Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Cincinnati, Ohio

Medicare and Medicaid fraud cost Ohio taxpayers billions of dollars annually. While the majority of medical companies and drug companies are ethical and work within the legal channels, there are those who do not. When fraud happens, everybody loses. Medicare and Medicaid whistleblower lawyers assist healthcare workers to file suits on behalf of the federal or state government to report this type of fraud.

The state and federal government put a lot of trust in medical and pharmaceutical companies. When that trust is ill-placed, it depends on private citizens in Ohio to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Cincinnati, Ohio

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the market. understand that coming forward is challenging and many things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, and work relentlessly with you and the state of federal government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Cincinnati, Ohio

The False Claims Act is an essential statute that permits the government to combat scams and abuse in health care programs across the United States. In Ohio, the government has lost millions to fraudulent Medicaid activity. Regrettably, state and federal governments have restricted resources when it comes to taking on scams against government healthcare programs.

 

Consequently, the government has become reliant on private people and healthcare workers to come forward when they learn of deceptive activity. Whistleblower laws enable a worker or a private individual to come forward with a civil claim on behalf of the government, against the individual or 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 private individual or healthcare employee who brings a whistleblower claim on behalf of the government is entitled to a reward of in between 15 percent and 25 percent of the recovery in the suit. If the federal government picks not to enter into the suit, the whistleblower may receive a benefit of in between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in Cincinnati, Ohio

In a qui tam lawsuit, the offender might be liable for approximately 3 times the damage to the state as well as additional charges of approximately $5,500 to $11,000 for each separate violation.

Statute of Limitations in Cincinnati, 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 started within three years of the date of discovering the fraudulent activity, or within 6 years after the activity occurred, whichever happened later on, but not more than 10 years after the activity occurred.

Working With an Experienced Whistleblower Attorney

If you have information about deceitful activity regarding Ohio’s Medicaid program in Cincinnati, Ohio, you must know your rights and what you may anticipate in a qui tam suit. In order to understand your rights, it is important to speak with an experienced whistleblower lawyer. At Khurana Law Firm, P.C., our experienced team of whistleblower attorneys will help you understand how a qui tam lawsuit works along with your rights and options. Contact us for a confidential, 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 Cincinnati, 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 Cincinnati, Ohio,  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 A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Cincinnati, Ohio

When you become aware of fraud involving Medicare or Medicaid in Cincinnati, Ohio, you need the advice of a knowledgeable whistleblower lawyer, someone who can guarantee that your claim is totally examined and filed accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity for a financial reward. Reporting Medicare and Medicaid fraud is an intricate matter –  don’t attempt 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 legal representatives to assist in your battle against Medicare and Medicaid scams. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam lawsuit to report the scams and allow you to collect a financial benefit. Because all whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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