Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Bensalem, Pennsylvania

Medicare and Medicaid fraud cost Pennsylvania taxpayers billions of dollars annually. Although the majority of medical service providers and drug companies are honest and work within the system, there are those who do not. When fraud occurs, everybody loses. Medicaid and Medicare whistleblower lawyers help people who work in the healthcare system to submit suits on behalf of the government to report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in Bensalem, Pennsylvania

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the market. We know that stepping forward is not simple and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, for court, and work relentlessly with both you and the state of federal government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Bensalem, Pennsylvania

While taxpayers fund Medicaid to enable low-income health care for those who need it, there are unscrupulous people and companies who defraud the state of Pennsylvania’s Medicaid program through fraudulent activity. These activities have actually cost the government countless dollars. State resources committed to the discovery of fraud are restricted and, consequently, the state must depend on health care providers and private citizens to report any knowledge of scams.

 

Under the federal False Claims Act, individuals who know of fraudulent activity versus the government have the ability to file a whistleblower suit to hold these parties responsible. Under the Act, an individual who brings a whistleblower claim is entitled to a reward in between 15 percent and 25 percent of any recovery, based upon their understanding and contributions. If the government selects not to intervene in the action, the whistleblower may receive in between 25 and 30 percent of the financial recovery.

 

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

Liability of the Defendant in Bensalem, Pennsylvania

Violations under the federal False Claims Act might lead to fines and penalties in the quantity of 3 times the damage to the government in addition to extra penalties of approximately $5,500 to $11,000 for each infraction.

Statute of Limitations in Bensalem, Pennsylvania

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

Dealing with an Experienced Whistleblower Attorney

If you suspect deceitful activity in regards to the Medicaid program in Bensalem, Pennsylvania, getting assistance from a skilled whistleblower attorney is vital. At Khurana Law Firm, P.C., we will help you identify if you have a legitimate 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 Bensalem, 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 Bensalem, 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Bensalem, Pennsylvania

When you become aware of fraudulent activity as it concerns Medicaid or Medicare in Bensalem, Pennsylvania, you require the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is fully investigated and filed accurately and without delay. By working with a skilled attorney you are increasing the chance that the federal or state government will step in, therefore increasing your chances for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  do not attempt 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 legal representatives to help in your fight against Medicare and Medicaid scams. We will examine your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we can represent you in a qui tam suit to help report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can help.

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