Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Haverford, Pennsylvania

Medicaid and Medicare fraud cost Pennsylvania taxpayers billions of dollars every year. Although many medical companies and drug companies are honest and work within the legal channels, there are those who do not. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower lawyers assist people who work in the healthcare system to file lawsuits on behalf of the government to help report these kinds of scams.

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

Work with

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and fraud in the industry. We know that coming forward is difficult and many things might be at stake. When you come to us, your case is held in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely examine your claim, diligently and carefully prepare your case, for court, 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 Haverford, Pennsylvania

While taxpayers help fund Medicaid in order to allow low-income healthcare for those who need it, there are dishonest people and companies who defraud the state of Pennsylvania’s Medicaid program through fraudulent activity. These activities have cost the state government countless dollars. State resources devoted to the discovery of fraud are restricted and, as a result, the state needs to count on health care providers and private citizens to report any knowledge of fraudulent activity.

 

Under the federal False Claims Act, individuals who know of fraudulent activity versus the government have the capability to file a whistleblower suit to hold these parties liable. 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 chooses not to intervene in the action, the whistleblower might receive in between 25 and 30 percent of the financial recovery.

 

Whistleblower laws offer added employee protection to avoid an employer from retaliating, discharging, threatening, or discriminating against a whistleblower.

Liability of the Defendant in Haverford, Pennsylvania

Infractions under the federal False Claims Act may lead to fines and charges in the quantity of three times the harm to the government as well as additional penalties of as much as $5,500 to $11,000 for each violation.

Statute of Limitations in Haverford, Pennsylvania

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

Working With an Experienced Whistleblower Attorney

If you suspect deceptive activity as it concerns the Medicaid program in Haverford, Pennsylvania, getting assistance from an experienced whistleblower attorney is vital. 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 alternatives. Contact us for a totally 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 Haverford, 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 Haverford, 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Haverford, Pennsylvania

When you become aware of fraud that may concern Medicare or Medicaid in Haverford, Pennsylvania, you need the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is totally examined and filed accurately and without delay. By dealing with a knowledgeable attorney you are increasing the chance that the government will step in, therefore increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam attorneys to assist in your battle against Medicaid and Medicare fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we may represent you in a qui tam claim to report the fraud and allow you to collect a reward. All whistleblower cases are on contingency, you pay nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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