Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Tennessee taxpayers billions of dollars annually. While the majority of medical providers and drug companies are ethical and work within the legal channels, some don’t. When fraud happens, everybody loses. Medicare and Medicaid whistleblower lawyers can assist healthcare professionals to submit claims on behalf of the government to report this sort of fraud.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is hard and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Smyrna, Tennessee

When a private citizen learns of of fraud being perpetrated 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 allow whistleblowers who discover deceitful activity against the state government to submit qui tam claims and collect a percentage of the recovery.

 

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

 

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

 

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

Liability of the Defendant in Smyrna, Tennessee

The defendant 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 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 violation.

Statute of Limitations in Smyrna, Tennessee

Either act requires that a whistleblower submit their complaint within ten years of the infraction.

Working With an Experienced Whistleblower Lawyer

State governments don’t have the resources to root out fraud without the support of whistleblowers. As a result, laws have been enacted to protect and reward them for their efforts. If you have knowledge of fraud against the state of Tennessee, you may have the right to pursue a whistleblower lawsuit and obtain a financial reward. At the Khurana Law Firm, we represent those who courageously submit qui tam suits and assist states in holding perpetrators accountable. 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 Smyrna, 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 Smyrna, 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 Smyrna, Tennessee

When you become aware of fraud that may concern Medicaid or Medicare in Smyrna, Tennessee, you may need the guidance of a skilled whistleblower attorney, someone who can ensure that your claim is totally examined and submitted accurately and promptly. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will intervene, thus increasing your chances 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 practical experience as national qui tam attorneys to help in your battle against Medicare and Medicaid fraud. Our attorneys will examine your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam lawsuit to report the fraud and allow you to collect 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 be of help.

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