Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Alpharetta, Georgia

Medicare and Medicaid fraud cost Georgia taxpayers billions of dollars every year. While many medical service providers and drug companies are ethical and work within the system, some don’t. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower attorneys can assist healthcare workers to submit lawsuits on behalf of the government to help report these kinds of scams.

The federal and state governments place a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, it relies on every day people in Georgia to come forward to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Alpharetta, Georgia

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the market. understand that stepping forward is hard and lots of things might be at stake. When you come to us, your case is held in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work relentlessly 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 Alpharetta, Georgia

That state of Georgia allows people to come forward to report deceitful activity against the state’s Medicaid program under the Georgia False Medicaid Claims Act and permits them to bring case against these parties on behalf of the state.

 

Under the Taxpayer Protection False Claims Act, whistleblowers may likewise file a qui tam claim if they are aware of individuals, business, or other entities that intentionally send false or fraudulent claims or intentionally and improperly prevent obligations to the state or local government. This type of action requires the written approval of the Georgia Attorney General.

 

Under both acts, a whistleblower might possibly recuperate between 15 and 25 percent of the financial recovery in a reward when the Georgia Attorney General is participant to the litigation. If the state does not join the lawsuit, the whistleblower might be rewarded between 25 and 30 percent of the recovery. The court may lower an award depending on the function that the whistleblower had in the fraud or if the action was based on details that was publicly disclosed.

 

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

Liability of the Defendant in Alpharetta, Georgia

Under both acts, the offender may be ordered to pay up to 3 times the amount of harm to the state. The defendant can likewise be ordered to pay fines of $5,500 to $11,000 per violation.

Statute of Limitations in Georgia

Under both laws, a whistleblower needs to start their grievance within 10 years of the date of the violation.

Working With an Experienced Whistleblower Attorney

If you are aware of Medicaid fraud in Alpharetta, Georgia,, you may be able to submit a qui tam claim holding that entity responsible. Contact Khurana Law Firm for a confidential, no-cost assessment in order 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 are a healthcare worker in Alpharetta, Georgia, get in touch with us 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. If you are a healthcare worker in Alpharetta, Georgia,  you can report Medicare fraud when you 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; We are proud to represent healthcare workers in Alpharetta, Georgia

When you become aware of fraud that may concern Medicaid or Medicare in Alpharetta, Georgia, you may need the advice of a skilled whistleblower lawyer, someone who can guarantee that your claim is completely examined and submitted accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the government will step in, hence increasing your chances for a financial 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 have years of prior experience as national qui tam legal representatives to help in your fight against Medicare and Medicaid scams. We will evaluate your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we may 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 nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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