Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Georgia

Medicare and Medicaid fraud cost Georgia taxpayers billions of dollars every year. Although most medical companies and drug companies are ethical and work within the system, there are those who don’t. When fraud happens, everybody can lose. Medicaid and Medicare whistleblower attorneys assist healthcare workers to file claims on behalf of the federal or state government to help report this type of fraud.

The state and federal 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 Georgia 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 Georgia.

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the market. We know that stepping forward is hard and many things may 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, carefully prepare your case, for court, and work relentlessly with you and the state of federal government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Georgia

That state of Georgia enables individuals to come forward to report fraudulent activity against the state’s Medicaid program under the Georgia False Medicaid Claims Act and allows them to bring suit against these parties on behalf of the state. 

 

Under the Taxpayer Protection False Claims Act, whistleblowers may also file a qui tam lawsuit if they are aware of individuals, companies, or other entities that knowingly submit false or fraudulent claims or knowingly and improperly avoid obligations to the state or local government. This requires the written approval of the Georgia Attorney General.

 

Under both acts, a whistleblower may potentially recover between 15 and 25 percent of the recovery in a reward when the Georgia Attorney General is party to the suit. If the state does not join the suit, the whistleblower may be rewarded between 25 and 30 percent of the recovery. The court may reduce an award depending on the role that the whistleblower had in the fraud or if the action was based on information that was publicly disclosed. 

 

Under both the Georgia False Medicaid Claims Act and the Georgia Taxpayer Protection False Claims Act, the whistleblower is protected from employer retaliation.

Liability of the Defendant in Georgia

Under both acts, the defendant may be ordered to pay up to three times the amount of harm to the state. The defendant can also be ordered to pay fines of $5,500 to $11,000 per violation.

Statute of Limitations in Georgia

Under both laws, a whistleblower must initiate their complaint within ten years of the date of the violation.

Working With an Experienced Whistleblower Attorney

If you have knowledge of Medicaid fraud in the state of Georgia, you may have the right to file a qui tam lawsuit holding that party accountable.  Contact Khurana Law Firm for a confidential, no-cost consultation to understand your rights and protections under Georgia whistleblower laws. 

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 An Experienced WHISTLEBLOWER ATTORNEY

If you’ve become aware of fraudulent activity as it concerns Medicaid or Medicare, you need the guidance of an experienced whistleblower lawyer, someone who can guarantee that your claim is completely examined and submitted accurately and promptly. By working with a knowledgeable lawyer you are increasing the chance that the government will intervene, therefore increasing the chance for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam attorneys to help in your fight against Medicaid and Medicare scams. We will examine your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam lawsuit to help report the fraud and enable you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to to schedule a confidential consultation.

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