Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Pennsylvania taxpayers billions of dollars each year. While many medical companies and drug companies are ethical and work within the system, some don’t. When scams are perpetrated, everyone can lose. Medicaid and Medicare whistleblower lawyers can help healthcare professionals to file lawsuits on behalf of the government to help report these kinds of scams.

The state and federal government put a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government depends on regular folks in Pennsylvania to come forward to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Bethlehem city, Pennsylvania

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the market. We know that stepping forward is not easy and lots of things might 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 investigate your claim, diligently and carefully prepare your case, and work relentlessly with you and the state of federal government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Bethlehem city, Pennsylvania

While taxpayers help fund Medicaid to enable low-income healthcare for those who need it, there are unethical individuals and business entities who defraud the state of Pennsylvania’s Medicaid program through deceptive activity. These activities have actually cost the state government countless dollars. State resources dedicated to the discovery of scams are limited and, as a result, the state must rely on healthcare providers and others to report any knowledge of fraudulent activity.

 

Under the federal False Claims Act, individuals who know of deceitful activity against the government have the ability to submit a whistleblower lawsuit to hold these parties accountable. Under the Act, an individual who brings a whistleblower claim is entitled to a benefit between 15 percent and 25 percent of any recovery, based on their understanding and contributions. If the government chooses not to intervene in the action, the whistleblower might get in between 25 and 30 percent of the financial recovery.

 

Whistleblower laws offer included staff member defense to avoid a company from striking back, discharging, threatening, or victimizing a whistleblower.

Liability of the Defendant in Bethlehem city, Pennsylvania

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

Statute of Limitations in Bethlehem city, Pennsylvania

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

Working With an Experienced Whistleblower Attorney

If you suspect fraudulent activity in regards to the Medicaid program in Bethlehem city, Pennsylvania, getting assistance from a knowledgeable whistleblower attorney is essential. At Khurana Law Firm, P.C., we will help you figure out if you have a legitimate whistleblower claim and help you understand your rights and alternatives. Contact us for a 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 Bethlehem city, 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 Bethlehem city, 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Bethlehem city, Pennsylvania

When you become aware of potential fraud involving Medicaid or Medicare in Bethlehem city, Pennsylvania, you need the advice of an experienced whistleblower attorney, someone who can guarantee that your claim is fully examined and filed accurately and quickly. By dealing with a skilled lawyer you are increasing the chance that the government will intervene, therefore increasing the chance for a financial 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 have years of experience as national qui tam attorneys to assist in your battle against Medicaid and Medicare fraud. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam lawsuit to report the scams and allow you to collect a reward. All whistleblower work is on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can be of help.

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