Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Rhode Island

Medicare and Medicaid fraud cost Rhode Island taxpayers billions of dollars annually. While many medical companies and drug companies are ethical and work within the legal channels, there are those who do not. When fraud occurs, everybody can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare professionals to file lawsuits on behalf of the federal or state government to help report this type of fraud.

The federal and state governments put a a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, it counts on private citizens in Rhode Island to come forward to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Rhode Island

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

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, and work relentlessly 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 Rhode Island

If you have become aware of fraudulent activity in connection with the Rhode Island Medicaid program, the Rhode Island False Claims Act allows whistleblowers to file a qui tam lawsuit on behalf of the state. The Rhode Island False Claims Act makes it unlawful for anyone who knowingly files fraudulent claims, misappropriates state property, or avoids obligations to the state, in addition to other violations. 

 

Under the Rhode Island False Claims Act, an individual who files a successful qui tam lawsuit may be entitled to receive an award of between 15 and 25 percent of the recovery by the state if the state joins the lawsuit. If the whistleblower proceeds in the lawsuit independent of the state, he or she may be entitled to between 25 and 30 percent of a successful recovery. 

 

A whistleblower is also protected against any employer retaliation for bringing forth a qui tam lawsuit or assisting the state in a recovery.

Liability of the Defendant in Rhode Island

If the defendant is found liable, he or she may be ordered to pay up to three times the damage to the state as well as penalties of between $5,500 and $11,000 per violation. The defendant will also be liable for the costs of any civil action to recover these damages.

Statute of Limitations in Rhode Island

In the state of Rhode Island, a plaintiff must file a whistleblower claim within ten years of the violation.

Working With an Experienced Whistleblower Attorney

If you have knowledge of Medicaid fraud in the state of Rhode Island, you may be entitled to file a whistleblower lawsuit under the Rhode Island False Claims Act. Getting the guidance of a skilled whistleblower attorney can help you understand your rights and protections under the Rhode Island False Claims Act.  Contact Khurana Law Firm 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 can report it 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. To report Medicare fraud, 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

If you’ve become aware of deceptive activity that may concern Medicare or Medicaid, you need the guidance of a knowledgeable whistleblower attorney, someone who can guarantee that your claim is completely investigated and submitted accurately and promptly. By dealing with a skilled lawyer you are increasing the chance that the government will intervene, hence increasing the chance for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  do not 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 legal representatives to assist in your fight against Medicare and Medicaid scams. We will review your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam suit to help report the scams and enable you to gather a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to learn how we can be of help.

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