Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Newark, Ohio

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars each year. Although most medical service providers and drug companies are honest and work within the legal channels, some don’t. When scams are perpetrated, everyone loses. Medicaid and Medicare whistleblower lawyers help healthcare workers to submit claims on behalf of the federal or state government to report this type of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Newark, Ohio

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the industry. We know that stepping forward is hard and lots of things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Newark, Ohio

The False Claims Act is an important statute that permits the government to combat fraud and abuse in health care programs across the country. In Ohio, the government has lost millions to deceitful Medicaid activity. Unfortunately, state and federal governments have restricted resources when it comes to dealing with fraud against government healthcare programs.

 

As a result, the government often relies on private individuals and health care workers to come forward when they learn of fraudulent 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 healthcare employee 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 elects not to participate in the lawsuit, the whistleblower might receive a benefit of in between 25 and 30 percent of the financial 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 Newark, Ohio

In a qui tam suit, the offender may be accountable for up to 3 times the harm to the state as well as extra charges of approximately $5,500 to $11,000 for each separate infraction.

Statute of Limitations in Newark, Ohio

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

 

A qui tam claim should be commenced within 3 years of the date of finding the deceptive activity, or within six years after the activity happened, whichever took place later on, however not more than 10 years after the activity took place.

Working With an Experienced Whistleblower Attorney

If you know of fraudulent activity regarding Ohio’s Medicaid program in Newark, Ohio, you ought to understand your rights and what you may anticipate in a qui tam claim. In order to understand your rights, getting assistance from a knowledgeable whistleblower lawyer is necessary. At Khurana Law Firm, P.C., our skilled group of whistleblower lawyers will help you understand how a qui tam lawsuit works along with your rights and alternatives. 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 Newark, 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 Newark, 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 LAWYER; We are proud to represent healthcare workers in Newark, Ohio

If you’ve become aware of deceptive activity involving Medicare or Medicaid in Newark, Ohio, you require the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is completely investigated and filed accurately and without delay. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing the possibility for a financial reward. Reporting Medicare and Medicaid scams is a complex matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam lawyers to assist in your fight against Medicare and Medicaid fraud. We will review your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we may represent you in a qui tam claim to report the scams and enable you to gather a reward. All whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can help.

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