Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Erie, Pennsylvania

Medicare and Medicaid fraud cost Pennsylvania taxpayers billions of dollars every year. Although the majority of medical companies and drug companies are ethical and work within the legal channels, some don’t. When fraud happens, everyone can lose. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to file lawsuits on behalf of the federal or state government to report these kinds of scams.

The federal and state governments put a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it depends on regular folks in Pennsylvania to come forward to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Erie, Pennsylvania

At Khurana Law Firm, P.C., as skilled 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 challenging 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 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 deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Erie, Pennsylvania

While taxpayers fund Medicaid to allow low-income health care for those who require it, there are dishonest individuals and business entities who defraud the state of Pennsylvania’s Medicaid program through fraudulent activity. These activities have actually cost the state government countless dollars. State resources devoted to the discovery of fraud are restricted and, subsequently, the state must depend on healthcare providers and others to report any knowledge of fraudulent activity.

 

Under the federal False Claims Act, individuals who are aware of deceptive activity against the government have the capability to submit a whistleblower claim to hold these parties liable. Under the Act, a person who brings a whistleblower claim is entitled to a benefit between 15 percent and 25 percent of any financial recovery, based on their understanding and contributions. If the government selects not to intervene in the action, the whistleblower might get between 25 and 30 percent of the financial recovery.

 

Whistleblower laws offer included worker protection to prevent a company from retaliating, discharging, threatening, or victimizing a whistleblower.

Liability of the Defendant in Erie, Pennsylvania

Offenses under the federal False Claims Act may result in fines and charges in the amount of 3 times the harm to the government along with extra charges of approximately $5,500 to $11,000 for each infraction.

Statute of Limitations in Erie, Pennsylvania

Under the federal False Claims Act, a whistleblower claim must be commenced within 3 years of the date of finding the deceitful activity and within 6 years after the activity took place, whichever occurred later on, but not more than 10 years after the activity took place.

Working With an Experienced Whistleblower Attorney

If you suspect deceptive activity in regards to the Medicaid program in Erie, Pennsylvania, getting assistance from a knowledgeable 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 confidential, no-cost consultation 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 Erie, 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 Erie, 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 LAWYER; We are proud to represent healthcare workers in Erie, Pennsylvania

If you’ve become aware of deceitful activity that may involve Medicaid or Medicare in Erie, Pennsylvania, you may need the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is totally investigated and submitted accurately and promptly. By dealing with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, hence increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud 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 experience as national qui tam lawyers to assist in your battle against Medicaid and Medicare fraud. We will evaluate your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we can represent you in a qui tam lawsuit to help report the scams and enable you to gather a financial benefit. Because all whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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