Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Albuquerque, New Mexico

Medicare and Medicaid fraud cost New Mexico taxpayers billions of dollars every year. Although most medical companies and drug companies are honest and work within the system, there are those who do not. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower attorneys assist healthcare workers to submit lawsuits on behalf of the federal or state government to help report these kinds of scams.

The federal and state governments place a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, it depends on regular folks in New Mexico to come forward and to report scams. People like you.

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare employees in Albuquerque, New Mexico

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the market. understand that stepping forward is not easy 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 comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, and work tirelessly with you and the state of federal government to help bring deceptive Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Albuquerque, New Mexico

In the state of New Mexico, there are laws that may hold those parties who commit scams against the state responsible for their actions. Under the New Mexico Medicaid False Claims Act and the New Mexico Fraud Against Taxpayers Act, a whistleblower who has knowledge of fraudulent activity against the state has the power to file a qui tam claim against the culprit on behalf of the state.

 

The New Mexico Fraud Against Taxpayers Act holds parties responsible who take part in a variety of deceptive activity against the state, such as fraudulently presenting false claims for payment to the state, misappropriating property of the state or political subdivision, avoiding paying the state or political subdivision, in addition to other actions.

 

The New Mexico Medicaid False Claims Act holds entities accountable who intentionally send false claims to New Mexico’s Medicaid program.

 

Whistleblowers who file a successful qui tam claim are entitled to receive between 15 and 25 percent of the funds recovered if the state becomes party to the case. If the state chooses not to step in, the person can continue individually and be granted between 25 and 30 percent of the successful recovery.

 

A whistleblower is also given protection from company retaliation as a result of filing the lawsuit or assisting in the state’s recovery.

Liability of the Defendant in Albuquerque, New Mexico

An accused in a qui tam claim in New Mexico may be required to pay up to three times the harm to the state under the New Mexico Medicaid False Claims Act. Under the New Mexico Fraud Against Taxpayers Act, the accused might be ordered to pay up to three times the harm to the state in addition to penalties of in between $5,000 and $10,000 per infraction.

Working With an Experienced Whistleblower Attorney

If you know of fraudulent activity in Albuquerque, New Mexico, you might be able to submit a whistleblower civil claim on behalf of the state and be rewarded for your brave efforts. At Khurana Law Firm, P.C., our skilled whistleblower attorneys can help you understand your rights and alternatives under the law. Contact us for a confidential, no-cost consultation so as to discuss your case.

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 Albuquerque, New Mexico, 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 Albuquerque, New Mexico,  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 LAWYER; We are proud to represent healthcare workers in Albuquerque, New Mexico

If you’ve become aware of fraudulent activity that may involve Medicaid or Medicare in Albuquerque, New Mexico, you require the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is totally examined and filed accurately and without delay. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing the chance for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  don’t attempt 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 legal representatives to help in your fight against Medicaid and Medicare fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we may represent you in a qui tam lawsuit to help report the fraud and allow you to gather a reward. All whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

Service areas