Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Roswell, Georgia

Medicaid and Medicare 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, there are those who don’t. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower lawyers help healthcare professionals to file lawsuits on behalf of the federal or state government to help report these kinds of scams.

The federal and state governments put a good deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government counts on every day people in Georgia to come forward to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Roswell, Georgia

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that coming forward is difficult and lots of things might be at stake. When you come to us, your case is held in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, diligently prepare your case, for court, and work tirelessly with both you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Roswell, Georgia

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

 

Under the Taxpayer Protection False Claims Act, whistleblowers may likewise submit a qui tam lawsuit if they are aware of people, companies, or other entities that purposefully send false or deceitful claims or intentionally and incorrectly prevent responsibilities to the state or local government. This type of action involves the written approval of the Georgia Attorney General.

 

Under both acts, a whistleblower might potentially recover between 15 and 25 percent of the recovery in compensation when the Georgia Attorney General is participant to the lawsuit. If the state does not join the litigation, the whistleblower might be rewarded between 25 and 30 percent of the recovery. The court might decrease an award depending upon the function that the whistleblower had in the fraud or if the action was based upon details that was publicly disclosed.

 

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

Liability of the Defendant in Roswell, Georgia

Under both acts, the offender may be required to pay up to 3 times the amount of damage to the state. The offender 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 initiate their problem within ten years of the date of the offense.

Working With an Experienced Whistleblower Attorney

If you know of Medicaid scams in Roswell, Georgia,, you might have the right to file a qui tam lawsuit holding that party liable. Contact Khurana Law Firm for a confidential, no-cost consultation 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 Roswell, 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 Roswell, 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 LAWYER; We are proud to represent healthcare workers in Roswell, Georgia

When you become aware of potential fraud that may concern Medicaid or Medicare in Roswell, Georgia, you may need the advice of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is completely examined and submitted accurately and quickly. By dealing with a knowledgeable lawyer you are increasing the chance that the government will intervene, hence increasing the chance for a financial reward. Reporting Medicare and Medicaid 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 lawyers to assist in your battle against Medicare and Medicaid scams. We will examine your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we may represent you in a qui tam claim to report the scams and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

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