Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in North Charleston, South Carolina

Medicaid and Medicare fraud cost South Carolina taxpayers billions of dollars each year. Although the majority of medical providers and drug companies are ethical and work within the legal channels, some don’t. When fraud occurs, everybody loses. Medicare and Medicaid whistleblower lawyers can assist people who work in the healthcare system to file claims on behalf of the federal or state government to report this sort of fraud.

The federal and state governments place a good deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government depends on private citizens in South Carolina to come forward to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in North Charleston, South Carolina

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the market. We know that stepping forward is not easy and lots of things may be at stake. When you come to us, your case is held in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, diligently prepare your case, for court, and work tirelessly with you and the federal or state government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in North Charleston, South Carolina

Medicaid fraud costs state and federal governments billions of dollars each year. In an effort to combat Medicaid scams, lots of states have enacted whistleblower statutes to enable private citizens to come forward with details 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 may have the ability to submit a whistleblower claim under the federal False Claims Act. This entitles private individuals or healthcare employees to step forward with info concerning Medicaid scams and file a civil claim on behalf of the government.

 

While the False Claims Act holds parties liable for the scams they commit, a qui tam lawsuit incentivizes the whistleblower with rewards based upon a portion of the recovery. If the government has actually participated in the claim, the whistleblower stands to get between 15 and 25 percent of the recovery. In the event where the government has declined to enter into the suit, 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 arrangement that safeguards the whistleblower from an employer’s punitive acts.

Liability of the Defendant in North Charleston, South Carolina

When an entity or an individual is found in transgression of the False Claims Act, they can be held accountable for as much as 3 times the damage to the government. In addition, they can also be ordered to pay penalties of $5,500 to $11,000 per offense.

Statute of Limitations in North Charleston, South Carolina

The statute of limitations in a whistleblower claim is the longer of six years from the date of the fraud being committed or 3 years after the government knows about or ought to 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 fraud. If you are thinking about a qui tam lawsuit, you need to totally 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 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 North 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 North 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in North Charleston, South Carolina

If you’ve become aware of potential fraud that may concern Medicaid or Medicare in North Charleston, South Carolina, you require the advice of a skilled whistleblower attorney, someone who can ensure that your claim is completely investigated and filed accurately and immediately. By working with a skilled attorney you are increasing the chance that the government will intervene, therefore increasing your chances for a financial reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam legal representatives to help in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will evaluate 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 suit to report the fraud and enable you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to learn how we can help.

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