Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Summerville, South Carolina

Medicare and Medicaid fraud cost South Carolina taxpayers billions of dollars annually. Although most medical service providers and drug companies are honest and work within the legal channels, there are those who don’t. When fraud occurs, everyone can lose. Medicare and Medicaid whistleblower attorneys can help healthcare professionals to file suits on behalf of the federal or state government to help report these kinds of scams.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Summerville, 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. understand that coming forward is challenging and numerous things may 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 prepare your case, for court, and work relentlessly with you and the federal or state government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Summerville, South Carolina

Medicaid fraud costs federal and state governments billions of dollars each year. In an effort to fight Medicaid scams, many states have enacted whistleblower statutes to enable private citizens to step forward with information in order 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 might be able to submit a whistleblower claim under the federal False Claims Act. This entitles private individuals or healthcare employees to come forward with info regarding Medicaid scams and file a civil suit on behalf of the government.

 

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

Liability of the Defendant in Summerville, South Carolina

When an individual or entity is found in violation of the False Claims Act, they can be held responsible for as much as 3 times the damage to the government. In addition, they can likewise be instructed to pay penalties of $5,500 to $11,000 per infraction.

Statute of Limitations in Summerville, 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 three years after the government learns about or ought to learn about the material facts, however 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 people who come forward to report Medicaid fraud. If you are thinking about 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 kept 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 Summerville, 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 Summerville, 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 Summerville, South Carolina

If you’ve become aware of deceitful activity that may involve Medicaid or Medicare in Summerville, South Carolina, you require the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is totally investigated and submitted accurately and quickly. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, therefore increasing the chance for a financial reward. Reporting Medicaid and Medicare fraud is an intricate 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 lawyers to assist in your fight against Medicare and Medicaid scams. Our attorneys will review your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam lawsuit to report the scams and enable 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 help.

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