Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Woodbridge, New Jersey

Medicaid and Medicare fraud cost New Jersey taxpayers billions of dollars every year. While most medical providers and drug companies are ethical and work within the legal channels, some do not. When fraud takes place, everyone loses. Medicare and Medicaid whistleblower attorneys assist healthcare professionals to submit suits on behalf of the federal or state government to help report these kinds of scams.

The state and federal governments place a good deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government relies on regular folks in New Jersey to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Woodbridge, 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 market. We know that coming forward is difficult and lots of things might 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 examine your claim, diligently prepare your case, for court, and work tirelessly with both you and the federal or state 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 Woodbridge, New Jersey

Under the New State of New Jersey False Claims Act, people who may have become informed of fraudulent Medicare activity can file 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 responsible for their fraudulent claims or fraudulent practices. Whistleblowers may also be able to recuperate a financial benefit for the information and for the involvement in bringing 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 any person who sends a claim to the State for {money, property| or services that he understands or must know is false.” In these cases, anyone who is a party to defrauding the state government as it relates to Medicare claims may be held accountable for their activity. A defendant can be ordered to pay up to 3 times the amount by which the state government was hurt in addition to additional fines in between $5,500 and $11,000 for each violation.

What Is A Whistleblower Entitled To?

An effective qui tam claim might entitle a whistleblower to receive a reward between 15 percent 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 benefit of as much as 25 percent and 30 percent of the recovery amount.

 

If a whistleblower was involved in the planning or initiation of the fraud, or if their information was based on something that was stemmed from the media or any public hearing, that award may be minimized.

Is a Whistleblower Protected in Woodbridge, 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 fraud in Woodbridge, New Jersey, get the legal assistance of an skilled whistleblower legal representatives 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 Woodbridge, 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 Woodbridge, 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 Woodbridge, New Jersey

If you’ve become aware of fraud as it concerns Medicaid or Medicare in Woodbridge, New Jersey, you need the guidance of a knowledgeable whistleblower attorney, someone who can ensure that your claim is totally investigated and filed accurately and without delay. By dealing with a knowledgeable attorney you are increasing the chance that the government will intervene, therefore increasing the possibility for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  don’t 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 attorneys to help in your fight against Medicare and Medicaid scams. We will examine your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam suit to help report the fraud and allow you to gather a reward. Because all whistleblower cases are on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can be of help.

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