Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Hillsboro, Oregon

Medicare and Medicaid fraud cost Oregon taxpayers billions of dollars every year. Although many medical companies and drug companies are ethical and work within the system, some don’t. When fraud occurs, everyone can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare professionals to submit lawsuits on behalf of the government to report these kinds of scams.

The federal and state governments place a great deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government counts on regular folks in Oregon to come forward to report scams. People like you.

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Hillsboro, Oregon

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. understand that coming forward is difficult and many things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our substantial 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 assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Hillsboro, Oregon

Federal and state governments may lose billions of dollars every year in health care fraud. In Oregon, although the state does not have a false claims act of its own, a private citizen who has knowledge of fraudulent activity against the Medicaid program may have the ability to submit a qui tam suit under the federal False Claims Act.

 

The federal False Claims Act entitles a a private citizen to file a civil claim on behalf of the government to recuperate their part of the damages from fraudulent activity. The act entitles the whistleblower to collect a reward and provides employer retaliation protection to the whistleblower.

 

If the federal government picks to intervene in the lawsuit, a whistleblower might be able to collect in between 15 and 25 percent of the funds recovered by the federal government. If the federal government chooses not to participate in the litigation, the whistleblower might be able to gather between 25 and 30 percent of the recovery.

Liability of the Defendant in Hillsboro, Oregon

Under the federal False Claims Act, a defendant in a qui tam lawsuit can be mandated to pay damages in the amount of as much as triple the monetary harm to the federal government in addition to considerable fines for each infraction.

Statute of Limitations in Oregon

Under the federal False Claims Act, a whistleblower is required to submit their complaint within ten years of the date of the violation.

Working With an Experienced Whistleblower Lawyer

Federal and state governments depend on private individuals to come forward with details relating to health care fraud. For their heroic efforts, a whistleblower may be entitled to substantial awards. If you have knowledge of deceitful Medicaid activity in Hillsboro, Oregon, you may have the ability to submit a whistleblower suit and collect a a financial award under the federal False Claims Act. At Khurana Law Firm, our knowledgeable whistleblower attorneys can help. We provide a no-cost consultation to discuss your case and your rights under the law. Contact us to set up 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 Hillsboro, 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 Hillsboro, 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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Work With An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Hillsboro, Oregon

If you’ve become aware of potential fraud involving Medicare or Medicaid in Hillsboro, Oregon, you need the advice of a skilled whistleblower lawyer, someone who can make sure that your claim is totally investigated and filed accurately and promptly. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the possibility for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  do not try to do this alone, we are here to help.

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

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