Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Upper Darby, Pennsylvania

Medicare and Medicaid fraud cost Pennsylvania taxpayers billions of dollars each year. Although the majority of medical service providers and drug companies are ethical and work within the system, some do not. When fraud happens, everybody can lose. Medicare and Medicaid whistleblower lawyers can assist healthcare workers to submit suits on behalf of the government to report this sort of fraud.

The state and federal governments put a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it relies on every day people in Pennsylvania to come forward and to report scams. People like you.

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Upper Darby, Pennsylvania

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that stepping forward is challenging and many things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our extensive experience representing whistleblowers nationwide, we completely examine your claim, diligently and carefully prepare your case, and work tirelessly with both you and the state of federal government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Upper Darby, Pennsylvania

While taxpayers fund Medicaid to enable low-income health care for those who need it, there are deceitful individuals and business entities who defraud the state of Pennsylvania’s Medicaid program through fraudulent activity. These activities have actually cost the government millions of dollars. State resources devoted to the discovery of scams are limited and, as a result, the state must count on health care service providers and others to report any knowledge of scams.

 

Under the federal False Claims Act, people who are aware of deceitful activity versus the government have the ability to submit a whistleblower claim to hold these parties accountable. Under the Act, a person who brings a whistleblower claim is entitled to a benefit between 15 percent and 25 percent of any financial recovery, based on 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 provide added staff member protection to avoid a company from striking back, discharging, threatening, or discriminating against a whistleblower.

Liability of the Defendant in Upper Darby, Pennsylvania

Violations under the federal False Claims Act might result in fines and charges in the amount of 3 times the harm to the government as well as extra charges of approximately $5,500 to $11,000 for each offense.

Statute of Limitations in Upper Darby, Pennsylvania

Under the federal False Claims Act, a whistleblower claim must be begun within 3 years of the date of discovering the deceitful activity and within 6 years after the activity occurred, whichever occurred later on, but not more than 10 years after the activity occurred.

Dealing with an Experienced Whistleblower Attorney

If you suspect deceptive activity as it concerns the Medicaid program in Upper Darby, Pennsylvania, getting assistance from an experienced whistleblower attorney is necessary. At Khurana Law Firm, P.C., we will help you determine if you have a legitimate 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 Upper Darby, 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 Upper Darby, 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Upper Darby, Pennsylvania

When you become aware of fraud that may concern Medicaid or Medicare in Upper Darby, Pennsylvania, you require the guidance of an experienced whistleblower attorney, someone who can guarantee that your claim is totally investigated and filed accurately and immediately. By working with an experienced lawyer you are increasing the chance that the government will step in, thus increasing the chance for a financial reward. Reporting Medicaid and Medicare scams is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam legal representatives to assist in your battle against Medicare and Medicaid fraud. Our attorneys will examine 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 lawsuit to report the scams and allow you to gather 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 learn how we can be of help.

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