Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Akron, Ohio

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars each year. Although the majority of medical service providers and drug companies are honest and work within the legal channels, there are those who do not. When fraud occurs, everybody can lose. Medicare and Medicaid whistleblower lawyers assist healthcare workers to file suits on behalf of the government to help report this sort of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in Akron, Ohio

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the industry. We know that coming forward is challenging and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Akron, Ohio

The False Claims Act is an essential statute that enables the government to fight fraud and abuse in healthcare programs throughout the nation. In Ohio, the government has lost millions to fraudulent Medicaid activity. Unfortunately, state and federal governments have limited resources when it pertains to taking on 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 deceitful activity. Whistleblower laws allow a staff member or a private individual to come forward with a civil claim on behalf of the government, against the individual or business entity engaged in fraudulent activity.

 

The federal False Claims Act allows people 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 participate in the suit, the whistleblower may get a benefit of between 25 and 30 percent of the recovery.

 

In addition to a benefit, whistleblower laws provide an added protection to whistleblowers in order to avoid retaliation, discharge, or discrimination by a company.

Liability of the Defendant in Akron, Ohio

In a qui tam suit, the defendant might be liable for as much as three times the damage to the state along with extra penalties of approximately $5,500 to $11,000 for each separate violation.

Statute of Limitations in Akron, Ohio

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

 

A qui tam lawsuit needs to be begun within three years of the date of discovering the deceptive activity, or within 6 years after the activity happened, whichever took place later, however not more than 10 years after the activity took place.

Working With an Experienced Whistleblower Attorney

If you know of deceitful activity relating to Ohio’s Medicaid program in Akron, Ohio, you should understand your rights and what you may expect from a qui tam claim. In order to understand your rights, getting guidance from a knowledgeable whistleblower attorney is vital. At Khurana Law Firm, P.C., our skilled group of whistleblower lawyers will help you understand how a qui tam lawsuit works along with your rights and options. Contact us for a private, no-cost assessment 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 are a healthcare worker in Akron, Ohio, 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 Akron, Ohio,  you can report Medicare fraud when you 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Akron, Ohio

If you’ve become aware of potential fraud that may involve Medicaid or Medicare in Akron, Ohio, you need the guidance of an experienced whistleblower lawyer, someone who can ensure that your claim is fully investigated and filed accurately and without delay. By working with a skilled lawyer you are increasing the chance that the federal or state government will step in, hence increasing the chance for a reward. Reporting Medicaid and Medicare scams is a complicated matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam attorneys to assist in your fight against Medicaid and Medicare scams. Our attorneys will review your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we may represent you in a qui tam suit to report the fraud and enable you to gather a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to learn how we can be of help.

Service areas