Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in St. Louis, Missouri

Medicare and Medicaid fraud cost Missouri taxpayers billions of dollars each year. Although the majority of medical companies and drug companies are ethical and work within the legal channels, there are those who do not. When fraud occurs, everybody can lose. Medicaid and Medicare whistleblower attorneys can assist healthcare workers to submit suits on behalf of the federal or state government to report this sort of fraud.

The federal and state governments put a good deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it depends on regular folks in Missouri to come forward and to report fraud. People like you.

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in St. Louis, Missouri

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and scams in the market. understand that coming forward is not easy and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence .

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

schedule a
confidential consultation

Whistleblower Laws in St. Louis, Missouri

A person who knows of deceitful Medicaid activity in the state might file a whistleblower match 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 have the ability to bring a qui tam claim on behalf of the state, although Medicaid fraud might be a civil violation.

 

Instead, the private citizen can elect to file a claim under the federal False Claims Act.  If an individual does so, the federal government can decide to sign up with a qui tam claim under the False Claims Act or decline to join. If the federal government chooses to sign up with, a whistleblower might be able to gather in between 15 and 25 percent of the funds recovered by the federal government as a reward. If the federal government decides not to be a participant in the case, the whistleblower can collect between 25 and 30 percent of the recovered funds and as well as repayment for their expenses related to bringing the claim.

 

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

Liability of the Defendant in St. Louis, Missouri

Under the federal False Claims Act, the offender might be ordered to pay damages to the federal government in the quantity of up to 3 times the amount of financial damage. In addition, the offender will likewise be required to pay substantial necessary charges for each claim violation.

Statute of Limitations in St. Louis, Missouri

Under the federal False Claims Act, a whistleblower is required to file their claim within 10 years of the date of the offense.

Working With an Experienced Whistleblower Attorney

The government relies on heroic private citizens who have evidence of deceptive Medicaid activity to come forward to hold these entities responsible. Consequently, the government offers significant rewards to these individuals who bravely file whistleblower suits.

 

If you know of Medicaid fraud in St. Louis, Missouri, we might be able to help. With over 20 years of experience in complicated litigation, qui tam, and whistleblower law, the Khurana Law Firm offers a no-cost consultation so we can go over 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 are a healthcare worker in St. Louis, 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 St. Louis, Missouri,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in St. Louis, Missouri

When you become aware of fraud as it concerns Medicaid or Medicare in St. Louis, Missouri, you may need the guidance of an experienced whistleblower attorney, someone who can guarantee that your claim is completely examined and submitted accurately and immediately. By dealing with a knowledgeable attorney you are increasing the chance that the government will step in, hence increasing the chance for a reward. Reporting Medicaid and Medicare scams is an intricate matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam lawyers to help in your battle against Medicare and Medicaid fraud. We will review your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and enable you to collect a financial benefit. All whistleblower work is on contingency, you pay nothing until there is a recovery. Get in touch with us today to learn how we can be of help.

Service areas