Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Great Falls, Montana

Medicaid and Medicare fraud cost Montana taxpayers billions of dollars annually. Although many medical service providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud occurs, everybody loses. Medicare and Medicaid whistleblower lawyers help people who work in the healthcare system to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

The state and federal governments place a good deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it relies on every day people in Montana to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Great Falls, Montana

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the market. We know that stepping forward is not easy and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, and work relentlessly with you and the state of federal government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Great Falls, Montana

State governments count on individual whistleblowers with information of Medicaid scams to come forward to hold deceitful activity in check and penalize those who execute offenses. A private individual who is aware of deceitful activity against the Montana Medicaid program may submit a whistleblower claim under the Montana False Claims Act.

 

A whistleblower, or qui tam claim, is a civil suit on behalf of the state of Montana that holds those who carry out deceitful activity liable for their violations and recovers financial losses to the state of Montana.

 

If the state of Montana joins the lawsuit and prosecutes the matter, the whistleblower might be granted in between 15 and 25 percent of their monetary recuperation. If the state refuses to participate in the claim, the whistleblower may be awarded between 25 and 30 percent of the recovery in addition to repayment of any costs associated with filling the suit.

 

The Montana False Claims Act likewise safeguards a whistleblower against any company retaliation as an outcome of filing the suit.

Liability of the Defendant in Great Falls, Montana

In Montana, the offender can be required to pay up to 3 times the monetary damage caused to the state in addition to charges of in between $5,500 and $11,000 per violation.

Statute of Limitations in Great Falls, Montana

A whistleblower must submit a suit within 10 years of the offense date in order to be considered for a qui tam claim.

Working With an Experienced Whistleblower Lawyer

If you have become aware of fraudulent activity against the Montana Medicaid program, getting the legal suggestions of a skilled whistleblower lawyer is critical. At Khurana Law Firm, P.C., we have over 20 years of experience in intricate litigation, qui tam, and whistleblower law throughout the United States. Contact us for a confidential, no-cost consultation to discuss your case and understand your rights and protections under the law.

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 Great Falls, Montana, 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 Great Falls, Montana,  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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WORKING WITH An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Great Falls, Montana

When you become aware of potential fraud that may concern Medicaid or Medicare in Great Falls, Montana, you may need the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is completely investigated and submitted accurately and without delay. By dealing with a skilled attorney you are increasing the chance that the government will intervene, hence increasing the chance for a reward. Reporting Medicaid and Medicare scams is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam attorneys to help in your fight against Medicaid and Medicare fraud. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam claim to report the fraud and allow you to gather a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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