Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in West Virginia

Medicaid and Medicare fraud cost West Virginia taxpayers billions of dollars annually. Although many medical service providers and drug companies are ethical and work within the system, there are those who do not. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower lawyers can help people who work in the healthcare system to submit suits on behalf of the government to report this sort of fraud.

The state and federal government put a great deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government depends on every day people in West Virginia to come forward to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in West Virginia

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your heroic choice to come forward to report abuse and fraud in the industry. We know that stepping forward is hard and lots of things may 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 thoroughly examine your claim, carefully prepare your case, and work relentlessly with you and the federal or state government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in West Virginia

The state of West Virginia has not passed a state false claims act. However, a private individual who has evidence of fraudulent Medicaid activity against the federal government may still file a qui tam lawsuit under the federal False Claims Act in West Virginia. 

 

The federal False Claims Act entitles a whistleblower to file a lawsuit on behalf of the government to recover damages from fraudulent Medicaid activity and collect a reward if there is a successful recovery. A whistleblower is also protected against any employer retaliation for filing a lawsuit and assisting the government in their recovery. 

 

When the federal government intervenes in the suit, the whistleblower may collect between 15 and 25 percent of the recovery. If the government chooses not to intervene in the lawsuit, the whistleblower may be entitled to collect between 25 and 30 percent of the recovery as a reward.

Liability of the Defendant in West Virginia

Under the federal False Claims Act, the defendant in a successful qui tam recovery can be ordered to pay damages of up to three times the financial harm to the government in addition to significant fines for each violation.

Statute of Limitations in West Virginia

A whistleblower must file their complaint within ten years of the date of the violation.

Working With an Experienced Whistleblower Attorney

If you have evidence of fraudulent Medicaid activity in the state of West Virginia, you may be able to file a qui tam lawsuit under the federal False Claims Act. Getting the guidance of an experienced whistleblower lawyer will help you understand your rights and protections under the federal False Claims Act.  At Khurana Law Firm, we offer a confidential, no-cost consultation to discuss your case. 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER

When you become aware of fraud that may involve Medicare or Medicaid, you may need the advice of a skilled whistleblower lawyer, someone who can make sure that your claim is completely investigated and filed accurately and without delay. By working with a skilled attorney you are increasing the chance that the federal or state government will step in, therefore increasing the possibility for a reward. Reporting Medicare and Medicaid fraud is an intricate matter –  do not 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 lawyers to assist in your fight against Medicare and Medicaid scams. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam claim to report the scams and allow you to gather a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can help.

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