Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Pawtucket, Rhode Island

Medicare and Medicaid fraud cost Rhode Island taxpayers billions of dollars every year. Although the majority of medical companies and drug companies are honest and work within the legal channels, some don’t. When fraud occurs, everybody can lose. Medicaid and Medicare whistleblower lawyers can help healthcare workers to file claims on behalf of the federal or state government to report this type of fraud.

The state and federal governments place a lot of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government counts on every day people 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 Pawtucket, Rhode Island

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the market. understand that coming 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 comprehensive experience representing whistleblowers nationwide, we completely examine your claim, diligently prepare your case, and work tirelessly with both you and the state of federal government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Pawtucket, Rhode Island

If you have become aware of deceitful activity connected with the Rhode Island Medicaid program, the Rhode Island False Claims Act allows you to become a whistleblower in order to to submit a qui tam suit on behalf of the state. The Rhode Island False Claims Act makes it illegal for anybody who intentionally files fraudulent claims, misappropriates state property or avoids responsibilities to the state, in addition to other infractions.

 

Under the Rhode Island False Claims Act, a person who submits a successful qui tam claim might be entitled to get 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 suit independent of the state, she or he may be entitled to in between 25 and 30 percent of a successful recuperation.

 

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

Liability of the Defendant in Pawtucket, Rhode Island

If the offender is discovered responsible, he or she 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 infraction. The defendant will also be liable for the costs of any civil action to recover these damages.

Statute of Limitations in Pawtucket, Rhode Island

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

Working With an Experienced Whistleblower Lawyer

If you are aware of Medicaid scams in Pawtucket, Rhode Island, you may be entitled to submit 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 completely 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 Pawtucket, 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 Pawtucket, 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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Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Pawtucket, Rhode Island

When you become aware of fraud that may involve Medicaid or Medicare in Pawtucket, Rhode Island, you require the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the government will intervene, thus increasing the opportunity for a reward. Reporting Medicaid and Medicare scams is a complex matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam attorneys to help in your fight against Medicare and Medicaid scams. We will evaluate your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam claim to report the fraud and enable you to gather a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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