Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in New Jersey

Medicare and Medicaid fraud cost New Jersey taxpayers billions of dollars every year. While many medical service providers and drug companies are honest and work within the system, there are those who don’t. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower lawyers can help healthcare professionals to submit claims on behalf of the government to help report these kinds of scams.

The state and federal government put a a lot of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government depends on every day people in New Jersey to come forward to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in New Jersey.

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and scams in the industry. understand that stepping forward is difficult and numerous 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 thoroughly examine your claim, diligently and carefully prepare your case, for court, and work relentlessly with you and the state of federal government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws Under the New Jersey False Claims Act

Following the New NJ False Claims Act, private citizens who may have become conscious of deceitful Medicare activity can file a qui tam claim on behalf of the government. Under the New Jersey False Claims Act, parties who defraud the government can be held responsible for their fraudulent claims or fraudulent practices. Whistleblowers may likewise have the ability to recover a reward for the information and participation in bringing those entities or parties to justice.

What Is the New Jersey False Claims Act?

The NJ State False Claims Act imposes civil charges on anybody who submits a claim to the state for services, money, or property that they know or should understand is fraudulent or false. In this case, anyone who is a party to defrauding the state government where it concerns Medicare claims may be held liable for this activity. A defendant can be ordered to pay up to three times the amount by which the New Jersey government was harmed in addition to additional fines in between $5,500 and $11,000 for each infraction.

What Is A Whistleblower Entitled To in New Jersey?

A successful qui tam claim may entitle a whistleblower to get a reward between 15 percent and 25 percent of the recovery if the state government ends up being party to the claim. If the government elects not to become party to the claim, the whistleblower might then be entitled to a benefit of 25 and 30 percent of the recovery amount.

 

If a whistleblower was associated with the planning or initiation of the fraud, or if their information was based upon something that was originated from the media or any public hearing, that award might be reduced.

Is a Whistleblower Protected in New Jersey?

Whistleblowers in New Jersey are protected by law from retaliation by an employer when they have submitted a claim or otherwise offered help to the state in pursuing a fraudulent claim.

How Long Does A Whistleblower Have to File A Claim in New Jersey?

Under the New Jersey False Claims Act, a whistleblower can not sue more than ten years after the date of the offense.

 

If you have knowledge of Medicare or Medicaid fraud in New Jersey, get the legal assistance of experienced whistleblower lawyers at Khurana Law Firm, P.C. For a completely confidential, no-cost assessment, call now: (888) 335-5107.

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 can report it 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. To report Medicare fraud, 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 LAWYER

When you become aware of potential fraud involving Medicare or Medicaid, you require the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is totally investigated and filed accurately and promptly. By working with an experienced attorney you are increasing the chance that the federal or state government will step in, hence increasing the chance for a 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 prior experience as national qui tam legal representatives to assist in your fight against Medicaid and Medicare scams. We will review your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we may represent you in a qui tam suit to help report the fraud and enable you to collect a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Contact us today to to schedule a confidential consultation.

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