Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in Gresham, Oregon

Medicare and Medicaid fraud cost Oregon taxpayers billions of dollars each year. Although many medical companies and drug companies are ethical and work within the system, there are those who do not. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower attorneys can assist people who work in the healthcare system to file claims on behalf of the federal or state government to help report this sort of fraud.

The federal and state governments put a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, the government depends on private citizens in Oregon to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Gresham, Oregon

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 industry. understand that stepping forward is hard and many 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 completely examine your claim, carefully prepare your case, and work relentlessly 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 Gresham, Oregon

State and federal governments lose billions of dollars every year in healthcare fraud. In Oregon, although the state does not have a false claims act of its own, a private individual who knows of fraudulent activity against the Medicaid program may be able to submit a qui tam lawsuit under the federal False Claims Act.

 

The federal False Claims Act entitles an individual to file a civil claim on behalf of the government to recover their part of the damages from deceptive activity. The act entitles the whistleblower to collect a financial reward and affords employer retaliation protection to the whistleblower.

 

If the federal government chooses to intervene in the suit, a whistleblower may have the ability to get in between 15 and 25 percent of the recovery by the federal government. If the government selects not to participate in the lawsuit, the whistleblower may be able to gather in between 25 and 30 percent of the recovery.

Liability of the Defendant in Gresham, Oregon

Under the federal False Claims Act, a defendant in a qui tam suit can be mandated to pay damages in the amount of up to triple the monetary damage to the federal government in addition to significant fines for each infraction.

Statute of Limitations in Oregon

Under the federal False Claims Act, a whistleblower has to file their complaint within ten years of the date of the offense.

Working With an Experienced Whistleblower Lawyer

Federal and state governments rely on private citizens to come forward with details concerning healthcare scams. For their heroic efforts, a whistleblower might be entitled to considerable awards. If you have knowledge of fraudulent Medicaid activity in Gresham, Oregon, you might be able to submit a whistleblower lawsuit and collect a reward under the federal False Claims Act. At Khurana Law Firm, our skilled whistleblower attorneys can help. We provide a no-cost consultation to discuss your case and your rights under the law. Contact us to arrange an appointment.

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 Gresham, Oregon, 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 Gresham, Oregon,  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 LAWYER; We are proud to represent healthcare workers in Gresham, Oregon

When you become aware of fraudulent activity as it concerns Medicare or Medicaid in Gresham, Oregon, you need the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is completely investigated and submitted accurately and immediately. By working with a skilled attorney you are increasing the chance that the government will intervene, thus increasing the chance for a reward. Reporting Medicaid and Medicare fraud is a complicated matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam attorneys to help in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we can represent you in a qui tam claim to report the fraud and enable you to gather a reward. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to learn how we can be of help.

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