Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Santa Fe, New Mexico

Medicaid and Medicare fraud cost New Mexico taxpayers billions of dollars annually. Although the majority of medical service providers 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 lawyers can help healthcare professionals to submit claims on behalf of the federal or state government to report this sort of fraud.

The federal and state government put a good deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government relies on private citizens in New Mexico to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Santa Fe, New Mexico

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the industry. understand that coming forward is not simple 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 completely investigate your claim, diligently and carefully prepare your case, for court, and work tirelessly with both you and the federal or state government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Santa Fe, New Mexico

In the state of New Mexico, there are laws that hold those parties who commit fraud against the state accountable for their acts. Under the New Mexico Medicaid False Claims Act and the New Mexico Fraud Against Taxpayers Act, a whistleblower who learns of deceptive activity against the state has the capacity to submit a qui tam suit against the transgressor on behalf of the state.

 

The New Mexico Fraud Against Taxpayers Act holds individuals or corporations liable who participate in a variety of fraudulent activity against the state, such as fraudulently providing false claims for payment to the state, misappropriating property of the state or political subdivision, avoiding paying the state or political subdivision, along with other activities.

 

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

 

Whistleblowers who submit a successful qui tam claim are entitled to get between 15 and 25 percent of the recovery if the state ends up being party to the litigation. If not, the person can proceed independently and be granted between 25 and 30 percent of the funds recovered.

 

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

Liability of the Defendant in Santa Fe, New Mexico

A defendant in a qui tam suit in New Mexico might be ordered to pay up to 3 times the harm 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 harm to the state as well as penalties of between $5,000 and $10,000 per infraction.

Working With an Experienced Whistleblower Attorney

If you know of deceitful activity in Santa Fe, New Mexico, you may be able to file a whistleblower civil suit on behalf of the state and be rewarded for your brave efforts. At Khurana Law Firm, P.C., our knowledgeable whistleblower attorneys can help you understand your rights and alternatives under the law. Contact us for a confidential, no-cost consultation 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 Santa Fe, 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 Santa Fe, 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Santa Fe, New Mexico

If you’ve become aware of fraudulent activity as it concerns Medicaid or Medicare in Santa Fe, New Mexico, you require the advice of an experienced whistleblower attorney, someone who can guarantee that your claim is fully investigated and submitted accurately and promptly. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, thus increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam lawyers to assist in your battle against Medicare and Medicaid fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we can represent you in a qui tam claim to report the scams and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to learn how we can be of help.

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