Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Clovis, New Mexico

Medicare and Medicaid fraud cost New Mexico taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are honest and work within the legal channels, there are those who do not. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower lawyers assist people who work in the healthcare system to submit claims on behalf of the government to report this type of fraud.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in Clovis, New Mexico

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the industry. We know that stepping forward is difficult and many things may be at stake. When you come to us, your case is held in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, and work relentlessly with both 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 Clovis, New Mexico

In the state of New Mexico, there are laws that may hold those parties who perpetrate 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 learns of fraudulent activity against the state has the capacity to file a qui tam lawsuit against the transgressor on behalf of the state.

 

The New Mexico Fraud Against Taxpayers Act holds entities accountable who engage 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, deceptively avoiding paying the state or political subdivision, as well as other actions.

 

The New Mexico Medicaid False Claims Act holds parties responsible who knowingly send false claims to New Mexico’s Medicaid program.

 

Whistleblowers who submit an effective qui tam suit are entitled to receive between 15 and 25 percent of the recovery if the state ends up being party to the case. If not, the person can continue independently and be awarded in between 25 and 30 percent of the successful recovery.

 

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

Liability of the Defendant in Clovis, New Mexico

A defendant in a qui tam lawsuit in New Mexico might be required to pay up to three times the damage to the state under the New Mexico Medicaid False Claims Act. Under the New Mexico Fraud Against Taxpayers Act, the accused may be ordered to pay up to 3 times the damage to the state as well as charges of in between $5,000 and $10,000 per violation.

Working With an Experienced Whistleblower Attorney

If you know of deceptive activity in Clovis, New Mexico, you may have the ability to file a whistleblower civil lawsuit on behalf of the state and be rewarded for your heroic efforts. At Khurana Law Firm, P.C., our knowledgeable whistleblower attorneys can help you understand your rights and options under the law. Contact us for a completely 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 Clovis, 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 Clovis, New Mexico,  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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Clovis, New Mexico

If you’ve become aware of potential fraud involving Medicaid or Medicare in Clovis, New Mexico, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can guarantee that your claim is completely investigated and submitted accurately and promptly. By dealing with an experienced lawyer you are increasing the chance that the government will intervene, therefore increasing your chances for a reward. Reporting Medicare and Medicaid fraud is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam lawyers to help in your battle against Medicare and Medicaid scams. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam lawsuit to help report the fraud and enable you to gather a reward. Because all whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to learn how we can be of help.

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