Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid fraud in Brownsville, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars annually. While most medical providers and drug companies are ethical and work within the legal channels, some do not. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower attorneys can help healthcare professionals to file claims on behalf of the federal or state government to report this type of fraud.

The federal and state government put a great deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, the government counts on every day people in Texas to come forward to report fraud. People like you.

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and scams in the market. We know that coming forward is not easy and many things might be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Brownsville, Texas

Individuals who have knowledge of deceptive 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 crimes against the Texas Medicaid program.

 

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

 

A different arrangement also exists that offers an award to an individual who reports deceptive activity in the Texas Medicaid program without bringing a qui tam claim. If the report leads to recovery of funds, the award is limited to 5 percent of the administrative penalty imposed on the party committing the scams.

 

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

Liability of the Defendant in Brownsville, Texas

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

 

Statute of Limitations in Brownsville, Texas

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

Working With an Experienced Whistleblower Lawyer

Medicaid fraud cost federal and state 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 Brownsville, Texas, you may 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 responsible. Contact us today to arrange 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 Brownsville, 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 Brownsville, 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 Brownsville, Texas

When you become aware of fraud that may concern Medicaid or Medicare in Brownsville, Texas, you require the advice of a skilled whistleblower lawyer, someone who can ensure that your claim is completely investigated and submitted accurately and immediately. By working with an experienced attorney you are increasing the chance that the federal or state government will step in, thus increasing the chance for a reward. Reporting Medicaid and Medicare scams 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 experience as national qui tam legal representatives to assist in your fight against Medicare and Medicaid fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we can represent you in a qui tam lawsuit to help report the fraud and enable you to collect a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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