Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Sterling Heights, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars each year. While most medical companies and drug companies are honest and work within the legal channels, there are those who don’t. When fraud occurs, everybody can lose. Medicare and Medicaid whistleblower attorneys can help healthcare professionals to file lawsuits on behalf of the government to report these kinds of scams.

The state and federal government put a great deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it counts on every day people in Michigan to come forward to report scams. People like you.

Work with

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that stepping 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 substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, for court, and work relentlessly with both you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Sterling Heights, Michigan

Michigan loses millions of dollars each year in Medicaid fraud and depends on people to step forward with details relating to deceptive activity. In the state of Michigan, whistleblowers can submit civil lawsuits against companies and people who present false or fraudulent claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is likewise illegal to pay or get funds in exchange for recommendations paid by Medicaid.

 

The Act allows the whistleblower to submit a qui tam claim against the parties on behalf of the state government in order to recover funds lost due to scams. When the government joins the lawsuit, a whistleblower can receive benefits in the amount of between 15 and 25 percent of the funds recovered to the state. If the state picks not to enter into the suit, the whistleblower might be awarded between 25% and 30%  of the financial recovery.

 

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

Liability of the Defendant in Sterling Heights, Michigan

If an offender is found guilty of defrauding the state, they might be ordered by the court to pay up to triple the amount of real harm that they caused, in addition to fines of in between $5,000 and $10,000 per individual offense.

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower needs to file their problem within ten years of the date of the violation.

Working With an Experienced Whistleblower Lawyer

While the decision to come forward can be a hard one, there is defense afforded under whistleblower laws. If you have information relating to Medicaid fraud in Sterling Heights, Michigan, we can provide guidance and information on what it means to be a whistleblower and how you are protected under the law. Contact the skilled whistleblower lawyers at Khurana Law Firm for a 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 Sterling Heights, 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 Sterling Heights, 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 Sterling Heights, Michigan

When you become aware of potential fraud that may involve Medicaid or Medicare in Sterling Heights, Michigan, you require the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is completely investigated and submitted accurately and immediately. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, thus increasing the chance for a financial reward. Reporting Medicare and Medicaid scams 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 Medicare and Medicaid scams. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we may represent you in a qui tam suit to report the scams and enable 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 learn how we can be of help.

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