Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Sioux Falls, South Dakota

Medicaid and Medicare fraud cost South Dakota taxpayers billions of dollars every year. Although the majority of medical providers and drug companies are ethical and work within the system, there are those who don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys can help people who work in the healthcare system to file claims on behalf of the government to help report these kinds of scams.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Sioux Falls, South Dakota

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the industry. understand that stepping forward is difficult and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, for court, and work tirelessly with you and the federal or state government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Sioux Falls, South Dakota

Federal and state governments may lose billions of dollars each year in Medicaid fraud. Although the state of South Dakota does not have its own version of a false claims act, a private citizen who has knowledge of Medicaid fraud may be entitled to submit a qui tam claim under the federal False Claims Act.

 

The federal False Claims Act permits private individuals with proof of Medicaid fraud to file a whistleblower lawsuit on behalf of the federal government. The act entitles the whistleblower to receive a portion of the funds recovered as a reward and likewise offers employer retaliation protection to the whistleblower.

 

If the federal government selects to enter into the litigation, a whistleblower may be able to get a financial reward in between 15 and 25 percent of the funds recovered. If the government selects not to intervene in the suit, the whistleblower might have the ability to gather in between 25 and 30 percent of the recovery.

Liability of the Defendant in Sioux Falls, South Dakota

Under the federal False Claims Act, the accused in a whistleblower lawsuit can be required to pay up to three times the monetary damage to the government in addition to substantial fines for each violation and the expenses for any civil litigation.

Statute of Limitations in South Dakota

Under the federal False Claims Act, a whistleblower is required to submit their complaint within 10 years of the date of the offense.

Working With an Experienced Whistleblower Attorney

Federal and state governments rely heavily on private citizens to come forward with relevant information concerning Medicaid fraud and reward them for their efforts. If you have evidence of scams against the South Dakota Medicaid program in Sioux Falls, South Dakota, you may be able to file a whistleblower claim and collect a percentage of the recovery under the federal False Claims Act. At Khurana Law Firm, our skilled whistleblower lawyers provide a no-cost assessment to discuss your rights and protections under the law. Contact us to arrange a consultation.

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 Sioux Falls, 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 Sioux Falls, 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 Sioux Falls, South Dakota

If you’ve become aware of deceptive activity that may involve Medicare or Medicaid in Sioux Falls, South Dakota, you require the advice of a knowledgeable whistleblower attorney, someone who can ensure that your claim is fully investigated and submitted accurately and promptly. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, thus increasing the possibility for a financial reward. Reporting Medicaid and Medicare scams is a complex matter –  do not 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 lawyers to assist in your battle against Medicaid and Medicare fraud. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam lawsuit to help report the scams and enable you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to learn how we can be of help.

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