Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Missouri

Medicare and Medicaid fraud cost Missouri taxpayers billions of dollars each year. Although the majority of medical providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud occurs, everybody can lose. Medicaid and Medicare whistleblower lawyers assist healthcare professionals to submit claims on behalf of the federal or state government to report this type of fraud.

The state and federal governments put a a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, it depends on every day people in Missouri to come forward to report fraud. People like you.

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare employees in Missouri

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 scams in the market. We know that stepping forward is challenging and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our extensive experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, for court, and work relentlessly with you and the federal or state government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Missouri

An individual who is aware of Medicaid fraudulent activity in the state may file a whistleblower suit under the federal False Claims Act, and be rewarded for their efforts. 

Though Missouri has enacted the Missouri Health Care Payment Fraud and Abuse Act, a whistleblower will not be able to bring a qui tam lawsuit on behalf of the state, even though Medicaid fraud may be a civil violation. 

The federal government can decide to join a qui tam lawsuit under the False Claims Act or decline to join. If the government chooses to join, a whistleblower may be able to collect between 15 and 25 percent of the recovery by the government as a reward. If the government decides not to be party in the suit, the whistleblower can collect between 25 and 30 percent of the recovery and as well as reimbursement for their costs associated with bringing the claim. 

Under the federal False Claims Act, a whistleblower is also protected against any employer retaliation as a result of filing a lawsuit.

If you are a Hawaii healthcare worker, get in touch with Hawaii Medicare Whistleblower attorney.

Liability of the Defendant in Missouri

Under the federal False Claims Act, the defendant may be ordered to pay damages to the government in the amount of up to three times the amount of financial harm. In addition, the defendant will also be required to pay significant mandatory penalties for each claim violation.

Statute of Limitations in Missouri

Under the federal False Claims Act, a whistleblower is required to file their lawsuit within ten years of the date of the violation.

Working With an Experienced Whistleblower Attorney

The government relies on heroic individuals who have evidence of fraudulent Medicaid activity to come forward to hold these parties accountable. Consequently, they offer substantial rewards to these individuals who bravely file whistleblower lawsuits. 


If you have knowledge of Medicaid fraud in Missouri, we can help. With over 20 years of experience in complex litigation, qui tam and whistleblower law, the Khurana Law Firm offers a no-cost consultation so we can discuss the elements of your case and help you understand your rights under the False Claims Act. Contact us to schedule an appointment.

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 can report it 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. To report Medicare fraud, 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

When you become aware of fraud as it concerns Medicare or Medicaid, 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 skilled lawyer you are increasing the chance that the federal or state government will step in, therefore increasing the possibility for a reward. Reporting Medicaid and Medicare scams is a complex matter –  don’t 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 assist in your fight against Medicare and Medicaid fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam lawsuit to help report the scams and enable you to gather a reward. All whistleblower work is on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can help.

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