Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Niagara Falls, New York

Medicaid and Medicare fraud cost New York State taxpayers billions of dollars each year. Although the majority of medical companies and drug companies are honest and work within the legal channels, some don’t. When fraud happens, everyone can lose. Medicare and Medicaid whistleblower lawyers can help healthcare professionals to file lawsuits on behalf of the federal or state government to report these kinds of scams.

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

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Niagara Falls, New York.

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the market. We know that stepping forward is hard and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, and work tirelessly with both you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Niagara Falls, New York Whistleblower Laws

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

In addition, The law affords whistleblowers job protection as well as the ability to collect rewardsbased on how much is recovered.

Liability of the Defendant in New York State

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 as well as any consequential damages. There may also be the added requirement of the defendant to pay additional fines from $6,000 to $12,000 for each individual violation.

Rewards to the Whistleblower in New York

Any person who becomes a whistleblower and who files a claim against the defendant may be able to receive between 15% to 25% of the government’s recovery if the government enters into the claim. On the other hand, if a whistleblower claim proceeds without the government entering into the claim, the plaintiff may be able to get between 25 to 30 percent of the recovery as a reward for coming forward.

 

If the whistleblower may have had an 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

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 in order to hold responsible parties accountable. Speak with an experienced NY whistleblower attorney to understand your legal rights to a potential reward for your efforts. Are you a healthcare worker in Niagara Falls, 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 Niagara Falls, 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 Niagara Falls, 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 LAWYER; We are proud to represent healthcare workers in Niagara Falls, New York

If you’ve become aware of deceitful activity as it concerns Medicare or Medicaid in Niagara Falls, New York, you need the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is fully investigated and submitted accurately and immediately. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, hence increasing your chances for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  do not 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 help in your fight against Medicare and Medicaid fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam suit to report the fraud and enable you to collect a reward. All whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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