Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Macon-Bibb County, Georgia

Medicare and Medicaid fraud cost Georgia taxpayers billions of dollars each year. While the majority of medical companies and drug companies are honest and work within the system, some do not. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower attorneys help people who work in the healthcare system to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Macon-Bibb County, 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 coming forward is not simple and many things may be at stake. When you come to us, your case is held in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently and carefully prepare your case, for court, and work tirelessly with both you and the state of federal government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Macon-Bibb County, Georgia

That state of Georgia makes it possible for people to come forward to report deceptive activity against the state’s Medicaid program under the Georgia False Medicaid Claims Act and allows them to bring suit against these parties on behalf of the state.

 

Under the Taxpayer Protection False Claims Act, whistleblowers may also submit a qui tam suit if they are aware of individuals, companies, or other entities that intentionally submit incorrect or deceptive claims or knowingly and incorrectly avoid obligations to the state or regional government. This requires the written approval of the Georgia Attorney General.

 

Under both acts, a whistleblower might potentially recover between 15 and 25 percent of the financial recovery in a reward when the Georgia Attorney General is participant to the suit. If the state does not participate in the suit, the whistleblower may be rewarded in between 25 and 30 percent of the recovery. The court may reduce an award depending upon the role that the whistleblower had in the scams 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 employer retaliation.

Liability of the Defendant in Macon-Bibb County, Georgia

Under both acts, the defendant may be ordered 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 offense.

Statute of Limitations in Georgia

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

Working With an Experienced Whistleblower Lawyer

If you know of Medicaid fraud in Macon-Bibb County, Georgia,, you might be able to file a qui tam lawsuit holding that party accountable. 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 Macon-Bibb 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 Macon-Bibb 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Macon-Bibb County, Georgia

When you become aware of potential fraud as it concerns Medicare or Medicaid in Macon-Bibb County, Georgia, you need the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is completely investigated and filed accurately and quickly. By dealing with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam lawyers to assist in your fight against Medicare and Medicaid fraud. We will evaluate your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we can represent you in a qui tam suit to 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. Contact us today to to schedule a confidential consultation.

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