Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Schenectady, New York

Medicaid and Medicare fraud cost NY State taxpayers billions of dollars each year. While most medical service providers and drug companies are ethical and work within the system, some do not. When fraud happens, everybody can lose. Medicaid and Medicare whistleblower lawyers can assist healthcare workers to file suits on behalf of the federal or state government to help report these kinds of scams.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Schenectady, New York.

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that coming forward is not easy and many things might be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Schenectady, New York Whistleblower Laws

In NY, individuals who may have knowledge of Medicaid fraud can 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 as well as the ability to collect rewardsbased on how much is recovered.

Liability of the Defendant in New York State

Under the state of New York 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 of between $6,000 and $12,000 for each separate violation.

Whisleblower Rewards in New York

Any party who becomes a whistleblower and who files a claim against the defendant has the ability to receive between 15% to 25% of the government’s recovery if the government enters into the claim. If a whistleblower claim proceeds without the government entering into the claim, the whistleblower may be able to receive from 25% to 30% of the recovery as a reward .

 

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

New York State: Whistleblower Statue of Limitations

A whistleblower complaint must be filed within ten years after the date of the violation.

If you have become aware of fraudulent Medicare or Medicaid activity in Schenectady, New York, you can file a qui tam claim to hold those parties accountable. Schedule a free consultation with an experienced NY whistleblower lawyer to understand your rights to a potential reward for your efforts. Are you a healthcare worker in Schenectady, New York who has information about healthcare fraud? Contact Khurana Law Firm, P.C. for a completely confidential, free 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 Schenectady, 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 Schenectady, 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Schenectady, New York

When you become aware of fraud that may involve Medicare or Medicaid in Schenectady, New York, you need the advice of a skilled whistleblower lawyer, someone who can make sure that your claim is totally investigated and filed accurately and without delay. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will intervene, hence increasing the opportunity for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam legal representatives to assist in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we believe that you have a legitimate claim, we may represent you in a qui tam suit to report the fraud and enable you to gather a reward. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can help.

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