Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Jersey City, New Jersey

Medicaid and Medicare fraud cost New Jersey taxpayers billions of dollars annually. Although most medical providers and drug companies are honest and work within the legal channels, there are those who don’t. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower attorneys can assist healthcare workers to file claims on behalf of the government to help report this sort of fraud.

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

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and scams in the industry. We know that coming forward is not easy and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, for court, and work relentlessly with both you and the federal or state government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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

Following the New State of New Jersey False Claims Act, private citizens who have become informed of deceitful Medicare activity can submit a qui tam claim on behalf of the government. Under this act Act, parties who defraud the government of New Jersey may be held responsible for their deceptive claims or deceptive practices. Whistleblowers might also be able to recuperate a financial benefit for the information and for the 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 penalties on anybody who submits a claim to the State for {money, property| or services that he knows or ought to know is incorrect.” In this case, anyone 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 3 times the amount by which the government was damaged in addition to extra fines in between $5,500 and $11,000 for each violation.

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 benefit of between 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 on something that was derived from the media or any public hearing, that award might be lowered.

Is a Whistleblower Protected in Jersey City, 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 sue more than ten years after the date of the infraction.

 

If you are aware of Medicare or Medicaid scams in Jersey City, New Jersey, get the legal help of an skilled whistleblower lawyers at Khurana Law Firm, P.C. For a 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 Jersey City, 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 Jersey City, 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Jersey City, New Jersey

If you’ve become aware of fraudulent activity involving Medicaid or Medicare in Jersey City, New Jersey, you may need the guidance of a skilled whistleblower lawyer, someone who can guarantee that your claim is fully investigated and filed accurately and promptly. By working with a knowledgeable attorney you are increasing the chance that the government will step in, thus increasing the possibility for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  do not 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 battle against Medicare and Medicaid fraud. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam claim to help report the scams and allow you to collect a reward. All whistleblower cases are on contingency, you pay nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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