Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Westland, Michigan

Medicaid and Medicare fraud cost Michigan taxpayers billions of dollars every year. Although many medical service providers and drug companies are honest and work within the legal channels, there are those who do not. When scams are perpetrated, everyone can lose. Medicare and Medicaid whistleblower lawyers help healthcare professionals to submit lawsuits on behalf of the government to help report this type of fraud.

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

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and fraud in the industry. understand that stepping forward is not easy and many things might be at stake. When you come to us, your case is held in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, and work tirelessly with you and the federal or state government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Westland, Michigan

Michigan loses millions of dollars each year in Medicaid scams and relies on people to step forward with information regarding deceitful activity. In the state of Michigan, whistleblowers can file civil lawsuits against businesses and individuals who present incorrect or deceitful claims to the state under the Michigan Medicaid False Claims Act. Under the Act, it is likewise unlawful to pay or receive funds in exchange for recommendations 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 so as to recover funds lost due to fraud. When the state government joins the suit, a whistleblower can receive rewards in the amount of between 15 and 25 percent of the recovery to the state. If the state picks not to participate in the suit, the whistleblower may be granted between 25% and 30%  of the 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 Westland, Michigan

If a defendant is found guilty of defrauding the state, they may be ordered to pay up to triple the amount of actual damage 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 submit their complaint within 10 years of the date of the offense.

Working With an Experienced Whistleblower Attorney

While the decision to come forward can be a tough one, there is protection afforded under whistleblower laws. If you have information concerning Medicaid fraud in Westland, 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 knowledgeable whistleblower attorneys at Khurana Law Firm for a confidential, no-cost consultation to go over 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 Westland, 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 Westland, 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 ATTORNEY; We are proud to represent healthcare workers in Westland, Michigan

If you’ve become aware of fraud that may concern Medicare or Medicaid in Westland, Michigan, you require the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and immediately. By working with a knowledgeable attorney you are increasing the chance that the government will step in, hence increasing the possibility 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 bring years of experience as national qui tam attorneys to help in your fight against Medicaid and Medicare scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam lawsuit to help report the scams and allow you to gather a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to learn how we can help.

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