Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Ohio

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars annually. Although most medical companies and drug companies are ethical and work within the legal channels, there are those who don’t. When scams are perpetrated, everyone can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare workers to submit lawsuits on behalf of the government to help report this type of fraud.

The federal and state governments place a a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it counts on every day people in Ohio to come forward to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Ohio.

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and scams in the market. understand that stepping forward is difficult and many things might 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 tirelessly with you and the federal or state government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Ohio

The False Claims Act is an important statute that allows the government to combat fraud and abuse in health care programs across the nation. In Ohio, the government has lost millions to fraudulent Medicaid activity. Unfortunately, state and federal governments have limited resources when it comes to tackling fraud against government healthcare programs.

 

Consequently, the government has become reliant on private individuals and health care employees to come forward when they know about fraudulent activity. Whistleblower laws allow an employee or individual to come forward with a civil lawsuit against the perpetrating individual or entity on behalf of the government. 

 

The federal False Claims Act allows for individuals to come forward and be rewarded for their efforts. Under the federal Act, any individual or employee who brings a whistleblower claim on behalf of the government is entitled to a reward of between 15 percent and 25 percent of the recovery in the suit. If the government chooses not to enter into the suit, the whistleblower may receive a reward of between 25 and 30 percent of the recovery. 

 

In addition to a reward, whistleblower laws offer an added protection to whistleblowers to prevent retaliation, discharge, or discrimination by an employer.

Liability of the Defendant in Ohio

In a qui tam lawsuit, the defendant may be liable for up to three times the harm to the state as well as additional penalties of up to $5,500 to $11,000 for each separate violation.

Statute of Limitations in Ohio

Under the federal False Claims Act, a whistleblower claim is limited by a statute of limitations as follows:

 

  • A qui tam lawsuit must be commenced within three years of the date of discovering the fraudulent activity, or 
  • Within six years after the activity occurred, whichever occurred later, 
  • But not more than ten years after the activity occurred.

Working With an Experienced Whistleblower Attorney

If you have information regarding fraudulent activity regarding Ohio’s Medicaid program, you should know your rights and what to expect from a qui tam lawsuit. getting guidance from an experienced whistleblower attorney is essential. At Khurana Law Firm, P.C., our skilled team of experienced whistleblower attorneys will help you understand the procedure as well as your rights and options. Contact us for a confidential, no-cost consultation to discuss your case. 

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 can report it 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. 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER

When you become aware of fraud that may concern Medicaid or Medicare, you require the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is completely investigated and filed accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the government will intervene, thus increasing the chance for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam attorneys to assist in your battle against Medicare and Medicaid fraud. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam suit to help report the fraud and enable you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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