Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Nashville-Davidson, Tennessee

Medicaid and Medicare fraud cost Tennessee taxpayers billions of dollars each year. Although many medical companies and drug companies are honest and work within the legal channels, some do not. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower lawyers can help healthcare workers to submit suits on behalf of the government to help report this sort of fraud.

The federal and state government place a great deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, it counts on private citizens in Tennessee to come forward to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Nashville-Davidson, Tennessee

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is challenging and many things may 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 relentlessly with both you and the state of federal government to assist in bringing deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Nashville-Davidson, Tennessee

When a private citizen learns of of scams being committed against the Tennessee state government, they have the benefit of 2 laws in order to bring forth a whistleblower complaint.

 

The Tennessee False Claims Act and the Tennessee Medicaid False Claims Act both allow whistleblowers who are aware of deceitful activity against the state government to file qui tam claims 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 join the suit. If the state elects not to participate in the suit, 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 joins the claim. If the state declines to join and the private individual pursues a successful case, the whistleblower might be awarded between 25 and 30 percent of the recovery.

 

A whistleblower is also provided protection from any employer retaliation as a result of bringing a suit or helping in the state’s lawsuit.

Liability of the Defendant in Nashville-Davidson, Tennessee

The accused 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 between $2,500 and $10,000 per offense.

 

The defendant in an effective Tennessee Medicaid False Claims Act might 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 Nashville-Davidson, Tennessee

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

Working With an Experienced Whistleblower Lawyer

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 know of fraud against the state of Tennessee, you might have the right to pursue a whistleblower suit and obtain a financial reward. At the Khurana Law Firm, we represent those who courageously file qui tam suits and assist states in holding offenders accountable. Contact us today to set up a no-cost consultation 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 Nashville-Davidson, 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 Nashville-Davidson, 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 Nashville-Davidson, Tennessee

When you become aware of fraud that may concern Medicare or Medicaid in Nashville-Davidson, Tennessee, you need the advice of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is totally investigated and submitted accurately and promptly. By working with an experienced attorney you are increasing the chance that the government will step in, hence increasing the chance for a financial reward. Reporting Medicare and Medicaid scams is an intricate matter –  do not 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 fight against Medicare and Medicaid fraud. We will examine your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we can represent you in a qui tam suit to report the fraud and enable you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to learn how we can help.

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