Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Allen, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars each year. While most medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower lawyers can assist healthcare workers to file suits on behalf of the federal or state government to report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Allen, Texas

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

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

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Whistleblower Laws in Allen, Texas

Private citizens who know of deceitful activity against the state of Texas might have whistleblower rights under 2 state statutes.

 

The Texas Medicaid Fraud Prevention Act holds those parties responsible who have sent fraudulent claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower might file a qui tam suit on behalf of the state when they have evidence of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in a successful action may be rewarded an amount between 15 and 25 percent of the funds recovered when the state elects to participate in the claim. If the private citizen pursues the suit independent of the state, they might be granted between 25 and 30 percent of the recovery.

 

A different arrangement also exists that provides for an award to an individual who reports deceitful 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 5 percent of the administrative charge enforced on the entity committing the scams.

 

The Texas Whistleblower Act protects public staff members from retaliation from any company that employs them if they report wrongdoing. This law does not afford defense for employees who work for personal businesses.

Liability of the Defendant in Allen, Texas

The accused in a successful qui tam lawsuit under the Texas Medicaid Fraud Prevention Act might be liable for penalties of between $5,500 and $11,000 per offense. If the unlawful conduct caused harm to the senior, disabled, or a minor, the accused may be liable for penalties of between $5,500 and $15,000.

 

Statute of Limitations in Allen, Texas

The whistleblower must file their complaint within 6 years of the date of the violation.

Working With an Experienced Whistleblower Attorney

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

 

If you have evidence of Medicaid scams in Allen, Texas, you may have the right to pursue a qui tam lawsuit and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who assist states in holding perpetrators responsible. Get in touch with us today to set up a confidential consultation in order 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 Allen, 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 Allen, 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Allen, Texas

If you’ve become aware of fraud that may concern Medicare or Medicaid in Allen, Texas, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is totally examined and filed accurately and promptly. By dealing with a knowledgeable attorney you are increasing the chance that the government will step in, hence increasing the possibility for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam legal representatives to help in your fight against Medicare and Medicaid scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we can represent you in a qui tam lawsuit to report the fraud and enable you to gather a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can be of help.

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