Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Brookhaven, Georgia

Medicaid and Medicare fraud cost Georgia taxpayers billions of dollars every year. While most medical service providers and drug companies are honest and work within the system, there are those who don’t. When fraud happens, everyone can lose. Medicaid and Medicare whistleblower lawyers can assist healthcare professionals to submit claims on behalf of the federal or state government to report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in Brookhaven, Georgia

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and scams in the market. We know that stepping forward is hard and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, and work relentlessly with both you and the state of federal government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Brookhaven, Georgia

That state of Georgia allows individuals to come forward to report fraudulent activity against the state’s Medicaid program under the Georgia False Medicaid Claims Act and enables them to bring suit against these parties 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, business, or other entities that intentionally send false or deceptive claims or knowingly and improperly avoid obligations to the state or local government. This involves the written approval of the Georgia Attorney General.

 

Under both acts, a whistleblower might potentially recuperate between 15 and 25 percent of the financial recovery in a reward when the Georgia Attorney General is participant to the case. If the state does not join the lawsuit, the whistleblower may be rewarded between 25 and 30 percent of the recovery. The court might minimize an award depending upon 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 shielded from employer retaliation.

Liability of the Defendant in Brookhaven, Georgia

Under both acts, the offender might be ordered to pay up to three times the quantity of damage to the state. The accused can also be ordered to pay fines of $5,500 to $11,000 per infraction.

Statute of Limitations in Georgia

Under both laws, a whistleblower must initiate their grievance within 10 years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

If you have knowledge of Medicaid fraud in Brookhaven, Georgia,, you might have the right to file a qui tam lawsuit holding that entity responsible. Contact Khurana Law Firm for a completely 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 Brookhaven, 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 Brookhaven, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Brookhaven, Georgia

If you’ve become aware of fraud that may concern Medicaid or Medicare in Brookhaven, Georgia, you may need the advice of a skilled whistleblower attorney, someone who can ensure that your claim is totally investigated and filed accurately and without delay. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, hence increasing the chance for a financial reward. Reporting Medicare and Medicaid scams 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 assist in your fight against Medicare and Medicaid scams. After you contact us, our attorneys will review 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 suit to report the scams and allow you to gather a financial benefit. All whistleblower work is on contingency, you pay nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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