Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Trenton, New Jersey

Medicare and Medicaid fraud cost New Jersey taxpayers billions of dollars annually. While most medical providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud occurs, everyone loses. Medicaid and Medicare whistleblower lawyers help people who work in the healthcare system to file suits on behalf of the government to report these kinds of scams.

The federal and state government put a good deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, the government depends 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 health care workers in Trenton, New Jersey

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the market. We know that stepping forward is challenging and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work tirelessly with both you and the state of federal government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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

Following the New Jersey False Claims Act, people who have become conscious of fraudulent Medicare activity may 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 accountable for their deceitful insurance claims or fraudulent practices. Whistleblowers can also be able to recuperate a financial benefit for their information and involvement in helping to bring those parties or entities to justice.

What Does the New Jersey False Claim Act Say?

The NJ State False Claims Act imposes civil penalties on anyone who sends a claim to the State for {money, property| or services that he knows or must know is fraudulent.” In this case, anyone who is a party to defrauding the state government where it concerns Medicare claims may be held accountable for their activity. A defendant can be ordered to pay up to three 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 and 25 percent of the recovery if the government ends up being party to the claim. If the state government selects not to become party to the claim, the whistleblower might then be entitled to a financial reward of as much as 25 percent and 30 percent of the recovery amount.

 

If a whistleblower was involved in the preparation or initiation of the illicit activity, or if their information was based upon something that was originated from the media or any public hearing, that award might be minimized.

Is a Whistleblower Protected in Trenton, New Jersey?

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 have knowledge of Medicare or Medicaid scams in Trenton, New Jersey, get the legal assistance of an knowledgeable whistleblower lawyers 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 Trenton, 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 Trenton, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Trenton, New Jersey

When you become aware of potential fraud that may involve Medicaid or Medicare in Trenton, New Jersey, you need the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is totally examined and submitted accurately and quickly. By working with a skilled attorney you are increasing the chance that the government will intervene, thus increasing the chance for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t try 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 battle against Medicare and Medicaid scams. Our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam suit to help report the fraud and enable you to gather a reward. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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