Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Vermont

Medicare and Medicaid fraud cost Vermont taxpayers billions of dollars every year. While most medical providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud happens, everybody can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare professionals to submit suits on behalf of the government to report these kinds of scams.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in Vermont

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and scams in the industry. understand that stepping forward is challenging and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Vermont

Vermont’s False Claims Act was enacted in 2015, mirroring the federal False Claims Act. The Vermont False Claims Act makes it unlawful to defraud Vermont’s state Medicaid program by presenting false or fraudulent claims for payment, misappropriating state property, or avoiding obligations to pay the state. 

 

Under the Vermont False Claims Act, a whistleblower with knowledge of fraudulent activity against the state has the right to bring forth a qui tam lawsuit on behalf of the state to hold parties accountable for their wrongdoing. A whistleblower may be entitled to between 15 and 25 percent of the recovery in a successful suit if the state joins the lawsuit. A whistleblower can collect between 25 and 30 percent of the financial recovery from a successful suit without the state’s involvement. 

 

The Vermont False Claims Act also protects a whistleblower from employer retaliation.

 

A unique attribute of Vermont’s False Claims Act is that a whistleblower may, in some cases, be able to bring a claim against a party committing fraud against the state if it took place before the enactment of the Act in 2015.

 

Liability of the Defendant in Vermont

Under the Vermont False Claims Act, the party committing fraud may be ordered to pay up to three times the financial harm to the state, in addition to penalties and fines of between $5,500 and $11,000 for each violation, and the costs to investigate and prosecute the violations

Statute of Limitations in Vermont

A whistleblower must file their lawsuit within ten years of the occurrence of the violation.

Working With an Experienced Whistleblower Attorney

If you have knowledge of fraudulent activity against the Medicaid program in the state of Vermont, the Vermont False Claims Act empowers you to come forward with a civil lawsuit on behalf of the state and collect a reward for a successful recovery. At Khurana Law Firm, our experienced qui tam lawyers offer a confidential, no-cost consultation so you can fully understand your rights and protections under the Vermont 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 ATTORNEY

When you become aware of fraud as it concerns Medicaid or Medicare, you need the guidance of a skilled whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and promptly. By working with a skilled attorney you are increasing the chance that the government will intervene, hence increasing your chances for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  don’t attempt 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 attorneys to assist in your battle against Medicaid and Medicare scams. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we can represent you in a qui tam suit to report the scams and allow you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can help.

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