Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Wilmington, North Carolina

Medicare and Medicaid fraud cost North Carolina taxpayers billions of dollars annually. Although many medical providers and drug companies are honest and work within the system, some don’t. When fraud happens, everybody can lose. Medicaid and Medicare whistleblower lawyers help people who work in the healthcare system to file lawsuits on behalf of the federal or state government to report this sort of fraud.

The state and federal governments place a good deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government counts on every day people in North Carolina to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Wilmington, 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 market. We know that stepping forward is not simple and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Wilmington, North Carolina

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

 

The North Carolina False Claims Act enables a whistleblower to file a civil claim on behalf of the State if they are aware of deceptive activity. The Act makes anyone who perpetrates Medicaid scams responsible for losses and damages to the State. It additionally enables whistleblowers to be rewarded for their heroic efforts.

 

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

 

Under the North Carolina False Claims Act, the whistleblower is likewise protected from any company retaliation that might arise from the reporting.

Liability of the Defendant in Wilmington, North Carolina

The offender in a whistleblower suit in North Carolina might be ordered to pay up to 3 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

People submitting a whistleblower claim in the state of North Carolina should submit their problem within ten 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, they will typically reward those individuals handsomely. If you may be aware of Medicaid fraud in Wilmington, 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 direct you. Contact us for a 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 Wilmington, 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 Wilmington, 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Wilmington, North Carolina

If you’ve become aware of fraudulent activity that may involve Medicaid or Medicare in Wilmington, North Carolina, you require the guidance of an experienced whistleblower attorney, someone who can ensure that your claim is completely investigated and filed accurately and promptly. By working with a skilled lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity 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 prior experience as national qui tam attorneys to help in your fight against Medicaid and Medicare scams. We will examine your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we may represent you in a qui tam suit to help report the scams and enable you to collect a reward. 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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