Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in South Valley, New Mexico

Medicare and Medicaid fraud cost New Mexico taxpayers billions of dollars annually. While most medical companies and drug companies are honest and work within the system, there are those who don’t. When fraud happens, everybody can lose. Medicare and Medicaid whistleblower attorneys help people who work in the healthcare system to file lawsuits on behalf of the government to help report this sort of fraud.

The state and federal governments place a good deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, it relies 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 workers in South Valley, New Mexico

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the market. 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 comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, and work tirelessly with you and the federal or state government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in South Valley, 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 deceitful activity against the state has the capacity to file a qui tam lawsuit against the wrongdoer on behalf of the state.

 

The New Mexico Fraud Against Taxpayers Act holds individuals or corporations responsible who take part in various deceptive activity against the state, including fraudulently providing false claims for payment to the state, abusing property of the state or political subdivision, avoiding paying the state or political subdivision, along with other actions.

 

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

 

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

 

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

Liability of the Defendant in South Valley, 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 might be ordered to pay up to 3 times the harm to the state as well as charges of between $5,000 and $10,000 per infraction.

Working With an Experienced Whistleblower Lawyer

If you learn of deceptive activity in South Valley, New Mexico, you may have the ability to file a whistleblower civil suit 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 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 South Valley, 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 South Valley, 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 South Valley, New Mexico

If you’ve become aware of potential fraud that may involve Medicare or Medicaid in South Valley, New Mexico, you may need the advice of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is completely examined and filed accurately and without delay. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will intervene, hence increasing the possibility for a financial reward. Reporting Medicaid and Medicare scams is an intricate 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 legal representatives to assist in your battle against Medicare and Medicaid scams. We will review your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we may represent you in a qui tam claim to help report the scams and allow you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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