Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Franklin, Tennessee

Medicare and Medicaid 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 don’t. When fraud happens, everybody can lose. Medicaid and Medicare whistleblower attorneys can assist healthcare workers to submit suits on behalf of the government to help report this sort of fraud.

The state and federal government put a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it counts on regular folks in Tennessee to come forward and to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in Franklin, Tennessee

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

With our comprehensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, 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 Franklin, Tennessee

When a private individual 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 learn of fraudulent activity versus 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 in between 25 and 33 percent of the recovery by the state if they take part in the lawsuit. If the state elects not to join the lawsuit, the whistleblower may collect in between 35 and 50 percent of the funds recovered.

 

Under the Tennessee Medicaid False Claims Act, a whistleblower might be awarded in between 15 and 25 percent of the recovery if the state joins the suit. If the state declines to participate in and the private individual pursues a successful case, the whistleblower might be awarded between 25 and 30 percent of the recovery.

 

A whistleblower is likewise given protection from any company retaliation as a result of bringing a claim or assisting in the state’s lawsuit.

Liability of the Defendant in Franklin, Tennessee

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

Statute of Limitations in Franklin, Tennessee

Both acts require that a whistleblower file their complaint within ten years of the infraction.

Working With an Experienced Whistleblower Attorney

State federal governments don’t have the resources to root out fraud without the assistance of whistleblowers. As a result, laws have been enacted to safeguard and reward the whistleblowers for their efforts. If you have become aware of fraud against the state of Tennessee, you might have the right to pursue a whistleblower lawsuit and get a financial reward. At the Khurana Law Firm, we represent those who courageously file qui tam claims and help states in holding perpetrators responsible. Contact us today to arrange 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 Franklin, 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 Franklin, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Franklin, Tennessee

When you become aware of fraudulent activity that may involve Medicaid or Medicare in Franklin, Tennessee, you may 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 an experienced lawyer you are increasing the chance that the federal or state government will step in, thus increasing the possibility for a financial reward. Reporting Medicare and Medicaid fraud is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam lawyers to assist in your battle against Medicare and Medicaid fraud. Our attorneys will review your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we can represent you in a qui tam claim to report the scams and allow you to gather a financial benefit. 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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