Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Pennsylvania taxpayers billions of dollars every year. While many medical service providers and drug companies are ethical and work within the legal channels, there are those who do not. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower attorneys assist healthcare workers to file lawsuits on behalf of the federal or state government to help report this type of fraud.

The federal and state governments put a great deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, it relies on private citizens in Pennsylvania to come forward and to report fraud. People like you.

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Lower Merion, Pennsylvania

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the industry. understand that stepping forward is not simple and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently prepare your case, for court, and work tirelessly with both you and the federal or state government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Lower Merion, Pennsylvania

While taxpayers help fund Medicaid in order to allow low-income health care for those who need it, there are unethical people and companies who defraud the state of Pennsylvania’s Medicaid program through fraudulent activity. These activities have actually cost the state government millions of dollars. State resources committed to the discovery of scams are restricted and, consequently, the state needs to rely on healthcare providers and private citizens to report any knowledge of scams.

 

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

 

Whistleblower laws use included staff member protection to prevent a company from retaliating, discharging, threatening, or discriminating against a whistleblower.

Liability of the Defendant in Lower Merion, Pennsylvania

Offenses under the federal False Claims Act might lead to fines and charges in the quantity of three times the harm to the government as well as extra charges of up to $5,500 to $11,000 for each offense.

Statute of Limitations in Lower Merion, Pennsylvania

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

Dealing with an Experienced Whistleblower Attorney

If you know of deceptive activity in regards to the Medicaid program in Lower Merion, Pennsylvania, getting guidance from a knowledgeable whistleblower lawyer is necessary. 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 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 Lower Merion, 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 Lower Merion, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Lower Merion, Pennsylvania

When you become aware of deceitful activity as it concerns Medicaid or Medicare in Lower Merion, Pennsylvania, you may need the guidance of an experienced whistleblower lawyer, someone who can ensure that your claim is totally examined and filed accurately and promptly. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will step in, therefore increasing the possibility for a reward. Reporting Medicare and Medicaid 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 lawyers to assist in your battle against Medicare and Medicaid scams. We will examine your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam claim to report the scams and allow you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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