Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Troy, New York

Medicaid and Medicare fraud cost NY State taxpayers billions of dollars every year. Although many medical companies and drug companies are ethical and work within the system, some do not. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower attorneys assist healthcare professionals to file claims on behalf of the government to report this sort of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Troy, New York.

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and fraud in the market. We know that coming forward is not easy and lots of things may be at stake. When you come to us, your case is held in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work relentlessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Troy, New York Whistleblower Laws

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

The law also gives whistleblowers job protection and the ability to collect rewardsbased on how much is recovered.

Liability of the Defendant in New York

Under the state of New York False Claims Act, the defendant may be required to pay fines in the amount of up to 3 times the harm caused to the government under the Act as well 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 individual violation.

Whisleblower Rewards in New York

Any person who becomes a whistleblower and 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. If a whistleblower claim proceeds without the government entering into the claim, the plaintiff may stand to get between from 25 percent to 30 percent of the recovery as a reward for coming forward.

 

On the other hand, if the whistleblower had an involvement in initiating or planning the fraudulent activity, 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 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.

Speaking with a Whistleblower Attorney

Have you become aware of Medicaid or Medicare fraud? You may be able to file a qui tam lawsuit in order to hold the responsible parties accountable. Speak with an experienced NY whistleblower lawyer to understand your legal rights to a possible whistleblower reward. Are you a healthcare worker in Troy, 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 Troy, 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 Troy, 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 ATTORNEY; We are proud to represent healthcare workers in Troy, New York

When you become aware of potential fraud as it concerns Medicare or Medicaid in Troy, New York, you need the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is totally investigated and submitted accurately and without delay. By dealing with a skilled attorney you are increasing the chance that the government will step in, therefore increasing your chances for a reward. Reporting Medicare and Medicaid scams is a complex matter –  do not try 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 attorneys to help in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we can represent you in a qui tam lawsuit to report the fraud and enable you to collect a reward. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can help.

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