Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Rochester Hills, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars each year. While the majority of medical companies and drug companies are honest and work within the system, some don’t. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower attorneys assist healthcare professionals to submit claims on behalf of the government to help report this sort of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Rochester Hills, Michigan

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and fraud in the industry. We know 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 .

With our comprehensive experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, and work relentlessly with both you and the state of federal government to help bring deceitful Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Rochester Hills, Michigan

Michigan loses millions of dollars each year in Medicaid fraud and counts on people to step forward with info relating to deceitful activity. In the state of Michigan, whistleblowers can file civil lawsuits against companies and individuals who provide 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 recommendations paid by Medicaid.

 

The Act enables the whistleblower to file a qui tam lawsuit against the parties on behalf of the state government in order to recuperate funds lost due to scams. When the state government enters the suit, a whistleblower can get rewards in the amount of between 15 and 25 percent of the funds recovered to the state. If the state picks not to participate in the suit, the whistleblower might be granted between 25 and 30 percent  of the sum recovered.

 

Under whistleblower laws, the whistleblower is likewise safeguarded from any company retaliation against them in participating in a suit.

Liability of the Defendant in Rochester Hills, 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 actual 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 submit their grievance within 10 years of the date of the violation.

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 Rochester Hills, Michigan, we can provide guidance and helpful information on what it means to be a whistleblower and how you are protected under the law. Contact the experienced whistleblower attorneys at Khurana Law Firm for a confidential, no-cost consultation and to go over 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 Rochester Hills, 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 Rochester Hills, 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
WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Rochester Hills, Michigan

If you’ve become aware of fraud that may involve Medicare or Medicaid in Rochester Hills, Michigan, you may need the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is totally examined and submitted accurately and without delay. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will step in, hence increasing the opportunity for a financial reward. Reporting Medicare and Medicaid scams is an intricate matter –  don’t 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 lawyers to assist in your fight against Medicaid and Medicare fraud. We will examine your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we can represent you in a qui tam lawsuit to report the fraud and enable you to collect a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to learn how we can help.

Service areas