Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Michigan taxpayers billions of dollars each year. While many medical providers and drug companies are ethical and work within the legal channels, some don’t. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower lawyers can help healthcare workers to file suits 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 pharmaceutical and medical providers. When that trust is ill-placed, it relies on private citizens in Michigan to come forward to report fraud. People like you.

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and fraud in the market. understand that coming forward is challenging and many things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, carefully prepare your case, for court, and work relentlessly with you and the state of federal government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Shelby, Michigan

Michigan loses millions of dollars each year in Medicaid fraud and relies on people to step forward with info regarding deceptive activity. In the state of Michigan, whistleblowers can file civil lawsuits against companies and people who provide incorrect or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also unlawful to pay or receive funds in exchange for referrals paid by Medicaid.

 

The Act makes it possible for the whistleblower to submit a qui tam lawsuit against the parties on behalf of the state government in order to recuperate funds lost due to fraud. When the government enters the suit, a whistleblower can receive rewards in the amount of between 15 and 25 percent of the recovery to the state. If the state elects not to get into the suit, the whistleblower might be awarded between 25% and 30%  of the recovery.

 

Under whistleblower laws, the whistleblower is likewise protected from any employer retaliation against them in bringing forth a suit.

Liability of the Defendant in Shelby, Michigan

If an offender is found guilty of defrauding the state, they may be ordered by the court to pay up to triple the amount of real damage that they caused, 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 submit 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 protection afforded under whistleblower laws. If you have information regarding Medicaid fraud in Shelby, Michigan, we can provide guidance and helpful information on what it means to be a whistleblower and how you are safeguarded under the law. Contact the skilled whistleblower lawyers at Khurana Law Firm for a completely confidential, no-cost consultation 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 Shelby, 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 Shelby, 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 Shelby, Michigan

If you’ve become aware of fraud that may involve Medicaid or Medicare in Shelby, Michigan, you require the advice of a skilled whistleblower attorney, someone who can guarantee that your claim is fully examined and filed accurately and without delay. By working with a knowledgeable attorney you are increasing the chance that the government will step in, therefore increasing the possibility for a reward. Reporting Medicaid and Medicare fraud 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 prior experience as national qui tam legal representatives to help in your battle against Medicaid and Medicare scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam suit to report the fraud and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can be of help.

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