Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Harrisburg, Pennsylvania

Medicare and Medicaid fraud cost Pennsylvania taxpayers billions of dollars every year. While most medical service providers and drug companies are honest and work within the legal channels, there are those who do not. When fraud occurs, everybody loses. Medicare and Medicaid whistleblower attorneys can help healthcare professionals to file lawsuits on behalf of the government to help report these kinds of scams.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Harrisburg, Pennsylvania

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic choice 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 comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, and work tirelessly with both you and the state of federal government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Harrisburg, Pennsylvania

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

 

Under the federal False Claims Act, individuals who are aware of deceptive activity versus 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 reward between 15 percent and 25 percent of any recovery, based upon their knowledge and contributions. If the government chooses not to intervene in the action, the whistleblower might get between 25 and 30 percent of the financial recovery.

 

Whistleblower laws offer added staff member security to prevent a company from striking back, discharging, threatening, or victimizing a whistleblower.

Liability of the Defendant in Harrisburg, Pennsylvania

Infractions under the federal False Claims Act may result in fines and charges in the quantity of 3 times the harm to the government along with extra penalties of as much as $5,500 to $11,000 for each violation.

Statute of Limitations in Harrisburg, Pennsylvania

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

Working With an Experienced Whistleblower Attorney

If you know of deceitful activity as it concerns the Medicaid program in Harrisburg, Pennsylvania, getting guidance from an experienced whistleblower lawyer is vital. At Khurana Law Firm, P.C., we can help you determine if you have a valid whistleblower claim and help you understand your rights and choices. 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 Harrisburg, 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 Harrisburg, 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 LAWYER; We are proud to represent healthcare workers in Harrisburg, Pennsylvania

If you’ve become aware of potential fraud that may involve Medicaid or Medicare in Harrisburg, Pennsylvania, you require the guidance of an experienced whistleblower attorney, someone who can ensure that your claim is completely investigated and submitted accurately and immediately. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity for a financial reward. Reporting Medicare and Medicaid scams 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 prior experience as national qui tam attorneys to help in your battle against Medicaid and Medicare fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam claim to report the fraud and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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