Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Grand Forks, North Dakota

Medicaid and Medicare fraud cost North Dakota taxpayers billions of dollars annually. Although most medical providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to file suits on behalf of the federal or state government to report this type of fraud.

The federal and state government put a great deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, it counts on every day people in North Dakota to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Grand Forks, North Dakota

At Khurana Law Firm, P.C., as skilled 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 difficult and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Grand Forks, North Dakota

In North Dakota, while there are laws prohibiting deceitful activity against the state’s Medicaid program, there are no state laws affording a whistleblower the ability to file a qui tam suit or get rewarded for their efforts.

 

However, a private citizen with details concerning fraudulent Medicaid activity may still submit a civil claim against the offending entity on behalf of the federal government under the federal False Claims Act.

 

Under the federal False Claims Act, a private citizen might file a qui tam claim against the perpetrator of Medicaid fraud to recover those losses to the federal government. The whistleblower may be awarded for these efforts in successful claims. If the federal government selects to get in into the lawsuit, the whistleblower may be awarded between 15 and 25 percent of the recuperation. If the federal government opts out of taking part in the suit, the whistleblower may be awarded between 25 and 30 percent of the recuperation for an effective claim.

 

The False Claims Act likewise shields whistleblowers against any employer retaliation as a result of filing a lawsuit or assisting the government.

Liability of the Defendant in Grand Forks, North Dakota

Under the federal False Claims Act, a defendant may be required to pay damages of approximately three times the harm to the federal government in addition to significant fines for each offense.

Statute of Limitations in Grand Forks, North Dakota

Under the federal False Claims Act, the whistleblower must file their complaint within 10 years of the date of the infraction.

Working With an Experienced Whistleblower Attorney

State and federal governments must often count on private individuals to step forward with knowledge of health care scams. For these heroic efforts, they are entitled to substantial rewards. If you learned of deceitful activity against the state Medicaid program in Grand Forks, North Dakota, you ought to seek the advice of a knowledgeable whistleblower lawyer to comprehend how a qui tam suit works and your rights under the laws. At Khurana Law Firm, we provide a confidential, no-cost assessment so as to discuss your case and your rights under the federal False Claims Act. Contact us today to arrange an appointment.

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 Grand Forks, North Dakota, 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 Grand Forks, North Dakota,  you can report Medicare fraud when you 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 Grand Forks, North Dakota

If you’ve become aware of deceitful activity as it concerns Medicare or Medicaid in Grand Forks, North Dakota, you require the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is completely examined and submitted accurately and without delay. By dealing with a knowledgeable lawyer you are increasing the chance that the federal or state government will step in, hence increasing the chance for a reward. Reporting Medicare and Medicaid scams is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam attorneys to assist in your battle against Medicare and Medicaid fraud. We will review your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we can represent you in a qui tam claim to help report the scams and allow you to collect a reward. Because all whistleblower work is on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can be of help.

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