Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Scranton, Pennsylvania

Medicare and Medicaid fraud cost Pennsylvania taxpayers billions of dollars each year. Although most medical providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud happens, everyone loses. Medicare and Medicaid whistleblower lawyers can assist people who work in the healthcare system to submit suits on behalf of the federal or state government to report this type of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Scranton, Pennsylvania

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and scams in the market. We know that coming forward is difficult and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we completely examine your claim, diligently and carefully prepare your case, 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 Scranton, Pennsylvania

While taxpayers help fund Medicaid to enable low-income health care for those who require it, there are unethical individuals and business entities who defraud the state of Pennsylvania’s Medicaid program through deceptive activity. These activities have cost the state government countless dollars. State resources devoted to the discovery of scams are restricted and, subsequently, the state should rely on healthcare service providers and others to report any knowledge of fraudulent activity.

 

Under the federal False Claims Act, people who are aware of deceitful activity versus the government have the ability 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 knowledge and contributions. If the government picks not to intervene in the action, the whistleblower might get in between 25 and 30 percent of the recovery.

 

Whistleblower laws offer included worker protection to prevent a company from retaliating, discharging, threatening, or discriminating against a whistleblower.

Liability of the Defendant in Scranton, Pennsylvania

Violations under the federal False Claims Act might result in fines and charges in the quantity 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 Scranton, Pennsylvania

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

Dealing with an Experienced Whistleblower Attorney

If you suspect fraudulent activity concerning the Medicaid program in Scranton, Pennsylvania, getting guidance from a knowledgeable whistleblower lawyer is essential. At Khurana Law Firm, P.C., we can help you identify if you have a legitimate whistleblower claim and help you understand your rights and alternatives. 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 Scranton, 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 Scranton, 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 ATTORNEY; We are proud to represent healthcare workers in Scranton, Pennsylvania

When you become aware of potential fraud involving Medicaid or Medicare in Scranton, Pennsylvania, you may need the advice of a skilled whistleblower lawyer, someone who can guarantee that your claim is totally investigated and filed accurately and immediately. By dealing with a knowledgeable lawyer you are increasing the chance that the government will intervene, therefore increasing the possibility for a financial 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 have years of experience as national qui tam lawyers to help in your fight against Medicaid and Medicare scams. We will review your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we may 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 up until there is a settlement. Contact us today to learn how we can be of help.

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