Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Toledo, Ohio

Medicaid and Medicare fraud cost Ohio taxpayers billions of dollars annually. While the majority of medical providers and drug companies are honest and work within the system, some do not. When fraud happens, everyone can lose. Medicare and Medicaid whistleblower lawyers can assist people who work in the healthcare system to file suits on behalf of the federal or state government to report these kinds of scams.

The state and federal governments place a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government counts on regular folks 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 Toledo, Ohio

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

With our extensive experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, for court, and work relentlessly with you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Toledo, Ohio

The False Claims Act is an important statute that permits the government to combat scams and abuse in health care programs throughout the nation. In Ohio, the government has lost millions to deceitful Medicaid activity. Sadly, state and federal governments have restricted resources when it comes to tackling fraud 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 claim on behalf of the government, against the person or entity engaged in fraudulent activity.

 

The federal False Claims Act enables private citizens 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 lawsuit. If the government chooses not to get in the lawsuit, the whistleblower may get a reward of in between 25 and 30 percent of the financial recovery.

 

In addition to a reward, whistleblower laws offer an additional protection to whistleblowers in order to avoid retaliation, discharge, or discrimination by an employer.

Liability of the Defendant in Toledo, Ohio

In a qui tam claim, the defendant might be liable for up to 3 times the harm to the state as well as extra charges of approximately $5,500 to $11,000 for each different infraction.

Statute of Limitations in Toledo, Ohio

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

 

A qui tam suit should be started within 3 years of the date of finding the deceitful activity, or within six years after the activity occurred, whichever happened later, however not more than ten years after the activity happened.

Dealing with an Experienced Whistleblower Attorney

If you know of deceitful activity concerning Ohio’s Medicaid program in Toledo, Ohio, you need to know your rights and what you may anticipate in a qui tam claim. In order to understand your rights, it is important 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 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 Toledo, 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 Toledo, 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 Toledo, Ohio

If you’ve become aware of fraud involving Medicare or Medicaid in Toledo, Ohio, you require the guidance of an experienced whistleblower attorney, someone who can guarantee that your claim is completely examined and submitted accurately and without delay. By dealing with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, thus increasing your chances for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam lawyers to help in your fight against Medicare and Medicaid fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam claim to report the fraud and allow you to collect a reward. Because all whistleblower cases are on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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