Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in St. Peters, Missouri

Medicaid and Medicare fraud cost Missouri taxpayers billions of dollars each year. While many medical service providers and drug companies are honest and work within the system, some don’t. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower lawyers can help healthcare professionals to file suits on behalf of the government to help report this type of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in St. Peters, Missouri

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and scams in the market. understand that coming forward is difficult and lots of things may 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 examine your claim, carefully prepare your case, and work relentlessly with you and the state of federal government to help bring deceptive Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in St. Peters, Missouri

An individual who learns of fraudulent Medicaid activity in the state may submit a whistleblower fit 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, although Medicaid fraud may be a civil infraction.

 

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

 

Under the federal False Claims Act, a whistleblower is likewise protected against any employer retaliation as an outcome of filing a claim.

Liability of the Defendant in St. Peters, Missouri

Under the federal False Claims Act, the offender might be ordered to pay damages to the government in the amount of as much as three times the amount of financial harm. In addition, the offender will also be ordered to pay significant necessary penalties for each claim violation.

Statute of Limitations in St. Peters, Missouri

Under the federal False Claims Act, a whistleblower must submit their lawsuit within 10 years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

The government depends on brave individuals who have evidence of fraudulent Medicaid activity to come forward to hold these entities liable. Subsequently, the government provides significant rewards to these people who bravely submit whistleblower claims.

 

If you are aware of Medicaid fraud in St. Peters, Missouri, we may 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 go over the elements of your case and help you understand your rights under the False Claims Act. Contact us to arrange a consultation.

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. Peters, 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. Peters, 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
WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in St. Peters, Missouri

If you’ve become aware of potential fraud involving Medicaid or Medicare in St. Peters, Missouri, you may need the guidance of a skilled whistleblower lawyer, someone who can make sure that your claim is completely examined and filed accurately and without delay. By working with a skilled attorney you are increasing the chance that the government will step in, hence increasing your chances for a reward. Reporting Medicare and Medicaid scams is a complex 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 attorneys to help in your battle against Medicaid and Medicare fraud. We will review your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam claim to report the fraud and enable you to gather a reward. Because 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.

Service areas