Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost New Jersey taxpayers billions of dollars each year. Although most medical service providers and drug companies are honest and work within the legal channels, there are those who don’t. When scams are perpetrated, everyone loses. Medicare and Medicaid whistleblower lawyers help healthcare workers to file lawsuits on behalf of the federal or state government to help report these kinds of scams.

The federal and state government place a great deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government depends on private citizens in New Jersey to come forward to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare workers in Wayne, New Jersey

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the market. understand that coming forward is challenging 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 comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, and work relentlessly with you and the federal or state government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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

Following the New NJ False Claims Act, private citizens who have become cognizant of deceitful Medicare activity can file a qui tam claim on behalf of the government. Under the New Jersey False Claims Act, parties who defraud the government of New Jersey can be held responsible for their deceptive insurance claims or deceptive practices. Whistleblowers might likewise be able to recover a benefit for their information and participation in bringing those entities or parties to justice.

What Does the New Jersey False Claim Act Say?

The New Jersey False Claims enforces civil penalties on anybody who sends a claim to the State for {money, property| or services that he knows or ought to know is fraudulent.” In these cases, anyone who is a party to defrauding the state government where it concerns Medicare claims may be held liable for this activity. A defendant may be ordered to pay up to 3 times the amount by which the state government was harmed in addition to extra fines in between $5,500 and $11,000 for each offense.

What Is A Whistleblower Entitled To?

A successful qui tam claim may entitle a whistleblower to receive a benefit of between 15 and 25 percent of the recovery if the state government becomes party to the claim. If the state government chooses not to become party to the claim, the whistleblower may then be entitled to a reward of as much as 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 on something that was originated from the media or any public hearing, that award may be decreased.

Is a Whistleblower Protected in Wayne, 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 10 years after the date of the violation.

 

If you are aware of Medicare or Medicaid fraud in Wayne, New Jersey, get the legal support of an knowledgeable whistleblower attorneys at Khurana Law Firm, P.C. For a 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 Wayne, 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 Wayne, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Wayne, New Jersey

When you become aware of potential fraud that may concern Medicaid or Medicare in Wayne, New Jersey, you need the advice of an experienced whistleblower attorney, someone who can make sure that your claim is fully investigated and filed accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the government will intervene, hence increasing the possibility for a reward. Reporting Medicaid and Medicare scams 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 prior experience as national qui tam legal representatives to help in your battle against Medicare and Medicaid scams. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we can represent you in a qui tam suit to report the fraud and enable you to collect a financial benefit. Because all whistleblower cases are 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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