Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid scams in Elyria, Ohio

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars each year. Although many medical companies and drug companies are ethical and work within the system, there are those who do not. When fraud occurs, everybody can lose. Medicare and Medicaid whistleblower lawyers help healthcare professionals to file lawsuits on behalf of the federal or state government to report this sort of fraud.

The state and federal government put a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government counts on every day people in Ohio to come forward and to report scams. People like you.

Work with

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the market. understand that stepping forward is hard and many things might be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Elyria, Ohio

The False Claims Act is a crucial statute that enables the government to fight scams and abuse in healthcare programs throughout the United States. In Ohio, the government has lost millions to deceitful Medicaid activity. Unfortunately, state and federal governments have limited resources when it concerns tackling fraud against government healthcare programs.

 

Consequently, the government often relies on private individuals and health care workers to come forward when they know about deceptive activity. Whistleblower laws permit an employee or a private individual to come forward with a civil lawsuit on behalf of the government, against the person or business 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 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 elects not to enter into the suit, the whistleblower may get a reward of in between 25 and 30 percent of the financial recovery.

 

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

Liability of the Defendant in Elyria, Ohio

In a qui tam claim, the offender may be responsible for up to 3 times the damage to the state along with extra charges of up to $5,500 to $11,000 for each separate violation.

Statute of Limitations in Elyria, Ohio

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

 

A qui tam suit must be commenced within 3 years of the date of discovering the deceitful activity, or within 6 years after the activity occurred, whichever happened later, however not more than ten years after the activity took place.

Working With an Experienced Whistleblower Attorney

If you know of fraudulent activity relating to Ohio’s Medicaid program in Elyria, Ohio, you ought to understand your rights and what you may anticipate in a qui tam suit. In order to understand your rights, getting guidance 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 along with your rights and alternatives. Contact us for a personal, 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 are a healthcare worker in Elyria, 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 Elyria, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Elyria, Ohio

If you’ve become aware of potential fraud that may involve Medicaid or Medicare in Elyria, Ohio, you need the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is totally examined and filed accurately and immediately. By working with an experienced attorney you are increasing the chance that the government will step in, hence increasing the chance for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  don’t attempt 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 scams. Our attorneys will examine 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 lawsuit to report the scams and enable you to collect a financial benefit. Because all whistleblower work is on contingency, you pay nothing up until there is a recovery. Contact us today to to schedule a confidential consultation.

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