Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid scams in Wisconsin

Medicare and Medicaid fraud cost Wisconsin taxpayers billions of dollars each year. While the majority of medical providers and drug companies are honest and work within the legal channels, some do not. When fraud occurs, everyone can lose. Medicaid and Medicare whistleblower lawyers help people who work in the healthcare system to file suits on behalf of the federal or state government to help report this sort of fraud.

The federal and state government put a a lot of trust in pharmaceutical and medical companies. When that trust is ill-placed, the government depends on regular folks in Wisconsin to come forward to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in Wisconsin

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and fraud in the market. understand that coming forward is difficult and many 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, diligently prepare your case, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Wisconsin

Although Wisconsin once had a state false claims act of its own, it was repealed in 2015. However, private whistleblowers with knowledge of fraudulent Medicaid activity in the state may file a qui tam claim under the federal False Claims Act. The federal False Claims Act enables private individuals to file a civil suit on behalf of the federal government against those who defraud the Medicaid program. 

 

Under the federal False Claims Act, the government can choose whether to intervene in the suit or not. If the federal government decides to join the lawsuit, the whistleblower may be able to collect between 15 and 25 percent of the recovery. If the government elects not to intervene in the lawsuit, the whistleblower can collect between 25 and 30 percent of the recovery. 

 

Under the federal False Claims Act, those who file qui tam lawsuits to report fraud and assist the government in financial recovery are also protected against any retaliation by their employer.

Liability of the Defendant in Wisconsin

In a successful qui tam lawsuit in Wisconsin, the defendant can be held liable for up to triple the amount of financial harm to the government and may also be required to pay significant penalties for each claim violation.

Statute of Limitations in Wisconsin

Under the federal False Claims Act, a whistleblower must file their complaint within ten years of the date of the violation.

Working With an Experienced Whistleblower Attorney

In Wisconsin, heroic individuals who have evidence of fraudulent Medicaid activity are entitled to file a qui tam lawsuit on behalf of the federal government and collect a reward for their efforts. If you have knowledge of fraud against the Medicaid program in the state of Wisconsin, we can help. At Khurana Law Firm, we are experienced qui tam lawyers and assist in whistleblower lawsuits throughout the country. Contact us for confidential, no-cost consultation so we can discuss your case and you can understand your rights and protections under the law.

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 ATTORNEY

If you’ve become aware of potential fraud that may involve Medicaid or Medicare, you require the guidance of an experienced whistleblower attorney, someone who can guarantee that your claim is fully investigated and filed accurately and quickly. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, hence increasing your chances for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam lawyers to assist in your battle against Medicare and Medicaid scams. After you get in touch our lawyers will review 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 claim to help report the fraud and enable you to gather a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

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