Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. Although many medical companies and drug companies are honest and work within the system, some don’t. When fraud occurs, everyone can lose. Medicaid and Medicare whistleblower lawyers assist healthcare workers to file lawsuits on behalf of the government to help report this type of fraud.

The state and federal governments place a good deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it counts on every day people in Texas to come forward and to report fraud. People like you.

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

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 market. understand that stepping forward is difficult and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Arlington, Texas

Individuals who have knowledge of fraudulent activity against the state of Texas might have whistleblower rights under 2 state laws.

 

The Texas Medicaid Fraud Prevention Act holds those entities responsible who have submitted deceitful claims and perpetuated crimes against the Texas Medicaid program.

 

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

 

A separate provision also exists that provides for an award to a person who reports fraudulent activity in the Texas Medicaid program without bringing a qui tam suit. If the report leads to the recovery, the award is restricted to five percent of the administrative charge enforced on the party committing the fraud.

 

The Texas Whistleblower Act safeguards public workers from retaliation from any agency that utilizes them if they report wrongdoing. This law does not provide protection for staff members who work for private companies.

Liability of the Defendant in Arlington, Texas

The offender in a successful qui tam suit under the Texas Medicaid Fraud Prevention Act might be accountable for charges of between $5,500 and $11,000 per infraction. If the illegal conduct caused harm to the elderly, handicapped, or a minor, the accused may be responsible for charges of in between $5,500 and $15,000.

 

Statute of Limitations in Arlington, Texas

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

Working With an Experienced Whistleblower Lawyer

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 assistance of whistleblowers and rewards them for their brave efforts.

 

If you have proof of Medicaid scams in Arlington, Texas, you might have the right to pursue a qui tam lawsuit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who assist states in order to hold culprits responsible. Get in touch with us today to schedule a confidential consultation 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 Arlington, 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 Arlington, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Arlington, Texas

When you become aware of deceptive activity that may involve Medicare or Medicaid in Arlington, Texas, you need the guidance of a skilled whistleblower lawyer, someone who can guarantee that your claim is fully investigated and submitted accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the government will intervene, thus increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not 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 Medicaid and Medicare fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we believe you have a valid claim, we can represent you in a qui tam lawsuit to help report the fraud and enable you to gather a reward. All whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to learn how we can be of help.

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