Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Lower Paxton, Pennsylvania

Medicare and Medicaid fraud cost Pennsylvania taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are honest and work within the system, there are those who do not. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower lawyers can assist healthcare workers to file claims 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, it relies on regular folks in Pennsylvania to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Lower Paxton, Pennsylvania

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic choice to come forward to report abuse and scams in the market. We know that stepping forward is not simple and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently and 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 Lower Paxton, Pennsylvania

While taxpayers help fund Medicaid in order to permit low-income health care for those who need it, there are deceitful individuals and companies who defraud the state of Pennsylvania’s Medicaid program through deceptive activity. These activities have actually cost the government countless dollars. State resources dedicated to the discovery of fraud are limited and, consequently, the state should rely on health care service providers and private citizens to report any knowledge of scams.

 

Under the federal False Claims Act, people who know of deceptive activity against the government have the capability to file a whistleblower claim to hold these parties responsible. Under the Act, an individual 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 chooses not to intervene in the action, the whistleblower might receive in between 25 and 30 percent of the financial recovery.

 

Whistleblower laws use added worker security to prevent an employer from retaliating, discharging, threatening, or discriminating against a whistleblower.

Liability of the Defendant in Lower Paxton, Pennsylvania

Violations 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 additional charges of up to $5,500 to $11,000 for each offense.

Statute of Limitations in Lower Paxton, Pennsylvania

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

Dealing with an Experienced Whistleblower Attorney

If you suspect fraudulent activity concerning the Medicaid program in Lower Paxton, Pennsylvania, getting assistance 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 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 Lower Paxton, 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 Paxton, 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 Lower Paxton, Pennsylvania

When you become aware of fraudulent activity that may concern Medicare or Medicaid in Lower Paxton, Pennsylvania, you require the advice of a skilled whistleblower attorney, someone who can ensure that your claim is fully examined and filed accurately and without delay. By dealing with an experienced lawyer you are increasing the chance that the government will step in, therefore increasing your chances for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not 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 assist in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we feel that you have a legitimate claim, we can represent you in a qui tam claim to report the fraud and enable you to collect a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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