Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Augusta-Richmond County, Georgia

Medicaid and Medicare fraud cost Georgia taxpayers billions of dollars annually. Although the majority of medical companies and drug companies are honest and work within the system, some don’t. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower lawyers can assist people who work in the healthcare system to file suits on behalf of the government to help report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare employees in Augusta-Richmond County, Georgia

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the industry. understand that stepping forward is hard 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, carefully prepare your case, and work tirelessly with both you and the federal or state government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Augusta-Richmond County, Georgia

That state of Georgia makes it possible for individuals to come forward to report deceptive activity against the state’s Medicaid program under the Georgia False Medicaid Claims Act and enables them to bring lawsuit against these entities on behalf of the state.

 

Under the Taxpayer Protection False Claims Act, whistleblowers might also submit a qui tam suit if they are aware of individuals, companies, or other entities that intentionally submit incorrect or fraudulent claims or purposefully and improperly prevent responsibilities to the state or local government. This involves the written approval of the Georgia Attorney General.

 

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

 

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 Augusta-Richmond County, Georgia

Under both acts, the defendant may be required to pay up to three times the amount of harm to the state. The accused can likewise be required to pay fines of $5,500 to $11,000 per infraction.

Statute of Limitations in Georgia

Under both laws, a whistleblower should initiate their problem within ten years of the date of the offense.

Working With an Experienced Whistleblower Lawyer

If you are aware of Medicaid fraud in Augusta-Richmond County, Georgia,, you may be able to submit a qui tam suit holding that entity liable. Contact Khurana Law Firm for a confidential, no-cost assessment in order to understand your rights and protections under Georgia whistleblower statutes.

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 Augusta-Richmond County, 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 Augusta-Richmond County, 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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Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Augusta-Richmond County, Georgia

If you’ve become aware of potential fraud as it concerns Medicaid or Medicare in Augusta-Richmond County, Georgia, you require the guidance of a skilled whistleblower attorney, someone who can guarantee that your claim is totally investigated and submitted accurately and without delay. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, hence increasing the chance 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 prior experience as national qui tam legal representatives to help in your fight against Medicare and Medicaid fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we may represent you in a qui tam lawsuit to report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to learn how we can help.

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