Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Lakewood, Ohio

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars each year. While many medical service providers and drug companies are ethical and work within the legal channels, some don’t. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower attorneys assist healthcare workers to submit lawsuits on behalf of the government to help report these kinds of scams.

The federal and state government place a good deal of trust in medical and pharmaceutical service 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 Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Lakewood, Ohio

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the industry. understand that stepping forward is not simple and many things may 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 completely examine your claim, diligently prepare your case, for court, and work tirelessly with both you and the state of federal government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Lakewood, Ohio

The False Claims Act is a crucial statute that permits the government to fight fraud and abuse in health care programs throughout the United States. In Ohio, the government has lost millions to fraudulent Medicaid activity. Sadly, state and federal governments have limited resources when it comes to dealing with fraud against government healthcare programs.

 

Subsequently, the government often relies on private people and health care staff members to come forward when they learn of deceitful activity. Whistleblower laws allow a healthcare employee or a private individual to come forward with a civil suit on behalf of the government, against the individual or business 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 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 lawsuit. If the federal government elects not to enter into the suit, the whistleblower may receive a reward of in between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in Lakewood, Ohio

In a qui tam claim, the offender might be accountable for up to 3 times the harm to the state along with additional charges of approximately $5,500 to $11,000 for each separate offense.

Statute of Limitations in Lakewood, Ohio

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

 

A qui tam suit must be commenced within three years of the date of finding the deceptive activity, or within 6 years after the activity occurred, whichever occurred later on, however not more than 10 years after the activity occurred.

Working With an Experienced Whistleblower Attorney

If you know of deceptive activity relating to Ohio’s Medicaid program in Lakewood, Ohio, you need to understand your rights and what you may anticipate in a qui tam suit. In order to understand your rights, it is essential to speak with an experienced whistleblower lawyer. At Khurana Law Firm, P.C., our skilled team of whistleblower attorneys will help you understand how a qui tam lawsuit works as well as your rights and alternatives. Contact us for a private, 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 Lakewood, 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 Lakewood, 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Lakewood, Ohio

If you’ve become aware of fraud as it concerns Medicare or Medicaid in Lakewood, Ohio, you may need the guidance of an experienced whistleblower attorney, someone who can ensure that your claim is fully examined and filed accurately and promptly. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, thus increasing the possibility for a reward. Reporting Medicaid and Medicare 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 practical experience as national qui tam legal representatives to assist in your fight against Medicaid and Medicare scams. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam suit to report the fraud and enable you to gather a financial benefit. All whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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