Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid scams in East Orange, New Jersey

Medicaid and Medicare fraud cost New Jersey taxpayers billions of dollars every year. Although the majority of medical companies and drug companies are ethical and work within the system, some do not. When fraud happens, everyone loses. Medicaid and Medicare whistleblower lawyers can help healthcare workers to file lawsuits on behalf of the government to help report this type of fraud.

The state and federal governments put a good deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government relies on private citizens in New Jersey to come forward to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in East Orange, New Jersey

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the industry. We know that stepping forward is challenging and lots of things may 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, carefully prepare your case, for court, and work relentlessly with both you and the federal or state government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws Under the New Jersey False Claims Act in East Orange, New Jersey

Following the New NJ False Claims Act, people who have become informed of fraudulent Medicare activity can submit a qui tam claim on behalf of the New Jersey state government. Under this act Act, parties who defraud the state government may be held accountable for their deceitful claims or fraudulent practices. Whistleblowers might likewise have the ability to recuperate a benefit for the information and involvement in helping to bring those entities or parties to justice.

What Does the New Jersey False Claim Act Say?

The New Jersey False Claims imposes civil charges on anyone who sends a claim to the State for {money, property| or services that he knows or ought to know is incorrect.” In these cases, anybody who is a party to defrauding the government where it concerns Medicare claims may be held liable for their activity. A defendant may be ordered to pay up to three times the amount by which the New Jersey government was hurt in addition to extra fines of between $5,500 and $11,000 for each offense.

What Is A Whistleblower Entitled To?

An effective qui tam claim may entitle a whistleblower to receive a benefit between 15 percent and 25 percent of the recovery if the state government becomes party to the claim. If the government chooses not to become party to the claim, the whistleblower may then be entitled to a benefit of between 25 percent and 30 percent of the recovery amount.

 

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

Is a Whistleblower Protected in East Orange, New Jersey?

In New York State, a whistleblower complaint must be filed within ten years after the date of the violation.

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

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

 

If you have knowledge of Medicare or Medicaid scams in East Orange, New Jersey, get the legal assistance of an 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 are a healthcare worker in East Orange, New Jersey, 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 East Orange, New Jersey,  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 An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in East Orange, New Jersey

When you become aware of potential fraud as it concerns Medicare or Medicaid in East Orange, New Jersey, you require the guidance of an experienced whistleblower attorney, someone who can guarantee that your claim is totally examined and submitted accurately and promptly. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, thus increasing the possibility for a reward. Reporting Medicare and Medicaid fraud is an intricate matter –  don’t try 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 Medicare and Medicaid scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we believe you have a valid claim, we may represent you in a qui tam claim to help report the fraud and enable you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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