Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in Rapid City, South Dakota

Medicare and Medicaid fraud cost South Dakota taxpayers billions of dollars each year. While the majority of medical providers and drug companies are ethical and work within the legal channels, some do not. When scams are perpetrated, everyone loses. Medicaid and Medicare whistleblower attorneys help healthcare workers to file lawsuits on behalf of the government to help report this sort of fraud.

The state and federal governments place a great deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it depends on every day people in South Dakota to come forward to report fraud. People like you.

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Rapid City, South Dakota

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 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 investigate your claim, diligently prepare your case, and work relentlessly with you and the federal or state government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Rapid City, South Dakota

Federal and state governments may lose billions of dollars every single year due to Medicaid scams. Although the state of South Dakota does not have its own variation of a false claims act, a private individual who learns of Medicaid fraud might be entitled to file a qui tam lawsuit under the federal False Claims Act.

 

The federal False Claims Act enables private citizens with evidence of Medicaid scams to submit a whistleblower lawsuit on behalf of the federal government. The act entitles the whistleblower to receive a portion of the recovery as an incentive and also offers employer retaliation protection to the whistleblower.

 

If the government chooses to participate in the case, a whistleblower may be able to get a financial reward between 15 and 25 percent of the funds recovered. If the federal government chooses not to intervene in the fit, the whistleblower may be able to gather between 25 and 30 percent of the funds recovered.

Liability of the Defendant in Rapid City, South Dakota

Under the federal False Claims Act, the defendant in a whistleblower lawsuit can be directed to pay up to three times the monetary damage to the government in addition to considerable fines for each violation and the expenses for any civil lawsuits.

Statute of Limitations in South Dakota

Under the federal False Claims Act, a whistleblower must submit their complaint within 10 years of the date of the infraction.

Working With an Experienced Whistleblower Attorney

Federal and state governments rely heavily on private citizens to come forward with information concerning Medicaid scams and reward the whistleblowers for their efforts. If you have proof of fraud against the South Dakota Medicaid program in Rapid City, South Dakota, you may be able to file a whistleblower suit and collect a percentage of the recovery under the federal False Claims Act. At Khurana Law Firm, our skilled whistleblower attorneys provide a no-cost assessment in order to discuss your protections and rights under the law. Contact us to schedule an appointment.

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 Rapid City, South Dakota, 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 Rapid City, South Dakota,  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 LAWYER; We are proud to represent healthcare workers in Rapid City, South Dakota

If you’ve become aware of fraudulent activity as it concerns Medicare or Medicaid in Rapid City, South Dakota, you require the advice of a skilled whistleblower attorney, someone who can guarantee that your claim is completely examined and submitted accurately and without delay. By working with a skilled lawyer you are increasing the chance that the federal or state government will intervene, hence increasing the possibility for a financial reward. Reporting Medicare and Medicaid fraud is a complicated 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 assist in your fight against Medicare and Medicaid fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we may represent you in a qui tam suit to help report the scams and allow you to gather a reward. Because all whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to to schedule a confidential consultation.

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