Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Cary, North Carolina

Medicare and Medicaid fraud cost North Carolina taxpayers billions of dollars every year. Although the majority of medical service providers and drug companies are honest and work within the legal channels, there are those who don’t. When fraud takes place, everybody can lose. Medicare and Medicaid whistleblower lawyers assist healthcare professionals to file lawsuits on behalf of the federal or state government to help report this type of fraud.

The state and federal governments place a lot of trust in medical and pharmaceutical companies. When that trust is ill-placed, the government counts on private citizens in North Carolina to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Cary, North Carolina

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and scams in the market. We know that coming forward is difficult and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, and work relentlessly with both you and the state of federal government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Cary, North Carolina

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

 

The North Carolina False Claims Act enables a whistleblower to submit a civil lawsuit on behalf of the State if they know of deceitful activity. The Act makes anybody who perpetrates Medicaid fraud accountable for losses and damages to the State. It additionally allows whistleblowers to be rewarded for their heroic efforts.

 

An effective whistleblower lawsuit might entitle the individual to awards of in between 15 and 25 percent of the state’s financial recovery if they they intervene in the suit. If the whistleblower elects to prosecute independently, he or she may be awarded 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 protected from any employer retaliation that might result from the reporting.

Liability of the Defendant in Cary, North Carolina

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

Statute of Limitations in North Carolina

Individuals filing a whistleblower suit in the state of North Carolina need to file their problem within ten years of the date of the offense.

Working With an Experienced Whistleblower Attorney

Because the state government relies on whistleblowers to recuperate lost funds due to Medicaid scams, the state will often reward those individuals handsomely. If you are aware of Medicaid fraud in Cary, North Carolina and elect to come forward, you should understand your rights and protections under the North Carolina False Claims Act. At Khurana Law Firm, P.C., our skilled team of whistleblower attorneys can advise and direct you. Contact us for a completely confidential, no-cost assessment 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 Cary, 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 Cary, 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 Cary, North Carolina

When you become aware of potential fraud that may concern Medicare or Medicaid in Cary, North Carolina, you need the guidance of a skilled whistleblower attorney, someone who can guarantee that your claim is fully examined and submitted accurately and promptly. By dealing with a knowledgeable lawyer you are increasing the chance that the government will step in, thus increasing your chances for a reward. Reporting Medicare and Medicaid fraud is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam lawyers to assist in your battle against Medicaid and Medicare scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we can represent you in a qui tam lawsuit to report the fraud and enable you to collect a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can be of help.

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