Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Clarksville, Tennessee

Medicaid and Medicare fraud cost Tennessee taxpayers billions of dollars annually. While most medical service providers and drug companies are honest and work within the system, there are those who do not. When scams are perpetrated, everyone can lose. Medicare and Medicaid whistleblower lawyers assist healthcare workers to file suits on behalf of the federal or state government to help report these kinds of scams.

The federal and state government put a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government depends on regular folks in Tennessee to come forward and to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing health care employees in Clarksville, Tennessee

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the market. We know that stepping forward is hard and lots of 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 both you and the state of federal government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Clarksville, Tennessee

When a private citizen learns of of fraud being perpetrated against the Tennessee state government, they have the benefit of 2 laws in order to produce a whistleblower complaint.

 

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

 

Under the Tennessee False Claims Act, a whistleblower might be awarded in between 25 and 33 percent of the funds recovered by the state if they take part in the suit. If the state declines to participate in the suit, the whistleblower might collect between 35 and 50 percent of the recovery.

 

Under the Tennessee Medicaid False Claims Act, a whistleblower might be granted between 15 and 25 percent of the recovery if the state participates in the claim. If the state elects not to to participate in and the private individual pursues an effective case, the whistleblower might be awarded between 25 and 30 percent of the recovery.

 

A whistleblower is also provided protection from any company retaliation as a result of bringing a claim or assisting in the state’s recovery.

Liability of the Defendant in Clarksville, Tennessee

The suspect in a successful Tennessee False Claim Act claim might 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 suspect in an effective Tennessee Medicaid False Claims Act may be ordered to pay up to triple the amount of damages to the state in addition to fines of between $5,000 and $25,000 per offense.

Statute of Limitations in Clarksville, Tennessee

Either act requires that a whistleblower submit their complaint within 10 years of the violation.

Working With an Experienced Whistleblower Attorney

State federal governments don’t have the resources to root out fraud without the help of whistleblowers. As a result, laws have been enacted to safeguard and reward the whistleblowers for their efforts. If you have become aware of scams against the state of Tennessee, you might be able to pursue a whistleblower suit and obtain a monetary reward. At the Khurana Law Firm, we represent those who courageously submit qui tam claims and help states in holding wrongdoers liable. 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 are a healthcare worker in Clarksville, Tennessee, 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 Clarksville, Tennessee,  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 ATTORNEY; We are proud to represent healthcare workers in Clarksville, Tennessee

If you’ve become aware of deceitful activity that may involve Medicare or Medicaid in Clarksville, Tennessee, you may need the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is totally investigated and submitted accurately and immediately. By dealing with a knowledgeable lawyer you are increasing the chance that the government will intervene, hence increasing the chance for a reward. Reporting Medicaid and Medicare fraud is a complicated matter –  don’t attempt 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 assist in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we can represent you in a qui tam claim to help report the scams and allow you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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