Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Jackson, Tennessee

Medicare and Medicaid fraud cost Tennessee taxpayers billions of dollars each year. While many medical companies and drug companies are honest and work within the system, there are those who do not. When fraud occurs, everybody can lose. Medicare and Medicaid whistleblower attorneys can help healthcare professionals to submit claims on behalf of the government to help report this type of fraud.

The state and federal governments place a good deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, the government relies 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 healthcare workers in Jackson, Tennessee

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the industry. We know that coming forward is difficult and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Jackson, Tennessee

When a private citizen learns of of scams 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 discover deceptive 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 granted in between 25 and 33 percent of the recovery by the state if they take part in the suit. If the state declines to participate in the lawsuit, the whistleblower might collect in between 35 and 50 percent of the recovery.

 

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 takes part in the suit. If the state elects not to to take part in and the individual pursues an effective case, the whistleblower may be awarded between 25 and 30 percent of the recovery.

 

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

Liability of the Defendant in Jackson, 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 in between $2,500 and $10,000 per offense.

 

The accused in a successful 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 Jackson, Tennessee

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

Working With an Experienced Whistleblower Attorney

State federal governments do not have the resources to root out scams without the support of whistleblowers. Consequently, laws have been enacted to protect and reward them for their efforts. If you have become aware of scams against the state of Tennessee, you might be able to pursue a whistleblower lawsuit and get a monetary reward. At the Khurana Law Firm, we represent those who courageously submit qui tam claims and assist states in holding offenders responsible. Contact us today to schedule 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 Jackson, 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 Jackson, 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 LAWYER; We are proud to represent healthcare workers in Jackson, Tennessee

If you’ve become aware of fraud that may concern Medicare or Medicaid in Jackson, Tennessee, you require the advice of a skilled whistleblower attorney, someone who can guarantee that your claim is completely examined and submitted accurately and promptly. By working with an experienced lawyer you are increasing the chance that the federal or state government will intervene, hence increasing the possibility for a financial reward. Reporting Medicare and Medicaid fraud is a complicated matter –  do not 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 attorneys to assist in your battle against Medicaid and Medicare scams. We will review your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam lawsuit to help report the fraud and enable you to gather a reward. All whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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