Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in West New York, New Jersey

Medicare and Medicaid fraud cost New Jersey taxpayers billions of dollars every year. Although the majority of medical providers and drug companies are honest and work within the system, there are those who do not. When scams are perpetrated, everyone can lose. Medicare and Medicaid whistleblower lawyers can help people who work in the healthcare system to submit suits on behalf of the federal or state government to report this sort of fraud.

The federal and state governments place a great deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government relies on private citizens 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 workers in West New York, New Jersey

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

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, and work relentlessly with you and the federal or state 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 West New York, New Jersey

Following the New NJ False Claims Act, people who have become informed of deceptive Medicare activity may submit a qui tam claim on behalf of the New Jersey state government. Under the New Jersey False Claims Act, parties who defraud the government can be held accountable for their deceitful insurance claims or deceptive practices. Whistleblowers can also be able to recuperate a reward 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 anyone who sends a claim to the State for {money, property| or services that he understands or must understand is incorrect.” In these cases, anybody who is a party to defrauding the government where it concerns 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 government was damaged in addition to extra fines of between $5,500 and $11,000 for each violation.

What Is A Whistleblower Entitled To?

A successful qui tam claim may entitle a whistleblower to get a benefit between 15 and 25 percent of the recovery if the state government becomes party to the claim. If the government chooses 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 associated with the planning or initiation of the fraud, or if their information was based on something that was originated from the media or any public hearing, that award may be reduced.

Is a Whistleblower Protected in West New York, 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 10 years after the date of the violation.

 

If you know of Medicare or Medicaid fraud in West New York, New Jersey, get the legal support of an skilled 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 West New York, 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 West New York, 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 LAWYER; We are proud to represent healthcare workers in West New York, New Jersey

When you become aware of deceptive activity that may involve Medicaid or Medicare in West New York, New Jersey, you need the advice of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is totally examined and submitted accurately and immediately. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, therefore increasing the opportunity for a financial reward. Reporting Medicare and Medicaid scams is a complex matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam legal representatives to help in your battle against Medicaid and Medicare scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we may represent you in a qui tam claim to report the scams and allow you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay nothing until there is a recovery. Get in touch with us today to learn how we can be of help.

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