Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Mentor, Ohio

Medicare and Medicaid fraud cost Ohio taxpayers billions of dollars each year. Although most medical providers and drug companies are ethical and work within the system, there are those who don’t. When fraud happens, everybody can lose. Medicaid and Medicare whistleblower lawyers can help people who work in the healthcare system to submit claims on behalf of the federal or state government to help report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Mentor, Ohio

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic choice to come forward to report abuse and scams in the market. We know that stepping forward is not easy and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Mentor, Ohio

The False Claims Act is an important statute that permits the government to combat fraud and abuse in healthcare programs throughout the nation. In Ohio, the government has lost millions to deceptive Medicaid activity. Unfortunately, state and federal governments have limited resources when it concerns taking on fraud against government healthcare programs.

 

Consequently, the government often relies on private individuals and health care staff members to come forward when they learn of deceitful activity. Whistleblower laws enable an employee or a private individual to come forward with a civil claim on behalf of the government, against the individual or entity engaged in fraudulent activity.

 

The federal False Claims Act permits people to come forward and be rewarded for their efforts. Under the federal act, any individual or staff member who brings a whistleblower claim on behalf of the government is entitled to a benefit of between 15 percent and 25 percent of the recovery in the suit. If the government picks not to enter into the suit, the whistleblower may 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 to avoid retaliation, discharge, or discrimination by a company.

Liability of the Defendant in Mentor, Ohio

In a qui tam suit, the accused might be liable for up to 3 times the harm to the state as well as extra penalties of up to $5,500 to $11,000 for each different offense.

Statute of Limitations in Mentor, Ohio

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

 

A qui tam lawsuit needs to be started within three years of the date of discovering the fraudulent activity, or within six years after the activity happened, whichever happened later on, but not more than ten years after the activity occurred.

Working With an Experienced Whistleblower Attorney

If you know of deceitful activity relating to Ohio’s Medicaid program in Mentor, Ohio, you should understand your rights and what you may expect from a qui tam lawsuit. In order to understand your rights, it is essential to speak with an experienced whistleblower lawyer. At Khurana Law Firm, P.C., our experienced team of whistleblower attorneys will assist you in understanding how a qui tam lawsuit works along with your rights and choices. 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 Mentor, 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 Mentor, 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 ATTORNEY; We are proud to represent healthcare workers in Mentor, Ohio

When you become aware of potential fraud as it concerns Medicare or Medicaid in Mentor, Ohio, you may need the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is completely examined and filed accurately and promptly. By working with a knowledgeable attorney you are increasing the chance that the government will step in, therefore increasing the chance for a financial reward. Reporting Medicaid and Medicare scams is a complicated 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 lawyers to help in your battle against Medicare and Medicaid fraud. We will review your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we may represent you in a qui tam suit 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. Get in touch with us today to to schedule a confidential consultation.

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