Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Ohio taxpayers billions of dollars annually. Although many medical providers and drug companies are honest and work within the legal channels, some don’t. When fraud takes place, everybody can lose. Medicare and Medicaid whistleblower attorneys help healthcare professionals to submit suits on behalf of the government to help report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Hamilton, Ohio

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and fraud in the industry. We know that stepping forward is difficult and lots of 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 thoroughly investigate your claim, diligently prepare your case, and work relentlessly with you and the state of federal government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Hamilton, Ohio

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

 

Consequently, the government often relies on private people and healthcare staff members to come forward when they know about fraudulent activity. Whistleblower laws allow a worker or a private individual to come forward with a civil lawsuit on behalf of the government, against the individual or business entity engaged in fraudulent activity.

 

The federal False Claims Act allows individuals to come forward and be rewarded for their efforts. Under the federal act, any individual or worker 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 picks not to participate in the lawsuit, the whistleblower might get a reward of in between 25 and 30 percent of the financial recovery.

 

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

Liability of the Defendant in Hamilton, Ohio

In a qui tam claim, the defendant may be liable for as much as 3 times the harm to the state along with extra penalties of as much as $5,500 to $11,000 for each different offense.

Statute of Limitations in Hamilton, Ohio

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

 

A qui tam suit needs to be begun within 3 years of the date of finding the deceitful activity, or within 6 years after the activity happened, whichever occurred later, however not more than 10 years after the activity occurred.

Working With an Experienced Whistleblower Attorney

If you have information about deceptive activity concerning Ohio’s Medicaid program in Hamilton, Ohio, you ought to understand 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 attorney. At Khurana Law Firm, P.C., our knowledgeable team of whistleblower lawyers will assist you in understanding how a qui tam lawsuit works as well as 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 Hamilton, 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 Hamilton, 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 LAWYER; We are proud to represent healthcare workers in Hamilton, Ohio

If you’ve become aware of fraud that may concern Medicaid or Medicare in Hamilton, Ohio, you may need the guidance of a skilled whistleblower lawyer, someone who can make sure that your claim is totally investigated and submitted accurately and quickly. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, hence increasing your chances for a reward. Reporting Medicaid and Medicare fraud is a complicated matter –  don’t 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 legal representatives to assist in your battle against Medicaid and Medicare scams. Our attorneys will review your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we may represent you in a qui tam lawsuit to report the scams and allow you to collect a reward. All whistleblower work is on contingency, you pay nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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