Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Utica, New York

Medicaid and Medicare fraud cost NY State taxpayers billions of dollars every year. Although most medical companies and drug companies are ethical and work within the system, some don’t. When scams are perpetrated, everyone can lose. Medicare and Medicaid whistleblower lawyers can help healthcare professionals to file suits on behalf of the government to report these kinds of scams.

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

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Utica, New York.

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the market. understand that stepping forward is hard and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

schedule a
confidential consultation

Utica, New York Whistleblower Laws

In NY, parties who may have knowledge of Medicaid fraud can file a qui tam or a whistleblower 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.

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

Liability of the Defendant in New York

Under the NY State 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 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 individual violation.

Rewards to the Whistleblower in New York

Any party who comes forward as a whistleblower and files a claim against the defendant may be able 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% of the recovery as their reward for coming forward.

 

If the whistleblower had an active involvement in initiating or planning 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 might be significantly reduced

New York State: Whistleblower Statue of Limitations

In New York State, 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 Utica, New York, you can file a qui tam claim to hold responsible parties accountable. Get the legal advice of an experienced New York whistleblower lawyer to understand your legal rights to a potential reward for your efforts. Are you a healthcare worker in Utica, 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 Utica, 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 Utica, New York to report Medicare fraud, contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Utica, New York

If you’ve become aware of fraud involving Medicaid or Medicare in Utica, New York, you require the advice of a skilled whistleblower attorney, someone who can ensure that your claim is totally investigated and submitted accurately and promptly. By dealing with an experienced lawyer you are increasing the chance that the government will intervene, therefore increasing your chances for a 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 experience as national qui tam lawyers to help in your battle against Medicare and Medicaid scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we may represent you in a qui tam claim to help report the fraud and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

Service areas