Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Southfield city, Michigan

Medicaid and Medicare fraud cost Michigan taxpayers billions of dollars annually. While the majority of medical companies and drug companies are honest and work within the legal channels, there are those who don’t. When fraud occurs, everyone loses. Medicaid and Medicare whistleblower attorneys assist healthcare workers to submit suits on behalf of the government to report this sort of fraud.

The state and federal government put a lot of trust in medical and pharmaceutical 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 attorneys; representing healthcare employees in Southfield city, Michigan

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the market. We know that coming forward is not simple and lots of things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently and carefully prepare your case, for court, and work tirelessly with both you and the federal or state government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Southfield city, Michigan

Michigan loses countless dollars each year in Medicaid fraud and depends on private citizens to come forward with information relating to fraudulent activity. In the state of Michigan, whistleblowers can submit civil suits 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 likewise illegal to pay or receive funds in exchange for recommendations paid by Medicaid.

 

The Act enables the whistleblower to submit a qui tam lawsuit against the parties on behalf of the government so as to recover funds lost due to fraud. When the government enters the suit, a whistleblower can get benefits in the amount of between 15 and 25 percent of the funds recovered to the state. If the state chooses not to participate in the suit, the whistleblower may be awarded between 25 and 30 percent  of the recovery.

 

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

Liability of the Defendant in Southfield city, Michigan

If an offender is found guilty of defrauding the state, they might be ordered 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 private infraction.

Statute of Limitations in Michigan

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

Working With an Experienced Whistleblower Lawyer

While the choice to come forward can be a challenging one, there is protection afforded under whistleblower laws. If you have information concerning Medicaid fraud in Southfield city, Michigan, we can provide guidance and information on what it means to be a whistleblower and how you are safeguarded under the law. Contact the knowledgeable whistleblower lawyers 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 Southfield 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 Southfield 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 LAWYER; We are proud to represent healthcare workers in Southfield city, Michigan

When you become aware of fraudulent activity that may involve Medicare or Medicaid in Southfield city, Michigan, you need the advice of a knowledgeable whistleblower attorney, someone who can ensure 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 government will intervene, thus increasing your chances for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam legal representatives to assist in your battle against Medicaid and Medicare fraud. Our attorneys will examine 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 claim to help report the scams and allow you to collect a reward. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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