Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Elizabeth, New Jersey

Medicare and Medicaid fraud cost New Jersey taxpayers billions of dollars annually. While many medical service providers and drug companies are ethical and work within the legal channels, some don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower lawyers can assist people who work in the healthcare system to file claims on behalf of the federal or state government to help report this type of fraud.

The federal and state governments place a great deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it relies on private citizens in New Jersey to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Elizabeth, New Jersey

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and fraud in the industry. understand that stepping forward is challenging and many things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our extensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, and work relentlessly with both you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws Under the New Jersey False Claims Act in Elizabeth, New Jersey

Under the New State of New Jersey False Claims Act, people who have become conscious of fraudulent Medicare activity can file a qui tam claim on behalf of the state government. Under the New Jersey False Claims Act, parties who defraud the government of New Jersey may be held responsible for their deceitful claims or deceptive practices. Whistleblowers may also have the ability to recuperate a reward for their information and for the involvement in bringing those entities or parties to justice.

What Does the New Jersey False Claim Act Say?

The New Jersey False Claims imposes civil penalties on anyone who sends a claim to the State for {money, property| or services that he understands or need to understand is incorrect.” In this case, anybody who is a party to defrauding the state government as it relates to Medicare claims can be held liable for this activity. A defendant can be ordered to pay up to 3 times the amount by which the state government was damaged in addition to extra fines of between $5,500 and $11,000 for each offense.

What Is A Whistleblower Entitled To?

A successful qui tam claim might entitle a whistleblower to receive a reward between 15 and 25 percent of the recovery if the government becomes party to the claim. If the state government selects not to become party to the claim, the whistleblower might then be entitled to a reward of as much as 25 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 stemmed from the media or any public hearing, that award may be reduced.

Is a Whistleblower Protected in Elizabeth, 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 offense.

 

If you are aware of Medicare or Medicaid fraud in Elizabeth, New Jersey, get the legal help of an knowledgeable whistleblower legal representatives 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 Elizabeth, 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. 

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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 Elizabeth, 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 Elizabeth, New Jersey

When you become aware of potential fraud as it concerns Medicaid or Medicare in Elizabeth, New Jersey, you may need the guidance of an experienced whistleblower attorney, someone who can guarantee that your claim is totally investigated and filed accurately and immediately. By dealing with an experienced attorney you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity for a reward. Reporting Medicare and Medicaid scams is a complex 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 fight against Medicare and Medicaid fraud. We will evaluate 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 claim to help report the fraud and enable you to gather a financial benefit. All whistleblower work is on contingency, you pay nothing up until there is a recovery. Contact us today to learn how we can be of help.

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