Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Apex, North Carolina

Medicaid and Medicare fraud cost North Carolina taxpayers billions of dollars each year. Although many medical service providers and drug companies are ethical and work within the system, some do not. When scams are perpetrated, everybody loses. Medicare and Medicaid whistleblower attorneys help people who work in the healthcare system to submit lawsuits on behalf of the federal or state government to report this type of fraud.

The federal and state government 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 North Carolina to come forward to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Apex, North Carolina

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 fraud in the market. We know that stepping forward is not simple and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Apex, North Carolina

Those who commit fraud against the Medicaid program in North Carolina cost millions of dollars to taxpayers. The State relies on whistleblowers to help combat scams in the Medicaid healthcare system. These individuals can come forward under the North Carolina False Claims Act.

 

The North Carolina False Claims Act enables a whistleblower to file a civil suit on behalf of the State if they know of deceptive activity. The Act makes anyone who commits Medicaid fraud liable for losses and damages to the State. It additionally allows whistleblowers to be rewarded for their heroic efforts.

 

A successful whistleblower litigation may entitle the person to awards of in between 15 and 25 percent of the state’s recovery if they they intervene in the lawsuit. If the whistleblower elects to prosecute separately, he or she might be awarded in between 25 and 30 percent of the healing. These benefits will be contingent on the whistleblower’s participation in the deceitful activity or the source of the info.

 

Under the North Carolina False Claims Act, the whistleblower is also safeguarded from any employer retaliation that might result from the reporting.

Liability of the Defendant in Apex, North Carolina

The offender in a whistleblower suit in North Carolina may be ordered to pay up to 3 times the actual damages to the state in addition to fines of between $5,500 and $11,000 for each violation.

Statute of Limitations in North Carolina

Individuals filing a whistleblower claim in the state of North Carolina should file their complaint within ten years of the date of the violation.

Working With an Experienced Whistleblower Attorney

Because of the state government’s dependence on whistleblowers to recuperate lost funds due to Medicaid scams, they will often reward those people handsomely. If you are aware of Medicaid fraud in Apex, North Carolina and choose to come forward, you should understand your rights and legal protections under the North Carolina False Claims Act. At Khurana Law Firm, P.C., our skilled team of whistleblower lawyers can advise and direct you. Contact us for a completely confidential, no-cost consultation and to discuss your case.

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 Apex, North Carolina, 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 Apex, North Carolina,  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 LAWYER; We are proud to represent healthcare workers in Apex, North Carolina

When you become aware of potential fraud as it concerns Medicare or Medicaid in Apex, North Carolina, you require the advice of a skilled whistleblower attorney, someone who can ensure that your claim is totally examined and filed accurately and quickly. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, thus increasing the possibility for a reward. Reporting Medicaid and Medicare scams is a complex 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 lawyers to help in your fight against Medicaid and Medicare scams. 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 report the scams and allow you to collect a reward. Because all whistleblower work is on contingency, you pay nothing until there is a recovery. Contact us today to learn how we can help.

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