Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Troy city, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars every year. Although many medical companies and drug companies are honest and work within the system, there are those who do not. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower lawyers can help healthcare workers to file suits on behalf of the government to report these kinds of scams.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Troy city, Michigan

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the industry. We know that coming forward is difficult and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently prepare your case, for court, and work relentlessly with both you and the federal or state government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Troy city, Michigan

Michigan loses millions of dollars each year in Medicaid fraud and counts on people to come forward with info concerning deceptive activity. In the state of Michigan, whistleblowers can file civil claims against companies and individuals who provide incorrect or fraudulent claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also prohibited to pay or receive funds in exchange for referrals reimbursed by Medicaid.

 

The Act allows the whistleblower to submit a qui tam lawsuit against the parties on behalf of the state government so as to recuperate funds lost due to fraud. When the state government joins the suit, a whistleblower can get rewards in the amount of between 15 and 25 percent of the funds recovered to the state. If the state selects not to get into the suit, the whistleblower may be granted between 25 and 30 percent  of the financial recovery.

 

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

Liability of the Defendant in Troy city, Michigan

If an accused is found guilty of defrauding the state, they might be ordered to pay up to triple the dollar amount of actual 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 needs to submit their grievance within ten years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

While the choice to come forward can be a tough one, there is defense afforded under whistleblower laws. If you have information as it relates to Medicaid scams in Troy 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 experienced whistleblower attorneys at Khurana Law Firm for a confidential, no-cost consultation and 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 Troy 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 Troy 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Troy city, Michigan

When you become aware of potential fraud involving Medicaid or Medicare in Troy city, Michigan, you require the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is totally investigated and submitted accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the government will step in, hence increasing the opportunity for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam lawyers to help in your battle against Medicare and Medicaid fraud. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we may represent you in a qui tam lawsuit to report the scams and enable you to collect a reward. Because all whistleblower work is on contingency, you pay 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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