Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid scams in Beaumont, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars annually. Although the majority of medical companies and drug companies are honest and work within the system, there are those who do not. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to file lawsuits 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 companies. When that trust is ill-placed, the government counts on regular folks in Texas to come forward to report fraud. People like you.

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Beaumont, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and fraud in the industry. We know that coming forward is difficult 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 substantial experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently and carefully prepare your case, for court, and work tirelessly with you and the state of federal government to help bring deceptive Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Beaumont, Texas

Individuals who learn 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 sent fraudulent claims and perpetuated crimes against the Texas Medicaid program.

 

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

 

A separate provision also exists that provides for an award to an individual who reports deceptive activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in the recovery, the award is limited to 5 percent of the administrative penalty imposed on the entity perpetrating the scams.

 

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

Liability of the Defendant in Beaumont, Texas

The defendant in an effective qui tam suit under the Texas Medicaid Fraud Prevention Act may be accountable for charges of in between $5,500 and $11,000 per offense. If the illegal conduct caused damage to the senior, disabled, or a minor, the defendant may be liable for penalties of between $5,500 and $15,000.

 

Statute of Limitations in Beaumont, Texas

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

Working With an Experienced Whistleblower Lawyer

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

 

If you have proof of Medicaid scams in Beaumont, Texas, you may be able to pursue a qui tam suit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who assist states in holding wrongdoers liable. Get in touch with us today to set up an appointment 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 Beaumont, 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 Beaumont, Texas,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Beaumont, Texas

If you’ve become aware of potential fraud as it concerns Medicaid or Medicare in Beaumont, Texas, you may need 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 knowledgeable attorney you are increasing the chance that the federal or state government will step in, hence increasing the possibility for a reward. Reporting Medicaid and Medicare scams is a complex matter –  don’t 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 attorneys to assist in your fight against Medicare and Medicaid scams. We will evaluate your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we may represent you in a qui tam lawsuit to report the fraud and enable you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Contact us today to learn how we can help.

Service areas