Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in West Bloomfield, Michigan

Medicaid and Medicare fraud cost Michigan taxpayers billions of dollars annually. Although most medical service providers and drug companies are ethical and work within the legal channels, there are those who do not. When scams are perpetrated, everyone can lose. Medicare and Medicaid whistleblower lawyers can help healthcare professionals to file suits on behalf of the government to help report these kinds of scams.

The federal and state government put a good deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government depends on every day people in Michigan to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in West Bloomfield, Michigan

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your heroic choice to come forward to report abuse and scams in the industry. We know that coming forward is challenging and many things might be at stake. When you come to us, your case is held in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, for court, and work tirelessly with both you and the state of federal government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in West Bloomfield, Michigan

Michigan loses millions of dollars each year in Medicaid fraud and relies on private citizens to come forward with information concerning deceitful activity. In the state of Michigan, whistleblowers can file civil suits against companies and people who provide incorrect or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is also prohibited to pay or get money 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 government so as to recuperate funds lost due to scams. When the government joins the suit, a whistleblower can get rewards in the amount of in between 15 and 25 percent of the recovery to the state. If the state selects not to enter into the suit, the whistleblower may be granted between 25% and 30%  of the recovery.

 

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

Liability of the Defendant in West Bloomfield, Michigan

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

Statute of Limitations in Michigan

Under the Michigan Medicaid False Claims Act, a whistleblower should submit their problem within ten years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

While the choice to come forward can be a hard one, there is defense afforded under whistleblower laws. If you have information as it relates to Medicaid scams in West Bloomfield, Michigan, we can offer guidance and information on what it means to be a whistleblower and how you are safeguarded under the law. Contact the knowledgeable whistleblower attorneys at Khurana Law Firm for a completely 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 West Bloomfield, 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 West Bloomfield, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in West Bloomfield, Michigan

When you become aware of potential fraud that may concern Medicaid or Medicare in West Bloomfield, Michigan, you require the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is fully investigated and submitted accurately and quickly. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity for a financial reward. Reporting Medicaid and Medicare scams is a complicated 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 legal representatives to help in your fight against Medicaid and Medicare scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we believe that you have a legitimate claim, we can represent you in a qui tam suit to report the fraud and enable you to gather a reward. Because all whistleblower work is on contingency, you pay nothing until there is a recovery. Contact us today to learn how we can be of help.

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