Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Johns Creek, Georgia

Medicaid and Medicare fraud cost Georgia taxpayers billions of dollars each year. Although the majority of medical providers and drug companies are ethical and work within the system, there are those who do not. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower lawyers can assist people who work in the healthcare system to submit suits on behalf of the federal or state government to help report this sort of fraud.

The federal and state governments place a great deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government counts 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 workers in Johns Creek, Georgia

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and scams in the market. We know that coming forward is not easy and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Johns Creek, 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 allows them to bring suit against these entities on behalf of the state.

 

Under the Taxpayer Protection False Claims Act, whistleblowers may likewise submit a qui tam suit if they know of people, business, or other entities that intentionally submit false or deceitful claims or purposefully and incorrectly avoid commitments to the state or local government. This requires the written approval of the Georgia Attorney General.

 

Under both acts, a whistleblower may potentially recuperate in between 15 and 25 percent of the financial recovery in a reward when the Georgia Attorney General is party to the lawsuit. If the state does not participate in the lawsuit, the whistleblower might be rewarded in between 25 and 30 percent of the financial recovery. The court might reduce an award depending upon the function that the whistleblower had in the fraud or if the action was based on information that was publicly divulged.

 

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

Liability of the Defendant in Johns Creek, Georgia

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

Statute of Limitations in Georgia

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

Working With an Experienced Whistleblower Lawyer

If you are aware of Medicaid fraud in Johns Creek, Georgia,, you might have the right to file a qui tam claim holding that party liable. Contact Khurana Law Firm for a completely confidential, no-cost assessment 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 Johns Creek, 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 Johns Creek, 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 LAWYER; We are proud to represent healthcare workers in Johns Creek, Georgia

When you become aware of fraudulent activity as it concerns Medicaid or Medicare in Johns Creek, Georgia, you need the advice of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is fully examined and filed accurately and immediately. By dealing with a knowledgeable lawyer you are increasing the chance that the government will intervene, thus increasing your chances for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam lawyers to assist in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam suit to help report the scams and enable you to gather a financial benefit. All whistleblower cases are on contingency, you pay nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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