Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Ohio taxpayers billions of dollars each year. Although most medical companies and drug companies are honest and work within the system, some don’t. When fraud happens, everyone loses. Medicare and Medicaid whistleblower attorneys assist healthcare professionals to file claims on behalf of the government to help report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in Lorain, Ohio

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the industry. understand that coming forward is challenging and many things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, diligently prepare your case, for court, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Lorain, Ohio

The False Claims Act is an important statute that permits the government to fight 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 dealing with fraud against government healthcare programs.

 

Consequently, the government often relies on private individuals and health care employees to come forward when they learn of deceitful activity. Whistleblower laws allow an employee 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 private citizens to come forward and be rewarded for their efforts. Under the federal act, any private individual or employee 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 federal government elects not to get in the suit, the whistleblower might get 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 in order to avoid retaliation, discharge, or discrimination by an employer.

Liability of the Defendant in Lorain, Ohio

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

Statute of Limitations in Lorain, Ohio

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

 

A qui tam lawsuit should be commenced within three years of the date of discovering the deceitful activity, or within 6 years after the activity occurred, whichever occurred later, but not more than 10 years after the activity took place.

Dealing with an Experienced Whistleblower Attorney

If you have information about fraudulent activity relating to Ohio’s Medicaid program in Lorain, Ohio, you ought to know your rights and what you may expect from a qui tam suit. In order to understand your rights, getting assistance from an experienced whistleblower lawyer is vital. 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 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 Lorain, 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 Lorain, 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 Lorain, Ohio

When you become aware of deceptive activity that may involve Medicaid or Medicare in Lorain, Ohio, you need the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is fully examined and submitted accurately and without delay. By working with a knowledgeable attorney you are increasing the chance that the government will intervene, therefore increasing the possibility for a reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not try 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 fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam lawsuit to help report the fraud and enable you to collect a reward. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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