Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Kansas City, Missouri

Medicaid and Medicare fraud cost Missouri taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are ethical and work within the legal channels, some don’t. When scams are perpetrated, everyone can lose. Medicaid and Medicare whistleblower lawyers can assist healthcare workers to submit suits on behalf of the federal or state government to report this sort of fraud.

The state and federal governments place a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government counts on every day people in Missouri to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Kansas City, Missouri

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the market. We know that stepping forward is difficult and many things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, and work tirelessly with you and the state of federal government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Kansas City, Missouri

A person who is aware of fraudulent Medicaid activity in Missouri might submit a whistleblower match under the federal False Claims Act, and be rewarded for their efforts.

 

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

 

Instead, the private citizen can chose to file a claim under the federal False Claims Act.  If an individual does so, the federal government can choose to sign up with a qui tam suit under the False Claims Act or decline to join. If the government selects to join, a whistleblower might be able to gather between 15 and 25 percent of the recovery by the government as a reward. If the government chooses not to be a participant in the lawsuit, the whistleblower can collect in between 25 and 30 percent of the recovered funds and in addition to reimbursement for their costs connected with bringing the case.

 

Under the federal False Claims Act, a whistleblower is also shielded against any employer retaliation as an outcome of submitting a suit.

Liability of the Defendant in Kansas City, Missouri

Under the federal False Claims Act, the accused might be ordered to pay damages to the government in the amount of up to three times the amount of financial damage. In addition, the accused will also be ordered to pay substantial mandatory penalties for each claim infraction.

Statute of Limitations in Kansas City, Missouri

Under the federal False Claims Act, a whistleblower must submit their claim within ten years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

The federal government depends on brave individuals who have proof of fraudulent Medicaid activity to come forward to hold these entities liable. As a result, they offer substantial rewards to these individuals who fearlessly submit whistleblower claims.

 

If you have knowledge of Medicaid fraud in Kansas City, Missouri, we might be able to help. With over 20 years of experience in complicated lawsuits, qui tam, and whistleblower law, the Khurana Law Firm provides 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 a visit.

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 Kansas City, Missouri, 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 Kansas City, Missouri,  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 Kansas City, Missouri

If you’ve become aware of fraud that may involve Medicare or Medicaid in Kansas City, Missouri, you require the guidance of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is totally investigated and filed accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the government will intervene, hence increasing the possibility for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  don’t 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 legal representatives to assist in your battle against Medicaid and Medicare scams. We will review 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 help report the fraud and enable you to collect a reward. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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