Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Allentown, Pennsylvania

Medicaid and Medicare fraud cost Pennsylvania taxpayers billions of dollars every year. While most medical companies and drug companies are honest and work within the legal channels, some do not. When scams are perpetrated, everybody can lose. Medicaid and Medicare whistleblower attorneys help people who work in the healthcare system to file claims on behalf of the federal or state government to help report this type of fraud.

The state and federal government put a great deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, it counts on every day people in Pennsylvania to come forward to report scams. People like you.

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Allentown, Pennsylvania

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and fraud in the industry. understand that stepping forward is challenging and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, and work relentlessly with both you and the federal or state government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Allentown, Pennsylvania

While taxpayers fund Medicaid to enable low-income health care for those who need it, there are unscrupulous people and business entities who defraud the state of Pennsylvania’s Medicaid program through fraudulent activity. These activities have actually cost the state government millions of dollars. State resources devoted to the discovery of scams are restricted and, as a result, the state must count on healthcare providers and others to report any knowledge of fraudulent activity.

 

Under the federal False Claims Act, people who are aware of deceptive activity versus the government have the ability to submit a whistleblower claim to hold these parties responsible. Under the Act, an individual who brings a whistleblower claim is entitled to a benefit between 15 percent and 25 percent of any financial recovery, based upon their understanding and contributions. If the government selects not to intervene in the action, the whistleblower might receive between 25 and 30 percent of the recovery.

 

Whistleblower laws offer added worker security to avoid a company from retaliating, discharging, threatening, or victimizing a whistleblower.

Liability of the Defendant in Allentown, Pennsylvania

Violations under the federal False Claims Act may lead to fines and penalties in the amount of 3 times the harm to the government in addition to additional penalties of as much as $5,500 to $11,000 for each infraction.

Statute of Limitations in Allentown, Pennsylvania

Under the federal False Claims Act, a whistleblower claim should be started within 3 years of the date of discovering the deceptive activity and within 6 years after the activity occurred, whichever happened later, however not more than 10 years after the activity took place.

Working With an Experienced Whistleblower Attorney

If you suspect deceptive activity as it concerns the Medicaid program in Allentown, Pennsylvania, getting assistance from an experienced whistleblower attorney is essential. At Khurana Law Firm, P.C., we can help you figure out if you have a valid whistleblower claim and help you understand your rights and options. Contact us for a totally confidential, no-cost assessment 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 Allentown, Pennsylvania, 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 Allentown, Pennsylvania,  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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Report Medical fraud
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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Allentown, Pennsylvania

When you become aware of fraud that may involve Medicare or Medicaid in Allentown, Pennsylvania, you may need the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is fully investigated and submitted accurately and immediately. By working with a skilled attorney you are increasing the chance that the government will intervene, hence increasing the possibility for a reward. Reporting Medicaid and Medicare fraud is an intricate matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam attorneys to assist in your battle against Medicare and Medicaid fraud. We will review your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we can represent you in a qui tam suit to help report the fraud and allow you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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