Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Royal Oak city, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars annually. Although most medical companies and drug companies are honest and work within the legal channels, there are those who do not. When scams are perpetrated, everybody loses. Medicare and Medicaid whistleblower attorneys can assist healthcare workers to file claims on behalf of the federal or state government to report this type of fraud.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in Royal Oak city, Michigan

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the market. We know that stepping forward is challenging and numerous things might 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 investigate your claim, diligently prepare your case, for court, and work tirelessly with both 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 Royal Oak city, Michigan

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

 

The Act enables the whistleblower to file a qui tam claim against the parties on behalf of the state government so as to recover funds lost due to scams. When the state government enters the suit, a whistleblower can get benefits in the amount of in between 15 and 25 percent of the funds recovered to the state. If the state elects not to enter into the suit, the whistleblower might be awarded between 25% and 30%  of the sum recovered.

 

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

Liability of the Defendant in Royal Oak city, Michigan

If an accused is found guilty of defrauding the state, they might be ordered to pay up to triple the amount of actual harm that they created, in addition to fines of in between $5,000 and $10,000 per individual infraction.

Statute of Limitations in Michigan

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

Working With an Experienced Whistleblower Attorney

While the choice to come forward can be a tough one, there is protection afforded under whistleblower laws. If you have information as it relates to Medicaid scams in Royal Oak city, Michigan, we can provide guidance and information on what it means to be a whistleblower and how you are secured under the law. Contact the knowledgeable whistleblower attorneys at Khurana Law Firm for a completely 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 Royal Oak 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 Royal Oak 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Royal Oak city, Michigan

When you become aware of fraud involving Medicaid or Medicare in Royal Oak city, Michigan, you may need the advice of a knowledgeable whistleblower lawyer, someone who can guarantee that your claim is completely examined and filed accurately and promptly. By dealing with a knowledgeable attorney you are increasing the chance that the government will step in, hence increasing your chances for a financial reward. Reporting Medicare and Medicaid 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 experience as national qui tam attorneys to assist in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam claim to report the scams and allow you to collect a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

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