Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Dunwoody, Georgia

Medicare and Medicaid fraud cost Georgia taxpayers billions of dollars annually. Although the majority of medical service providers and drug companies are honest and work within the system, some do not. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower attorneys assist people who work in the healthcare system to file claims on behalf of the government to help report this sort of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in Dunwoody, Georgia

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the industry. understand that coming forward is difficult and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

schedule a
confidential consultation

Whistleblower Laws in Dunwoody, Georgia

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

 

Under the Taxpayer Protection False Claims Act, whistleblowers might also file a qui tam claim if they are aware of people, companies, or other entities that knowingly submit incorrect or deceptive claims or knowingly and improperly avoid obligations to the state or local government. This type of action involves 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 compensation when the Georgia Attorney General is party to the case. If the state does not participate in the case, the whistleblower may be rewarded in between 25 and 30 percent of the financial recovery. The court might decrease an award depending upon the function that the whistleblower had in the scams or if the action was based upon info that was publicly divulged.

 

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 Dunwoody, Georgia

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

Statute of Limitations in Georgia

Under both laws, a whistleblower needs to initiate their grievance within ten years of the date of the offense.

Working With an Experienced Whistleblower Lawyer

If you know of Medicaid scams in Dunwoody, Georgia,, you might have the right to file a qui tam claim holding that entity responsible. Contact Khurana Law Firm for a confidential, no-cost consultation 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 Dunwoody, 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 Dunwoody, Georgia,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Dunwoody, Georgia

If you’ve become aware of potential fraud that may involve Medicaid or Medicare in Dunwoody, Georgia, you need the advice of a skilled whistleblower lawyer, someone who can ensure that your claim is totally examined and filed accurately and promptly. By working with a skilled lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the chance for a 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 bring years of practical experience as national qui tam attorneys to assist in your fight against Medicaid and Medicare fraud. After you get in touch our lawyers will examine 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 suit to report the scams and allow you to gather a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can be of help.

Service areas