Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in St. Clair Shores, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are honest and work within the system, some don’t. When fraud happens, everybody can lose. Medicare and Medicaid whistleblower attorneys can assist people who work in the healthcare system to file claims on behalf of the federal or state government to help report this type of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in St. Clair Shores, 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 industry. We know that coming forward is challenging and many 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, for court, and work relentlessly with both you and the federal or state government to help bring deceitful Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in St. Clair Shores, Michigan

Michigan loses millions of dollars each year in Medicaid scams and depends on people to come forward with information concerning deceitful activity. In the state of Michigan, whistleblowers can file civil claims against companies and individuals who provide incorrect or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is likewise unlawful to pay or get funds in exchange for referrals paid by Medicaid.

 

The Act enables the whistleblower to file a qui tam suit against the parties on behalf of the government so as to recuperate funds lost due to fraud. When the state government enters the lawsuit, a whistleblower can receive benefits in the amount of in between 15 and 25 percent of the funds recovered to the state. If the state chooses not to enter into the suit, the whistleblower might be awarded between 25 and 30 percent  of the financial recovery.

 

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

Liability of the Defendant in St. Clair Shores, Michigan

If an offender is found guilty of defrauding the state, they may be ordered to pay up to triple the dollar amount of real harm that they caused, in addition to fines of between $5,000 and $10,000 per specific infraction.

Statute of Limitations in Michigan

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

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 concerning Medicaid fraud in St. Clair Shores, 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 experienced whistleblower lawyers at Khurana Law Firm for a confidential, no-cost consultation 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 St. Clair Shores, 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 St. Clair Shores, 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
Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in St. Clair Shores, Michigan

If you’ve become aware of fraud that may involve Medicaid or Medicare in St. Clair Shores, Michigan, you need the advice of a skilled whistleblower lawyer, someone who can guarantee that your claim is fully investigated and filed accurately and quickly. By dealing with an experienced attorney you are increasing the chance that the government will intervene, hence increasing your chances for a financial reward. Reporting Medicaid and Medicare 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 prior experience as national qui tam lawyers to assist in your fight against Medicaid and Medicare fraud. 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 legitimate claim, we may represent you in a qui tam lawsuit to help report the fraud and allow you to collect a financial benefit. Because all whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

Service areas