Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost New Jersey taxpayers billions of dollars every year. While the majority of medical companies and drug companies are honest and work within the legal channels, some do not. When fraud takes place, everybody loses. Medicare and Medicaid whistleblower lawyers help people who work in the healthcare system to submit suits on behalf of the government to report this sort of fraud.

The federal and state government place a lot of trust in pharmaceutical and medical providers. When that trust is ill-placed, it counts on every day people in New Jersey to come forward and to report fraud. People like you.

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

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

With our substantial experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, for court, 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 Under the New Jersey False Claims Act in Edison, New Jersey

Under the New State of New Jersey False Claims Act, people who may have become conscious 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 can be held responsible for their fraudulent insurance claims or fraudulent practices. Whistleblowers may also be able to recuperate a reward for their information and involvement in bringing those parties or entities to justice.

What Does the New Jersey False Claim Act Say?

The NJ State False Claims Act imposes civil charges on anybody who submits a claim to the State for {money, property| or services that he knows or ought to know is false.” In this case, anyone who is a party to defrauding the state government as it relates to Medicare claims can 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 harmed in addition to additional fines of between $5,500 and $11,000 for each infraction.

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 government becomes party to the claim. If the government selects not to become party to the claim, the whistleblower might then be entitled to a financial reward of between 25 and 30 percent of the recovery amount.

 

If a whistleblower was associated with the planning or initiation of the illicit activity, or if their information was based upon something that was stemmed from the media or any public hearing, that award may be minimized.

Is a Whistleblower Protected in Edison, New Jersey?

In New York, 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 file a claim more than 10 years after the date of the violation.

 

If you have knowledge of Medicare or Medicaid fraud in Edison, New Jersey, get the legal assistance of an skilled whistleblower legal representatives at Khurana Law Firm, P.C. For a completely confidential, no-cost consultation, 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 Edison, 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 Edison, 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 ATTORNEY; We are proud to represent healthcare workers in Edison, New Jersey

When you become aware of fraud that may involve Medicare or Medicaid in Edison, New Jersey, you need the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is totally examined and submitted accurately and immediately. By working with an experienced attorney you are increasing the chance that the federal or state government will step in, thus increasing your chances for a reward. Reporting Medicaid and Medicare scams is a complicated matter –  do not 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 attorneys to assist in your battle against Medicare and Medicaid scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we can represent you in a qui tam lawsuit to help report the scams and enable you to gather a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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