Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost New York State taxpayers billions of dollars every year. While most medical providers and drug companies are honest and work within the legal channels, some don’t. When fraud occurs, everyone can lose. Medicaid and Medicare whistleblower attorneys help healthcare workers to submit claims on behalf of the government to report this type of fraud.

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

Work with

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the market. understand that coming forward is not easy and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently and carefully prepare your case, for court, and work tirelessly with you and the state of federal government to help bring fraudulent Medicare or Medicaid activity to justice.

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Rochester, New York Whistleblower Laws

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

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

Liability of the Defendant in NY

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 each separate violation.

Rewards to the Whistleblower in New York

Any party who comes forward as a whistleblower and who files a claim against the defendant has the ability to receive between 15 to 20 percent of the government’s recovery if the government enters into the claim. On the other hand, if a whistleblower claim proceeds without the government’s involvement, the plaintiff may stand to get between 25 to 30 percent of the recovery as their reward for coming forward.

 

If the whistleblower may have had an involvement in initiating or planning the fraud, or the information has been derived not by personal knowledge but had been disclosed by the media or public hearings, however, the reward might be reduced, in some cases significantly.

Whistleblower Statute of Limitations In New York

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 may be able to file a qui tam lawsuit in order to hold responsible parties accountable. Schedule a free consultation with an experienced NY whistleblower attorney to understand your rights to a potential whistleblower reward. Are you a healthcare worker in Rochester, New York who has information about healthcare fraud? Contact Khurana Law Firm, P.C. for a 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 Rochester, 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 Rochester, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Rochester, New York

When you become aware of deceitful activity that may involve Medicaid or Medicare in Rochester, New York, you may need the guidance of a skilled whistleblower lawyer, someone who can make sure that your claim is totally examined and filed accurately and promptly. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will step in, hence increasing your chances for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  don’t attempt 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. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we may represent you in a qui tam suit to report the scams and enable you to gather a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to learn how we can help.

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