Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost North Carolina taxpayers billions of dollars every year. Although the majority of medical service providers and drug companies are ethical and work within the system, some don’t. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower attorneys assist people who work in the healthcare system to file lawsuits on behalf of the government to help report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Wilson, 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 hard and lots of things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Wilson, North Carolina

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

 

The North Carolina False Claims Act allows a whistleblower to file a civil claim on behalf of the State if they are aware of deceitful activity. The Act makes anybody who perpetrates Medicaid fraud responsible for losses and damages to the State. It also makes it possible for whistleblowers to be rewarded for their heroic efforts.

 

An effective whistleblower litigation 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 lawsuit. If the whistleblower chooses to litigate independently, she or he might be granted in between 25 and 30 percent of the healing. These rewards 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 Wilson, North Carolina

The accused in a whistleblower claim in North Carolina may be ordered 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 offense.

Statute of Limitations in North Carolina

Individuals submitting a whistleblower suit in the state of North Carolina need to file their complaint within ten years of the date of the infraction.

Working With an Experienced Whistleblower Attorney

Because the state government relies on whistleblowers to recuperate lost funds due to Medicaid fraud, they will often reward those people handsomely. If you know of Medicaid fraud in Wilson, North Carolina and elect 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 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 Wilson, 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 Wilson, 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 Wilson, North Carolina

When you become aware of potential fraud as it concerns Medicare or Medicaid in Wilson, North Carolina, you need the advice of a knowledgeable whistleblower lawyer, someone who can guarantee that your claim is fully examined and filed accurately and without delay. By dealing with an experienced lawyer you are increasing the chance that the government will step in, therefore increasing the possibility for a reward. Reporting Medicare and Medicaid scams is an intricate matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam legal representatives to assist in your battle against Medicaid and Medicare fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we may represent you in a qui tam suit to help report the scams and allow you to gather a reward. All whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can be of help.

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