Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Charleston, South Carolina

Medicaid and Medicare fraud cost South Carolina taxpayers billions of dollars annually. While many medical providers and drug companies are ethical and work within the system, some don’t. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower attorneys assist healthcare professionals to file lawsuits on behalf of the federal or state government to help report this sort of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare employees in Charleston, 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. understand that stepping forward is difficult and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently 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 Charleston, South Carolina

Medicaid fraud costs state and federal governments billions of dollars each year. In an effort to combat Medicaid fraud, numerous states have enacted whistleblower laws to enable private citizens to step forward with details to hold these parties responsible 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 have the ability to file a whistleblower suit under the federal False Claims Act. This entitles private individuals or workers to step forward with info relating to Medicaid fraud and file a civil claim 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 portion of the financial recovery. If the government has actually participated in the lawsuit, the whistleblower stands to receive between 15 and 25 percent of the financial recovery. In the case where the government has declined to participate in the case, the whistleblower’s award can increase to between 25 and 30 percent of the recovery.

 

The False Claims Act likewise has an anti-retaliation arrangement that shields the whistleblower from a company’s punitive acts.

Liability of the Defendant in Charleston, South Carolina

When an entity or an individual is found in transgression of the False Claims Act, they can be held responsible for approximately 3 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 Charleston, South Carolina

The statute of limitations in a whistleblower claim is the longer of 6 years from the date of the scams being committed or three years after the government knows about or should know about the material realities, but not more than ten years from the date of the violation.

Working With an Experienced Whistleblower Lawyer

At Khurana Law Firm, P.C., we support the brave efforts of those individuals who step forward to report Medicaid fraud. If you are thinking about a qui tam suit, you must fully understand your rights and protections under the law. When you come to us, you can feel confident that your case will be kept in the strictest self-confidence. 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 Charleston, South 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 Charleston, South 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 Charleston, South Carolina

When you become aware of fraud that may involve Medicare or Medicaid in Charleston, South Carolina, you may need the advice of a skilled whistleblower lawyer, someone who can guarantee that your claim is fully investigated and filed accurately and immediately. By working with a skilled attorney you are increasing the chance that the government will step in, therefore increasing the opportunity for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  do not attempt 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 assist in your fight against Medicaid and Medicare fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we believe that you have a valid claim, we can represent you in a qui tam claim to help report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can be of help.

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