Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Raleigh, North Carolina

Medicaid and Medicare fraud cost North Carolina taxpayers billions of dollars every year. Although many medical service providers and drug companies are ethical and work within the system, there are those who don’t. When fraud occurs, everyone can lose. Medicare and Medicaid whistleblower attorneys help healthcare workers to file suits on behalf of the federal or state government to help report this type of fraud.

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

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Raleigh, North Carolina

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the industry. understand 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 examine your claim, diligently and carefully prepare your case, for court, and work relentlessly with both you and the state of federal government to help bring fraudulent Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Raleigh, North Carolina

Those who perpetrate scams against the Medicaid program in North Carolina cost millions of dollars to the taxpayer. The State relies on whistleblowers to help fight scams in the Medicaid health care system. These people can step forward under the North Carolina False Claims Act.

 

The North Carolina False Claims Act allows a whistleblower to file a civil suit on behalf of the State if they know of deceitful 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 brave efforts.

 

An effective whistleblower litigation might entitle the person to awards of between 15 and 25 percent of the state’s financial recovery if they they intervene in the suit. If the whistleblower elects to prosecute individually, she or he might be awarded in between 25 and 30 percent of the recovery. These rewards will be contingent on the whistleblower’s participation in the fraudulent activity or the source of the info.

 

Under the North Carolina False Claims Act, the whistleblower is also protected from any employer retaliation that may arise from the reporting.

Liability of the Defendant in Raleigh, North Carolina

The defendant in a whistleblower suit in North Carolina may be ordered to pay up to three times the real 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 suit in the state of North Carolina should file their problem within 10 years of the date of the infraction.

Working With an Experienced Whistleblower Attorney

Since the state government relies on whistleblowers to recuperate lost funds due to Medicaid fraud, the state will often reward those individuals handsomely. If you know of Medicaid fraud in Raleigh, 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 experienced team of whistleblower lawyers can advise and guide you. Contact us for a confidential, no-cost assessment 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 Raleigh, 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 Raleigh, North Carolina,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Raleigh, North Carolina

When you become aware of potential fraud that may involve Medicare or Medicaid in Raleigh, North Carolina, you require the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is completely examined and submitted accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the federal or state government will intervene, therefore increasing your chances for a financial reward. Reporting Medicare and Medicaid scams is a complex matter –  do not try 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 attorneys to assist in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we may represent you in a qui tam lawsuit to help report the scams and allow you to gather a financial benefit. All whistleblower cases are on contingency, you pay nothing until there is a recovery. Contact us today to learn how we can help.

Service areas