Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Pennsylvania taxpayers billions of dollars every year. While the majority of medical service providers and drug companies are honest and work within the system, some don’t. When fraud occurs, everyone can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare workers to submit lawsuits on behalf of the government to report this type of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Reading city, Pennsylvania

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that stepping forward is hard 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, for court, and work relentlessly with you and the federal or state government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Reading city, Pennsylvania

While taxpayers help fund Medicaid in order to allow low-income healthcare 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 cost the government countless dollars. State resources dedicated to the discovery of fraud are restricted and, consequently, the state needs to rely on health care service 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 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 benefit 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 may receive in between 25 and 30 percent of the recovery.

 

Whistleblower laws use included worker defense to prevent an employer from striking back, discharging, threatening, or discriminating against a whistleblower.

Liability of the Defendant in Reading city, Pennsylvania

Offenses under the federal False Claims Act might result in fines and charges in the amount of 3 times the damage to the government as well as additional penalties of up to $5,500 to $11,000 for each offense.

Statute of Limitations in Reading city, Pennsylvania

Under the federal False Claims Act, a whistleblower claim should be started within 3 years of the date of discovering the fraudulent activity and within 6 years after the activity happened, whichever took place later, however 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 Reading city, Pennsylvania, getting guidance from a skilled whistleblower lawyer 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 choices. 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 Reading city, 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 Reading city, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Reading city, Pennsylvania

If you’ve become aware of fraud that may involve Medicare or Medicaid in Reading city, Pennsylvania, you need the guidance of an experienced whistleblower lawyer, someone who can guarantee that your claim is totally investigated and filed accurately and without delay. By working with a skilled attorney you are increasing the chance that the government will intervene, thus increasing the opportunity for a reward. Reporting Medicare and Medicaid scams 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 experience as national qui tam attorneys to assist in your fight against Medicare and Medicaid fraud. Our attorneys will review your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we may represent you in a qui tam claim to report the scams and allow you to gather a financial benefit. Because all whistleblower work is on contingency, you pay nothing until there is a recovery. Get in touch with us today to learn how we can be of help.

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