you and the federal or state government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Pontiac, Michigan

Michigan loses millions of dollars each year in Medicaid fraud and counts on private citizens to come forward with information concerning fraudulent activity. In the state of Michigan, whistleblowers can file civil claims against companies and individuals who present incorrect or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also illegal to pay or get money in exchange for recommendations paid by Medicaid.

 

The Act enables the whistleblower to file a qui tam suit against the parties on behalf of the state government in order to recuperate funds lost due to scams. When the government enters the suit, a whistleblower can receive rewards in the amount of between 15 and 25 percent of the funds recovered to the state. If the state elects not to get into the suit, the whistleblower might be awarded between 25% and 30%  of the financial recovery.

 

Under whistleblower laws, the whistleblower is also protected from any company retaliation against them in bringing forth a lawsuit.

Liability of the Defendant in Pontiac, Michigan

If an offender is found guilty of defrauding the state, they may be ordered by the court to pay up to triple the dollar amount of real harm that they caused, 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 10 years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

While the choice to come forward can be a tough one, there is protection afforded under whistleblower laws. If you have information concerning Medicaid scams in Pontiac, Michigan, we can offer guidance and helpful information on what it means to be a whistleblower and how you are secured under the law. Contact the experienced whistleblower lawyers at Khurana Law Firm for a confidential, no-cost consultation and to discuss 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 Pontiac, 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 Pontiac, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Pontiac, Michigan

If you’ve become aware of fraudulent activity involving Medicare or Medicaid in Pontiac, Michigan, you need the guidance of a knowledgeable whistleblower attorney, someone who can guarantee that your claim is completely investigated and filed accurately and quickly. By dealing with an experienced attorney you are increasing the chance that the federal or state government will intervene, hence increasing your chances for a 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 bring years of practical experience as national qui tam lawyers to help in your fight against Medicare and Medicaid scams. We will review your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we may represent you in a qui tam lawsuit to report the scams and enable you to collect a financial benefit. Because all whistleblower work is on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can help.

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