Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in Tennessee

Medicaid and Medicare fraud cost Tennessee taxpayers billions of dollars each year. Although most medical providers and drug companies are honest and work within the legal channels, some do not. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower attorneys assist people who work in the healthcare system to submit claims on behalf of the government to report these kinds of scams.

The federal and state governments place a great deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it depends on private citizens in Tennessee to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Tennessee

At Khurana Law Firm, P.C., as skilled 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 difficult and many things may be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Tennessee

When a private individual knows of fraud being perpetrated against the Tennessee state government, they have benefit of two laws in order to bring forth a whistleblower complaint. 

 

The Tennessee False Claims Act and the Tennessee Medicaid False Claims Act both allow whistleblowers who are aware of fraudulent activity against the state government to file qui tam lawsuits and collect a percentage of the recovery. 

 

Under the Tennessee False Claims Act, a whistleblower may be awarded between 25 and 33 percent of the recovery by the state if they join the lawsuit. If the state declines to join the lawsuit, the whistleblower may collect between 35 and 50 percent of the recovery.

 

Under the Tennessee Medicaid False Claims Act, a whistleblower may be awarded between 15 and 25 percent of the recovery if the state joins the lawsuit. If the state declines to join and the individual pursues a successful case, the whistleblower may be awarded between 25 and 30 percent of the recovery. 

 

A whistleblower is also afforded protection from any employer retaliation as a result of bringing a lawsuit or assisting in the state’s recovery.

Liability of the Defendant in Tennessee

The defendant in a successful Tennessee False Claim Act claim may be required to pay up to triple the damages to the state in addition to fines of between $2,500 and $10,000 per violation. 

 

The defendant in a successful Tennessee Medicaid False Claims Act may be required to pay up to triple the amount of damages to the state in addition to fines of between $5,000 and $25,000 per violation.

Statute of Limitations in Tennessee

Either act requires that a whistleblower file their complaint within ten years of the violation.

Working With an Experienced Whistleblower Attorney

State governments don’t have the resources to root out fraud without the assistance of whistleblowers. Consequently, laws have been enacted to protect and reward them for their efforts. If you have knowledge of fraud against the state of Tennessee, you may have the right to pursue a whistleblower lawsuit and obtain a financial reward. At the Khurana Law Firm, we represent those who courageously file qui tam lawsuits and assist states in holding wrongdoers accountable. Contact us today to schedule an appointment to understand your rights and protections as a whistleblower.

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 can report it 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. To report Medicare fraud, contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

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Work With An Experienced WHISTLEBLOWER ATTORNEY

When you become aware of potential fraud as it concerns Medicaid or Medicare, you need the advice of a knowledgeable whistleblower attorney, someone who can ensure that your claim is fully investigated and submitted accurately and promptly. By working with a skilled lawyer 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 a complex matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam legal representatives to help in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we may represent you in a qui tam lawsuit to report the scams and enable you to collect a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to learn how we can be of help.

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