Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Warren city, Michigan

Medicare and Medicaid fraud cost Michigan taxpayers billions of dollars every year. While the majority of medical companies and drug companies are ethical and work within the system, there are those who don’t. When scams are perpetrated, everybody loses. Medicare and Medicaid whistleblower attorneys can help healthcare professionals to submit claims on behalf of the federal or state government to help report this type of fraud.

The state and federal governments place a great deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government counts on every day people in Michigan to come forward and to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Warren city, Michigan

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the market. understand that stepping forward is challenging and many things might 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 completely investigate your claim, carefully prepare your case, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Warren city, Michigan

Michigan loses millions of dollars each year in Medicaid scams and depends on individuals to come forward with details concerning fraudulent activity. In the state of Michigan, whistleblowers can submit civil suits against companies and individuals who present incorrect or fraudulent claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is likewise unlawful to pay or get money in exchange for referrals reimbursed by Medicaid.

 

The Act makes it possible for the whistleblower to file a qui tam lawsuit against the parties on behalf of the state government in order to recuperate funds lost due to scams. When the government enters 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 chooses not to get into the suit, the whistleblower may be granted between 25 and 30 percent  of the sum recovered.

 

Under whistleblower laws, the whistleblower is also safeguarded from any employer retaliation against them in bringing forth a lawsuit.

Liability of the Defendant in Warren city, Michigan

If a defendant is found guilty of defrauding the state, they might be ordered by the court to pay up to triple the amount of real damage that they created, in addition to fines of in between $5,000 and $10,000 per individual violation.

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower should file their problem within 10 years of the date of the violation.

Working With an Experienced Whistleblower Lawyer

While the decision to come forward can be a difficult one, there is protection afforded under whistleblower laws. If you have information as it relates to Medicaid fraud in Warren city, Michigan, we can provide guidance and helpful information on what it means to be a whistleblower and how you are secured under the law. Contact the skilled whistleblower lawyers at Khurana Law Firm for a completely 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 Warren 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 Warren 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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Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Warren city, Michigan

When you become aware of deceptive activity that may concern Medicare or Medicaid in Warren city, Michigan, you require the advice of a skilled whistleblower lawyer, someone who can ensure that your claim is totally investigated and submitted accurately and promptly. By dealing with a knowledgeable attorney you are increasing the chance that the government will intervene, therefore increasing the chance for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam legal representatives to help in your battle against Medicare and Medicaid fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we can represent you in a qui tam lawsuit to report the scams and enable you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can be of help.

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