Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in Rocky Mount, North Carolina

Medicare and Medicaid fraud cost North Carolina taxpayers billions of dollars annually. Although the majority of medical service providers and drug companies are honest and work within the system, there are those who do not. When scams are perpetrated, everybody loses. Medicare and Medicaid whistleblower lawyers can assist healthcare professionals to file lawsuits on behalf of the federal or state government to report this type of fraud.

The state and federal governments put a great deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, it relies on regular folks in North Carolina to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Rocky Mount, North Carolina

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the industry. We know that coming forward is hard and numerous things may 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 thoroughly examine your claim, diligently prepare your case, and work relentlessly with both you and the federal or state government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Rocky Mount, North Carolina

Those who commit fraud against the Medicaid program in North Carolina cost millions of dollars to taxpayers. The State depends on whistleblowers to assist fight scams in the Medicaid health care system. These individuals can come forward under the North Carolina False Claims Act.

 

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

 

An effective whistleblower suit might entitle the person 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 chooses to litigate separately, he or she might be granted between 25 and 30 percent of the healing. These benefits will be contingent on the whistleblower’s participation in the deceptive activity or the source of the information.

 

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

Liability of the Defendant in Rocky Mount, North Carolina

The accused in a whistleblower lawsuit in North Carolina might 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 suit in the state of North Carolina must submit their complaint within 10 years of the date of the violation.

Working With an Experienced Whistleblower Attorney

Because the state government relies on whistleblowers to recover lost funds due to Medicaid fraud, the state will typically reward those people handsomely. If you are aware of Medicaid scams in Rocky Mount, North Carolina and elect to come forward, you should understand your rights under the law and legal protections under the North Carolina False Claims Act. At Khurana Law Firm, P.C., our skilled team of whistleblower attorneys can advise and assist 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 Rocky Mount, 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 Rocky Mount, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Rocky Mount, North Carolina

When you become aware of fraud involving Medicare or Medicaid in Rocky Mount, North Carolina, you may need the guidance of a knowledgeable whistleblower attorney, someone who can ensure that your claim is totally investigated and filed accurately and quickly. By working with an experienced attorney you are increasing the chance that the federal or state government will intervene, therefore increasing the chance for a financial reward. Reporting Medicare and Medicaid scams is an intricate 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 help in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we may represent you in a qui tam suit to help report the scams and allow you to collect a reward. All whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to learn how we can help.

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