Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Winston-Salem, North Carolina

Medicare and Medicaid fraud cost North Carolina taxpayers billions of dollars every year. Although many medical service providers and drug companies are ethical and work within the legal channels, there are those who don’t. When fraud happens, everybody loses. Medicare and Medicaid whistleblower attorneys help healthcare professionals to file lawsuits on behalf of the government to help report these kinds of scams.

The federal and state government put a good deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, it relies on every day people in North Carolina to come forward and to report fraud. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare workers in Winston-Salem, North Carolina

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is not easy and many things might 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 completely examine your claim, diligently and carefully prepare your case, and work tirelessly with you and the federal or state government to help bring fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Winston-Salem, North Carolina

Those who perpetrate fraud against the Medicaid program in North Carolina cost countless dollars to the taxpayer. 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 allows a whistleblower to submit a civil suit on behalf of the State if they are aware of deceptive activity. The Act makes anybody who perpetrates Medicaid fraud responsible for losses and damages to the State. It also enables whistleblowers to be rewarded for their brave efforts.

 

A successful whistleblower suit may entitle the person to awards of in between 15 and 25 percent of the state’s financial recovery should they intervene in the claim. If the whistleblower elects to prosecute separately, she or he might be awarded in between 25 and 30 percent of the healing. These rewards will be contingent on the whistleblower’s involvement in the fraudulent activity or the source of the info.

 

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

Liability of the Defendant in Winston-Salem, North Carolina

The offender in a whistleblower suit in North Carolina may be ordered by the court 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 infraction.

Statute of Limitations in North Carolina

Individuals submitting a whistleblower claim in the state of North Carolina must submit 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, they will typically reward those individuals handsomely. If you are aware of Medicaid fraud in Winston-Salem, 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 skilled team of whistleblower lawyers can advise and assist you. Contact us for a 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 Winston-Salem, 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 Winston-Salem, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Winston-Salem, North Carolina

If you’ve become aware of fraud involving Medicaid or Medicare in Winston-Salem, North Carolina, you need the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is fully examined and submitted accurately and promptly. By dealing with an experienced attorney you are increasing the chance that the government will step in, hence increasing the possibility for a reward. Reporting Medicaid and Medicare fraud is a complex matter –  don’t try 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 attorneys to help in your fight against Medicare and Medicaid fraud. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we can represent you in a qui tam claim to report the scams and allow you to collect a reward. Because all whistleblower cases are on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can help.

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