Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Albany, New York

Medicaid and Medicare fraud cost New York State taxpayers billions of dollars annually. While many medical service providers and drug companies are honest and work within the system, some do not. When fraud happens, everyone loses. Medicare and Medicaid whistleblower attorneys can help healthcare professionals to file lawsuits on behalf of the government to help report this sort of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Albany, New York.

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the market. We know that coming forward is hard 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 substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, for court, and work relentlessly with you and the federal or state government to help bring deceptive Medicare or Medicaid activity to justice.

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Albany, New York Whistleblower Laws

In NY, parties who have knowledge of Medicaid fraud may file a whistleblower or qui tam or lawsuit under the New York False Claims Act. Under this law, parties who file fraudulent claims to state or local governments are liable for their fraudulent activity.

It also affords whistleblowers job protection and the ability to collect rewardsbased on how much is recovered.

Liability of the Defendant in New York

Under the New York False Claims Act, the defendant may be required to pay fines in the amount of up to three times the harm caused to the government under the Act and as any consequential damages. In addition, there may also be the added requirement of the defendant to pay additional fines from $6,000 to $12,000 for every separate violation.

Whisleblower Rewards in New York

Any party who comes forward as a whistleblower and files a claim against the defendant has the ability to receive between 15 and 25 percent of the government’s recovery if the government enters into the claim. If a whistleblower claim proceeds without the government’s involvement, the plaintiff may be able to get from 25% to 30% of the recovery as a reward for coming forward.

 

On the other hand, if the whistleblower may have had an involvement in planning or initiating the fraud, or in those cases where the information has been derived not by personal knowledge but had been disclosed by the media or public hearings, the reward may be significantly reduced

New York State: Whistleblower Statue of Limitations

In New York, a whistleblower complaint must be filed within ten years after the date of the violation.

Have you become aware of Medicaid or Medicare fraud? You might be able to file a qui tam lawsuit and hold the responsible parties accountable. Get the legal advice of an experienced New York whistleblower lawyer to understand your legal rights to a potential whistleblower reward. Are you a healthcare worker in Albany, New York who has information about healthcare fraud? Contact Khurana Law Firm, P.C. for a completely confidential, no-cost consultation.

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 Albany, New York, 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 Albany, New York to report Medicare fraud, contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

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WORKING WITH An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Albany, New York

If you’ve become aware of potential fraud as it concerns Medicare or Medicaid in Albany, New York, you require the advice of an experienced whistleblower lawyer, someone who can make sure that your claim is totally investigated and submitted accurately and promptly. By dealing with an experienced attorney you are increasing the chance that the government will step in, therefore increasing the chance for a financial reward. Reporting Medicaid and Medicare fraud is a complicated matter –  don’t 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 legal representatives to help in your fight against Medicaid and Medicare scams. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we may represent you in a qui tam lawsuit to help report the scams and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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