Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Columbia, South Carolina

Medicare and Medicaid fraud cost South Carolina taxpayers billions of dollars every year. Although the majority of medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud occurs, everyone can lose. Medicare and Medicaid whistleblower lawyers assist healthcare professionals to file lawsuits on behalf of the government to report this type of fraud.

The state and federal government place a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, it relies on private citizens in South Carolina to come forward and to report fraud. People like you.

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and fraud in the market. understand that coming forward is challenging and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently and carefully prepare your case, for court, and work relentlessly with you and the state of federal government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Columbia, South Carolina

Medicaid scams costs federal and state governments billions of dollars every year. In an effort to combat Medicaid scams, lots of states have enacted whistleblower laws to enable private citizens to come forward with details in order 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 scams may have the ability to file a whistleblower claim under the federal False Claims Act. This entitles private individuals or staff members to come forward with details concerning Medicaid scams and file a civil suit on behalf of the government.

 

While the False Claims Act holds parties accountable for the scams they perpetrate, a qui tam lawsuit incentivizes the whistleblower with rewards based upon a portion of the financial recovery. If the government has actually entered into 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 enter into the lawsuit, the whistleblower’s award can increase to in between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in Columbia, South Carolina

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

Statute of Limitations in Columbia, South Carolina

The statute of limitations in a whistleblower suit is the longer of six years from the date of the scams being committed or 3 years after the government knows about or should know about the material facts, but not more than 10 years from the date of the infraction.

Working With an Experienced Whistleblower Attorney

At Khurana Law Firm, P.C., we support the heroic efforts of those individuals who step forward to report Medicaid scams. If you are thinking about a qui tam claim, 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 confidence. Contact us for a confidential, no-cost consultation in order 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 Columbia, 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 Columbia, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Columbia, South Carolina

When you become aware of potential fraud that may concern Medicaid or Medicare in Columbia, South Carolina, you require the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is fully examined and filed accurately and quickly. By dealing with an experienced lawyer you are increasing the chance that the government will intervene, hence increasing the opportunity for a financial 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 have years of practical experience as national qui tam attorneys to help in your battle against Medicaid and Medicare scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe that you have a legitimate claim, we can represent you in a qui tam claim to help report the scams and enable you to gather a financial benefit. Because 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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