Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in Parma, Ohio

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars each year. While the majority of medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower lawyers can help people who work in the healthcare system to submit claims on behalf of the federal or state government to report these kinds of scams.

The state and federal governments place a great deal of trust in pharmaceutical and medical service providers. 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 Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Parma, Ohio

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the industry. We know that coming forward is challenging and numerous things might be at stake. When you come to us, your case is held in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, and work relentlessly with you and the federal or state government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Parma, Ohio

The False Claims Act is an essential statute that allows the government to combat scams and abuse in health care programs across the United States. In Ohio, the government has lost millions to deceptive Medicaid activity. Sadly, state and federal governments have limited resources when it comes to dealing with scams against government healthcare programs.

 

Consequently, the government has become reliant on private people and health care staff members to come forward when they know about fraudulent activity. Whistleblower laws enable a worker or a private individual to come forward with a civil lawsuit on behalf of the government, against the individual or entity engaged in fraudulent activity.

 

The federal False Claims Act allows individuals to come forward and be rewarded for their efforts. Under the federal act, any private 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 chooses not to enter into the lawsuit, the whistleblower might get a benefit of in between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in Parma, Ohio

In a qui tam suit, the defendant may be liable for as much as 3 times the harm to the state along with extra charges of up to $5,500 to $11,000 for each separate violation.

Statute of Limitations in Parma, 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 begun within 3 years of the date of discovering the deceptive activity, or within 6 years after the activity occurred, whichever happened later, however not more than 10 years after the activity occurred.

Dealing with an Experienced Whistleblower Attorney

If you know of deceitful activity regarding Ohio’s Medicaid program in Parma, Ohio, you must understand your rights and what you may anticipate in a qui tam lawsuit. In order to understand your rights, it is necessary to speak with an experienced whistleblower attorney. At Khurana Law Firm, P.C., our skilled group of whistleblower lawyers will help you understand how a qui tam lawsuit works as well as your rights and options. 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 Parma, 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 Parma, 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 LAWYER; We are proud to represent healthcare workers in Parma, Ohio

When you become aware of fraudulent activity that may concern Medicaid or Medicare in Parma, Ohio, you require the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is totally investigated and filed accurately and immediately. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will intervene, hence increasing the opportunity for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam legal representatives to assist in your fight against Medicare and Medicaid fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we may represent you in a qui tam claim to help report the scams and enable you to gather a financial benefit. All whistleblower cases are on contingency, you pay nothing until there is a recovery. Get in touch with us today to learn how we can help.

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