Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Abilene, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. While many medical companies and drug companies are honest and work within the legal channels, some do not. When fraud takes place, everyone loses. Medicare and Medicaid whistleblower lawyers can help healthcare professionals to file lawsuits on behalf of the federal or state government to report this type of fraud.

The state and federal government place a good deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, the government counts on private citizens in Texas to come forward and to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in Abilene, Texas

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 industry. 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 comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, and work relentlessly with both you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Abilene, Texas

Individuals who become aware of fraudulent activity against the state of Texas may have whistleblower rights under 2 state statutes.

 

The Texas Medicaid Fraud Prevention Act holds those parties liable who have submitted deceptive claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower may submit a qui tam claim on behalf of the state when they have proof of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in an effective action may be rewarded an amount between 15 and 25 percent of the recovery when the state elects to participate in the lawsuit. If the private citizen pursues the suit independent of the state, they may be awarded in between 25 and 30 percent of the recovery.

 

A separate arrangement also exists that provides for an award to a person who reports deceptive activity in the Texas Medicaid program without bringing a qui tam lawsuit. If the report results in recovery of funds, the award is limited to five percent of the administrative charge enforced on the entity perpetrating the scams.

 

The Texas Whistleblower Act safeguards public employees from retaliation from any company that utilizes them if they report wrongdoing. This law does not afford protection for employees who work for private companies.

Liability of the Defendant in Abilene, Texas

The defendant in an effective qui tam claim under the Texas Medicaid Fraud Prevention Act may be liable for charges of in between $5,500 and $11,000 per infraction. If the unlawful conduct caused damage to the senior, handicapped, or a minor, the defendant may be responsible for charges of between $5,500 and $15,000.

 

Statute of Limitations in Abilene, Texas

The whistleblower has to submit their complaint within six years of the date of the violation.

Working With an Experienced Whistleblower Lawyer

Medicaid scams cost state and federal governments and Texas taxpayers billions of dollars each year. To help root out this problem, the state and federal government depends on the support of whistleblowers and rewards them for their heroic efforts.

 

If you have evidence of Medicaid scams in Abilene, Texas, you might have the right to pursue a qui tam claim and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who help states in order to hold wrongdoers liable. Get in touch with us today to set up an appointment to discuss your case and understand your rights and defenses under Texas whistleblower laws.

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 Abilene, Texas, 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 Abilene, Texas,  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 ATTORNEY; We are proud to represent healthcare workers in Abilene, Texas

When you become aware of fraud involving Medicaid or Medicare in Abilene, Texas, you require the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is completely investigated and filed accurately and immediately. By working with a skilled lawyer you are increasing the chance that the government will intervene, thus increasing your chances 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 experience as national qui tam attorneys to assist in your fight against Medicaid and Medicare fraud. We will evaluate your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and enable you to collect a reward. All whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can be of help.

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