Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Utah

Medicare and Medicaid fraud cost Utah taxpayers billions of dollars annually. While many medical providers and drug companies are ethical and work within the system, some don’t. When fraud occurs, everyone can lose. Medicare and Medicaid whistleblower attorneys can assist people who work in the healthcare system to submit suits on behalf of the government to help report this type of fraud.

The federal and state government place a great deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government counts on private citizens in Utah to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care workers in Utah

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the industry. We know that coming forward is not easy and lots of things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, and work relentlessly with you and the federal or state government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Utah

Those who are aware of fraudulent Medicaid activity occurring in the State of Utah may file a whistleblower claim under the federal False Claims Act. The federal FCA entitles a private individual to file a qui tam lawsuit on behalf of the federal government to recover damages from fraudulent activity as it applies to their portion of the losses. The federal FCA entitles whistleblowers who file successful lawsuits to collect a reward of between 15 and 30 percent of the recovery to the government and offers protection against retaliation by an employer. 

 

While the state of Utah has enacted the Utah False Claims Act that makes it unlawful for parties to defraud the state Medicaid program, only the state may bring a civil lawsuit against those parties to recover funds that were lost. There are no whistleblower rewards provided under the Utah FCA for those who report fraudulent Medicaid activity.

Liability of the Defendant in Utah

Under the federal False Claims Act, a defendant may be required to pay damages in the amount of up to three times the financial harm to the federal government in addition to significant fines for each violation.

Statute of Limitations in Utah

Under the federal False Claims Act, a whistleblower who wants to file a qui tam lawsuit must file their complaint within ten years of the date of the violation.

Working With an Experienced Whistleblower Attorney

If you work for a medical provider in the state of Utah and have knowledge of fraudulent activity against the Medicaid program, the federal False Claims Act empowers you to come forward with that information and collect a substantial reward for a successful recovery. At Khurana Law Firm, we offer a confidential, no-cost consultation to discuss your case and your rights and protections under the federal False Claims Act. 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 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 fraud involving Medicare or Medicaid, you need the advice of a skilled whistleblower lawyer, someone who can make sure that your claim is completely investigated and filed accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the government will intervene, therefore increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is a complicated matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam attorneys to assist in your battle against Medicare and Medicaid fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam lawsuit to help report the scams and enable you to collect a reward. All whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can be of help.

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