Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Cranston, Rhode Island

Medicaid and Medicare fraud cost Rhode Island taxpayers billions of dollars every year. While the majority of medical service providers and drug companies are ethical 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 healthcare workers to submit suits on behalf of the federal or state government to help report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare employees in Cranston, Rhode Island

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the industry. understand that stepping forward is difficult and many 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, diligently and carefully prepare your case, for court, and work tirelessly with both you and the state of federal government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Cranston, Rhode Island

If you have become aware of deceitful activity in connection with the Rhode Island Medicaid program, the Rhode Island False Claims Act permits whistleblowers to file a qui tam claim on behalf of the state. The Rhode Island False Claims Act makes it unlawful for anyone who knowingly submits deceitful claims, misappropriates state property or evades obligations to the state, as well as other offenses.

 

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

 

A whistleblower is also protected against any company retaliation for bringing a qui tam lawsuit or helping the state in recovering funds.

Liability of the Defendant in Cranston, Rhode Island

If the accused is discovered responsible, she or he might be required to pay up to three times the damage to the state as well as charges of in between $5,500 and $11,000 per violation. The offender will likewise be responsible for the costs of any civil action to recover these damages.

Statute of Limitations in Cranston, Rhode Island

In the state of Rhode Island, a plaintiff should file a whistleblower claim within 10 years of the violation.

Working With an Experienced Whistleblower Lawyer

If you know of Medicaid scams in Cranston, Rhode Island, you may be entitled to file a whistleblower claim 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 assessment 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 Cranston, Rhode Island, 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 Cranston, Rhode Island,  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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Cranston, Rhode Island

If you’ve become aware of fraudulent activity involving Medicare or Medicaid in Cranston, Rhode Island, you require the guidance of a skilled whistleblower attorney, someone who can guarantee that your claim is totally examined and filed accurately and promptly. By working with a knowledgeable attorney you are increasing the chance that the government will step in, hence increasing the chance for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t try 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 legal representatives to assist in your fight against Medicare and Medicaid fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we can represent you in a qui tam claim to help report the fraud and allow you to collect a financial benefit. Because all whistleblower work is on contingency, you pay nothing up until there is a recovery. Contact us today to learn how we can help.

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