Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Cleveland, Tennessee

Medicare and Medicaid fraud cost Tennessee taxpayers billions of dollars every year. Although most medical providers and drug companies are ethical and work within the legal channels, some do not. When scams are perpetrated, everyone can lose. Medicaid and Medicare whistleblower attorneys help people who work in the healthcare system to file suits on behalf of the government to help report this sort of fraud.

The federal and state government place a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it depends on every day people in Tennessee to come forward to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Cleveland, Tennessee

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the market. We know that stepping forward is difficult and lots of things might be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Cleveland, Tennessee

When a private individual knows of scams being perpetrated against the Tennessee state government, they have the advantage of two laws in order to produce a whistleblower complaint.

 

The Tennessee False Claims Act and the Tennessee Medicaid False Claims Act both enable whistleblowers who learn of deceptive activity versus the state government to submit qui tam suits and collect a portion of the recovery.

 

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

 

Under the Tennessee Medicaid False Claims Act, a whistleblower may be awarded in between 15 and 25 percent of the funds recovered if the state joins the suit. If the state elects not to to participate in and the private individual pursues a successful case, the whistleblower might be awarded in between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in Cleveland, Tennessee

The defendant in an effective Tennessee False Claim Act claim might be ordered 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 might be ordered to pay up to triple the damages to the state in addition to fines of between $5,000 and $25,000 per violation.

Statute of Limitations in Cleveland, Tennessee

Both acts require that a whistleblower file their complaint within 10 years of the offense.

Working With an Experienced Whistleblower Attorney

State federal governments don’t have the resources to root out fraud without the help of whistleblowers. Consequently, laws have been enacted to protect and reward them for their efforts. If you have become aware of fraud against the state of Tennessee, you may have the right to pursue a whistleblower claim and obtain a financial reward. At the Khurana Law Firm, we represent those who courageously file qui tam claims and assist states in holding perpetrators liable. Contact us today to set up an appointment in order 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 Cleveland, 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 Cleveland, 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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WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Cleveland, Tennessee

If you’ve become aware of potential fraud that may concern Medicare or Medicaid in Cleveland, Tennessee, you may need the advice of an experienced whistleblower attorney, someone who can guarantee that your claim is totally investigated and submitted accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the government will intervene, hence increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam legal representatives to assist in your fight against Medicare and Medicaid fraud. We will examine your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we can represent you in a qui tam claim to report the fraud and enable you to gather a reward. Because all whistleblower work is on contingency, you pay nothing until there is a settlement. Get in touch with us today to learn how we can help.

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