Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in Farmington, New Mexico

Medicaid and Medicare fraud cost New Mexico taxpayers billions of dollars every year. Although many medical providers and drug companies are honest and work within the legal channels, some do not. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower lawyers can help healthcare workers to file suits on behalf of the federal or state government to report these kinds of scams.

The federal and state government place a great deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, it depends on private citizens in New Mexico to come forward to report scams. People like you.

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Farmington, New Mexico

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and scams in the industry. understand that coming forward is challenging and numerous 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 thoroughly investigate your claim, 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.

schedule a
confidential consultation

Whistleblower Laws in Farmington, New Mexico

In the state of New Mexico, there are laws that hold those parties who commit fraud against the state liable for their acts. Under the New Mexico Medicaid False Claims Act and the New Mexico Fraud Against Taxpayers Act, a whistleblower who knows of fraudulent activity against the state has the power to submit a qui tam claim against the perpetrator on behalf of the state.

 

The New Mexico Fraud Against Taxpayers Act holds entities accountable who participate in various deceitful activity against the state, including fraudulently presenting incorrect 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 purposefully send incorrect claims to New Mexico’s Medicaid program.

 

Whistleblowers who file an effective qui tam lawsuit are entitled to receive in between 15 and 25 percent of the recovery if the state ends up being party to the litigation. If the state chooses not to step in, the person can continue independently and be granted between 25 and 30 percent of the funds recovered.

 

A whistleblower is also afforded protection from company retaliation as a result of filing the case or helping in the state’s recovery.

Liability of the Defendant in Farmington, New Mexico

An accused in a qui tam claim in New Mexico may be required to pay up to 3 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 required to pay up to 3 times the damage to the state as well as charges of between $5,000 and $10,000 per violation.

Working With an Experienced Whistleblower Lawyer

If you are aware of fraudulent activity in Farmington, New Mexico, you may be able to submit a whistleblower civil claim on behalf of the state and be rewarded for your heroic efforts. At Khurana Law Firm, P.C., our experienced whistleblower attorneys can help you understand your rights and alternatives under the law. Contact us for a confidential, no-cost consultation in order 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 Farmington, 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 Farmington, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Farmington, New Mexico

If you’ve become aware of deceptive activity that may concern Medicaid or Medicare in Farmington, New Mexico, you need the advice of a skilled whistleblower attorney, someone who can make sure that your claim is fully investigated and filed accurately and without delay. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, hence increasing the possibility for a reward. Reporting Medicaid and Medicare scams is an intricate matter –  do not try to do this alone, we are here to help.

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

Service areas