Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Middletown, Ohio

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars annually. While many medical service providers and drug companies are ethical and work within the system, there are those who don’t. When scams are perpetrated, everybody can lose. Medicaid and Medicare whistleblower attorneys help healthcare professionals to file claims on behalf of the government to report this type of fraud.

The state and federal government put a good deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, it relies on private citizens in Ohio to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Middletown, Ohio

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the market. We know that coming forward is difficult and numerous things may be at stake. When you come to us, your case is held 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 federal or state government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Middletown, Ohio

The False Claims Act is a crucial statute that allows the government to combat fraud 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 tackling fraud against government health care programs.

 

As a result, the government often relies on private individuals and healthcare employees to come forward when they learn of deceitful activity. Whistleblower laws permit an employee or a private individual to come forward with a civil claim on behalf of the government, against the person or entity engaged in fraudulent activity.

 

The federal False Claims Act enables people to come forward and be rewarded for their efforts. Under the federal act, any private individual or worker 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 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 reward, whistleblower laws provide an added protection to whistleblowers in order to prevent retaliation, discharge, or discrimination by a company.

Liability of the Defendant in Middletown, Ohio

In a qui tam suit, the offender may be accountable for up to 3 times the damage to the state along with extra charges of up to $5,500 to $11,000 for each separate offense.

Statute of Limitations in Middletown, 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 begun within three years of the date of finding the fraudulent activity, or within 6 years after the activity took place, whichever happened later, however not more than 10 years after the activity took place.

Dealing with an Experienced Whistleblower Attorney

If you have information about deceptive activity concerning Ohio’s Medicaid program in Middletown, Ohio, you must know your rights and what you may anticipate in a qui tam suit. In order to understand your rights, it is vital to speak with an experienced whistleblower lawyer. At Khurana Law Firm, P.C., our knowledgeable group of whistleblower attorneys will help you understand how a qui tam lawsuit works as well as your rights and choices. 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 Middletown, 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 Middletown, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Middletown, Ohio

If you’ve become aware of fraud that may concern Medicaid or Medicare in Middletown, Ohio, you require the guidance of an experienced whistleblower attorney, someone who can ensure that your claim is fully examined and submitted accurately and quickly. By working with an experienced attorney you are increasing the chance that the government will step in, thus increasing the opportunity for a reward. Reporting Medicaid and Medicare scams is a complex matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam lawyers to help in your battle against Medicaid and Medicare scams. We will review your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam lawsuit to help report the fraud and allow 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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