Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Philadelphia, Pennsylvania

Medicaid and Medicare fraud cost Pennsylvania taxpayers billions of dollars annually. While most medical providers and drug companies are honest and work within the legal channels, there are those who do not. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower lawyers can help people who work in the healthcare system to submit claims on behalf of the federal or state government to help report this type of fraud.

The state and federal government place a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, the government relies on private citizens in Pennsylvania to come forward and to report fraud. People like you.

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the market. We know that coming forward is hard 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 substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully 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 Philadelphia, Pennsylvania

While taxpayers fund Medicaid in order to permit low-income healthcare for those who need it, there are unethical people and business entities who defraud the state of Pennsylvania’s Medicaid program through deceitful activity. These activities have cost the government millions of dollars. State resources committed to the discovery of fraud are limited and, as a result, the state should depend on healthcare providers and private citizens to report any knowledge of fraudulent activity.

 

Under the federal False Claims Act, individuals who know of deceptive activity against the government have the ability to submit a whistleblower claim to hold these parties liable. Under the Act, an individual who brings a whistleblower claim is entitled to a benefit in 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 between 25 and 30 percent of the financial recovery.

 

Whistleblower laws offer added worker defense to avoid a company from striking back, discharging, threatening, or victimizing a whistleblower.

Liability of the Defendant in Philadelphia, Pennsylvania

Violations under the federal False Claims Act may lead to fines and charges in the amount of three times the damage to the government in addition to additional penalties of as much as $5,500 to $11,000 for each infraction.

Statute of Limitations in Philadelphia, Pennsylvania

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

Working With an Experienced Whistleblower Attorney

If you know of deceitful activity concerning the Medicaid program in Philadelphia, Pennsylvania, getting guidance from an experienced whistleblower lawyer is essential. At Khurana Law Firm, P.C., we can help you determine if you have a legitimate whistleblower claim and help you understand your rights and choices. 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 Philadelphia, 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 Philadelphia, 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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Philadelphia, Pennsylvania

When you become aware of potential fraud that may involve Medicare or Medicaid in Philadelphia, Pennsylvania, you need the guidance of a skilled whistleblower lawyer, someone who can make sure that your claim is totally investigated and submitted accurately and quickly. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, thus increasing the possibility for a reward. Reporting Medicare and Medicaid fraud is an intricate matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam attorneys to help in your battle against Medicare and Medicaid fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we may represent you in a qui tam suit to report the scams and enable you to gather a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

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