Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Mount Vernon, New York

Medicaid and Medicare fraud cost New York State taxpayers billions of dollars each year. While most medical service providers and drug companies are honest and work within the legal channels, some do not. When fraud occurs, everybody can lose. Medicaid and Medicare whistleblower attorneys assist healthcare workers to file claims on behalf of the government to help report these kinds of scams.

The federal and state government put a great deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it depends on every day people in New York to come forward to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare workers in Mount Vernon, New York.

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that stepping forward is challenging and many things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, diligently and carefully prepare your case, and work tirelessly with you and the state of federal government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Mount Vernon, New York Whistleblower Laws

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

In addition, The law provides whistleblowers job protection and the ability to collect rewards.

Liability of the Defendant in NY

Under the NY State False Claims Act, the defendant may have 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 person who comes forward as a whistleblower and who 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 whistleblower may stand to receive between 25 to 30 percent of the recovery as a reward for coming forward.

 

On the other hand, if the whistleblower had an active involvement in initiating or planning the fraudulent activity, or in those cases where the information has been derived not from personal knowledge but from the media or public hearings, however, 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.

Experienced NY Whistleblower Lawyer Arvind Bob Khurana Is Here To Help

Have you become aware of Medicaid or Medicare fraud? You may be able to file a qui tam lawsuit and hold the responsible parties accountable. Schedule a free consultation with an experienced New York whistleblower lawyer to understand your legal rights to a possible whistleblower reward. Are you a healthcare worker in Mount Vernon, 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 Mount Vernon, 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 Mount Vernon, 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Mount Vernon, New York

When you become aware of fraud that may involve Medicaid or Medicare in Mount Vernon, New York, you require the advice of an experienced whistleblower attorney, someone who can ensure that your claim is totally investigated and submitted accurately and promptly. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, hence increasing your chances for a financial reward. Reporting Medicaid and Medicare scams is a complicated matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam attorneys to help in your fight against Medicare and Medicaid fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we believe you may have a legitimate 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 nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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