Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars every year. Although the majority of medical companies and drug companies are ethical and work within the legal channels, there are those who do not. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower lawyers help healthcare workers to file suits on behalf of the government to report these kinds of scams.

The federal and state governments place a great deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, it depends on private citizens in Ohio to come forward and to report fraud. People like you.

Work with

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and scams in the market. understand that stepping forward is not easy and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Cleveland, Ohio

The False Claims Act is an important statute that allows the government to combat scams and abuse in healthcare programs throughout the nation. In Ohio, the government has lost millions to fraudulent Medicaid activity. Sadly, state and federal governments have restricted resources when it pertains to taking on scams against government health care programs.

 

Consequently, the government often relies on private individuals and healthcare workers to come forward when they learn of deceptive activity. Whistleblower laws enable an employee or a private individual to come forward with a civil suit on behalf of the government, against the person or entity engaged in fraudulent activity.

 

The federal False Claims Act enables private citizens 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 benefit of in between 15 percent and 25 percent of the recovery in the suit. If the federal government chooses not to participate in the lawsuit, the whistleblower may receive a benefit of in between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in Cleveland, Ohio

In a qui tam claim, the accused may be liable for up to three times the damage to the state in addition to extra penalties of as much as $5,500 to $11,000 for each different infraction.

Statute of Limitations in Cleveland, Ohio

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

 

A qui tam claim must be begun within three years of the date of discovering the deceitful activity, or within 6 years after the activity occurred, whichever occurred later, however not more than 10 years after the activity occurred.

Dealing with an Experienced Whistleblower Attorney

If you know of fraudulent activity relating to Ohio’s Medicaid program in Cleveland, Ohio, you ought to know your rights and what you may anticipate in a qui tam lawsuit. In order to understand your rights, getting assistance from an experienced whistleblower attorney is necessary. At Khurana Law Firm, P.C., our experienced group of whistleblower attorneys will assist you in understanding how a qui tam lawsuit works in addition to your rights and choices. 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 Cleveland, 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 Cleveland, 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Cleveland, Ohio

When you become aware of fraud as it concerns Medicaid or Medicare in Cleveland, Ohio, you may need the advice of a knowledgeable whistleblower attorney, someone who can ensure that your claim is totally investigated and submitted accurately and quickly. By working with an experienced lawyer you are increasing the chance that the government will intervene, hence increasing the opportunity for a 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 have years of experience as national qui tam lawyers to help in your battle against Medicaid and Medicare scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam claim to report the fraud and enable you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can help.

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