Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Murfreesboro, Tennessee

Medicare and Medicaid fraud cost Tennessee taxpayers billions of dollars annually. While most medical providers and drug companies are ethical and work within the legal channels, some do not. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower lawyers can assist healthcare workers to submit suits on behalf of the federal or state government to report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare employees in Murfreesboro, Tennessee

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the industry. understand that stepping forward is difficult and lots of things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we completely examine 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 Murfreesboro, Tennessee

When a private citizen discovers of scams being committed against the Tennessee state government, they have the 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 permit whistleblowers who learn of deceitful activity versus the state government to file qui tam claims and collect a percentage of the recovery.

 

Under the Tennessee False Claims Act, a whistleblower might be granted between 25 and 33 percent of the funds recovered by the state if they take part in the claim. If the state elects not to take part in the claim, the whistleblower might collect in between 35 and 50 percent of the recovery.

 

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

 

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

Liability of the Defendant in Murfreesboro, Tennessee

The suspect in a successful Tennessee False Claim Act claim might be ordered to pay up to triple the damages to the state in addition to fines of in between $2,500 and $10,000 per infraction.

 

The suspect in a successful Tennessee Medicaid False Claims Act might 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 Murfreesboro, Tennessee

Either act requires that a whistleblower file their complaint within 10 years of the infraction.

Working With an Experienced Whistleblower Attorney

State federal governments do not have the resources to root out fraud without the help of whistleblowers. Subsequently, laws have been enacted to protect and reward them for their efforts. If you have knowledge of scams against the state of Tennessee, you may be able to pursue a whistleblower lawsuit and get a financial reward. At the Khurana Law Firm, we represent those who courageously file qui tam lawsuits and assist states in holding perpetrators liable. Contact us today to arrange 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 Murfreesboro, 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 Murfreesboro, 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 LAWYER; We are proud to represent healthcare workers in Murfreesboro, Tennessee

If you’ve become aware of fraud as it concerns Medicare or Medicaid in Murfreesboro, Tennessee, you need the advice of a skilled whistleblower attorney, someone who can make sure that your claim is fully examined and filed accurately and immediately. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will step in, thus increasing the chance for a financial reward. Reporting Medicaid and Medicare scams is an intricate matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam lawyers to help in your battle against Medicaid and Medicare fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we may represent you in a qui tam claim to report the fraud and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

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