Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Kettering, Ohio

Medicare and Medicaid fraud cost Ohio taxpayers billions of dollars every year. Although the majority of medical providers and drug companies are honest and work within the system, there are those who don’t. When fraud happens, everyone can lose. Medicare and Medicaid whistleblower lawyers help people who work in the healthcare system to submit lawsuits on behalf of the government to help report this sort of fraud.

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

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and scams in the industry. understand that coming forward is not easy and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Kettering, Ohio

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

 

As a result, the government often relies on private people and healthcare workers to come forward when they learn of fraudulent activity. Whistleblower laws enable a worker or a private individual to come forward with a civil lawsuit on behalf of the government, against the person or entity engaged in fraudulent activity.

 

The federal False Claims Act permits individuals 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 elects not to participate in the lawsuit, the whistleblower might get a benefit of between 25 and 30 percent of the recovery.

 

In addition to a benefit, whistleblower laws offer an additional protection to whistleblowers in order to prevent retaliation, discharge, or discrimination by an employer.

Liability of the Defendant in Kettering, Ohio

In a qui tam lawsuit, the defendant may be liable for approximately three times the harm to the state in addition to extra charges of as much as $5,500 to $11,000 for each separate violation.

Statute of Limitations in Kettering, Ohio

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

 

A qui tam claim needs to be commenced within 3 years of the date of finding the deceptive activity, or within 6 years after the activity occurred, whichever took place later, but not more than 10 years after the activity happened.

Working With an Experienced Whistleblower Attorney

If you have information about deceitful activity relating to Ohio’s Medicaid program in Kettering, Ohio, you ought to know your rights and what you may anticipate in a qui tam lawsuit. In order to understand your rights, it is necessary 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 in addition to your rights and options. Contact us for a confidential, 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 Kettering, 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 Kettering, 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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Report Medical fraud
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WORKING WITH An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Kettering, Ohio

If you’ve become aware of fraud that may concern Medicaid or Medicare in Kettering, Ohio, you need the guidance of a skilled whistleblower lawyer, someone who can ensure that your claim is completely investigated and submitted accurately and quickly. By dealing with an experienced attorney you are increasing the chance that the government will intervene, therefore increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam legal representatives to help in your battle against Medicare and Medicaid scams. We will examine your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we can represent you in a qui tam suit to help report the fraud and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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