Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in South Carolina

Medicare and Medicaid fraud cost South Carolina taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are honest and work within the legal channels, there are those who don’t. When scams are perpetrated, everyone loses. Medicaid and Medicare whistleblower attorneys assist healthcare workers to submit lawsuits on behalf of the government to report this type of fraud.

The state and federal governments place a great deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, it depends on every day people in South Carolina to come forward to report scams. People like you.

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing health care workers in South Carolina.

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the market. We know that coming forward is not easy and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, and work relentlessly with 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 South Carolina

Medicaid fraud costs state and federal governments billions of dollars each year. In an effort to combat Medicaid fraud, many states have enacted whistleblower laws to enable private citizens to come forward with information to hold these parties liable and recover those funds. 

While the state of South Carolina does not have a state false claims act, parties who have knowledge of Medicaid fraud may be able to file a whistleblower lawsuit under the federal False Claims Act. This entitles individuals and employees to come forward with information regarding Medicaid fraud and file a civil lawsuit on behalf of the government. 

While the False Claims Act holds parties liable for the fraud they perpetrate, a qui tam lawsuit incentivizes the whistleblower with rewards based on a percentage of the recovery. When the government has entered into the lawsuit, the whistleblower stands to receive between 15 and 25 percent of the recovery. In the case where the government has declined to enter into the suit, the whistleblower’s award can increase to between 25 and 30 percent of the recovery. 

The False Claims Act also has an anti-retaliation provision that protects the whistleblower from an employer’s retaliatory acts.

If you are a North Carolina healthcare worker, get in touch with North Carolina Medicare Whistleblower attorney.

Liability of the Defendant in South Carolina

When an individual or entity is found in violation of the False Claims Act, they can be held liable for up to three times the damage to the government. In addition, they can also be ordered to pay penalties of $5,500 to $11,000 per violation.

Statute of Limitations in South Carolina

The statute of limitations in a whistleblower lawsuit is the longer of six years from the date of the fraud being committed or three years after the government knows about or should know about the material facts, but not more than ten years from the date of the violation. 

Working With an Experienced Whistleblower Attorney

At Khurana Law Firm, P.C., we support the heroic efforts of those individuals who come forward to report Medicaid fraud. If you are considering a qui tam lawsuit, you should fully understand your rights and protections under the law. When you come to us, you can rest assured that your case will be held in the strictest confidence. 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 can report it 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. To report Medicare fraud, 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 LAWYER

If you’ve become aware of potential fraud that may concern Medicaid or Medicare, you need the advice of a skilled whistleblower attorney, someone who can make sure that your claim is fully examined and filed accurately and immediately. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the opportunity for a financial reward. Reporting Medicare and Medicaid fraud is a complicated matter –  do not 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 lawyers to help in your fight against Medicare and Medicaid fraud. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we believe that you have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and allow you to gather a financial benefit. Because all whistleblower work is on contingency, you pay nothing up until there is a recovery. Contact us today to to schedule a confidential consultation.

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