Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Mount Pleasant, South Carolina

Medicare and Medicaid fraud cost South Carolina taxpayers billions of dollars every year. Although many medical companies and drug companies are honest and work within the system, there are those who do not. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower lawyers can assist healthcare professionals to submit claims on behalf of the federal or state government to report these kinds of scams.

The state and federal governments put a great deal of trust in pharmaceutical and medical companies. When that trust is ill-placed, it relies on private citizens in South Carolina to come forward to report scams. People like you.

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in Mount Pleasant, South Carolina

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the industry. We know that stepping forward is challenging and lots of things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Mount Pleasant, South Carolina

Medicaid fraud costs federal and state governments billions of dollars every year. In an effort to fight Medicaid fraud, many states have enacted whistleblower laws to make it possible for private citizens to come forward with information to hold these parties responsible and recuperate those funds.

 

While the state of South Carolina does not have a state false claims act, parties who know of Medicaid scams might be able to submit a whistleblower suit under the federal False Claims Act. This entitles private individuals or healthcare employees to come forward with information relating to Medicaid scams and file a civil suit on behalf of the government.

 

While the False Claims Act holds parties liable for the fraud they perpetrate, a qui tam claim incentivizes the whistleblower with benefits based upon a percentage of the recovery. If the government has actually participated in the lawsuit, the whistleblower stands to get between 15 and 25 percent of the recovery. In the case where the government has declined to participate in the lawsuit, the whistleblower’s award can increase to between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in Mount Pleasant, South Carolina

When an individual or entity is found in violation of the False Claims Act, they can be held liable for up to 3 times the damage to the government. In addition, they can also be instructed to pay charges of $5,500 to $11,000 per violation.

Statute of Limitations in Mount Pleasant, 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 learn about the material realities, however not more than 10 years from the date of the offense.

Working With an Experienced Whistleblower Attorney

At Khurana Law Firm, P.C., we support the heroic efforts of those people who come forward to report Medicaid scams. If you are thinking about a qui tam lawsuit, you should totally understand your rights and protections under the law. When you contact us, you can feel confident that your case will be held in the strictest self-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 Mount Pleasant, 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 Mount Pleasant, 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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WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Mount Pleasant, South Carolina

If you’ve become aware of potential fraud as it concerns Medicare or Medicaid in Mount Pleasant, South Carolina, you need the guidance of a knowledgeable whistleblower lawyer, someone who can guarantee that your claim is totally examined and filed accurately and quickly. By working with a skilled attorney you are increasing the chance that the federal or state government will intervene, thus increasing your chances for a financial reward. Reporting Medicare and Medicaid scams is an intricate matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam attorneys to assist in your battle against Medicaid and Medicare scams. We will evaluate 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 suit to report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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