Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid scams in Bryan, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. Although the majority of medical companies and drug companies are honest and work within the system, some do not. When fraud happens, everybody loses. Medicare and Medicaid whistleblower lawyers assist people who work in the healthcare system to submit claims on behalf of the federal or state government to report these kinds of scams.

The state and federal governments put a good deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it depends on private citizens in Texas to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care workers in Bryan, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and fraud in the industry. We know that coming forward is not simple and many things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

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

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Whistleblower Laws in Bryan, Texas

Individuals who learn 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 liable who have sent deceitful claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower might submit a qui tam claim on behalf of the state when they have proof 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 recovery when the state intervenes in the claim. If the individual pursues the suit independent of the state, they may be awarded between 25 and 30 percent of the funds recovered.

 

A separate provision likewise exists that offers an award to an individual who reports deceitful activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in recovery of funds, the award is limited to five percent of the administrative charge imposed on the entity committing the fraud.

 

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

Liability of the Defendant in Bryan, Texas

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

 

Statute of Limitations in Bryan, Texas

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

Working With an Experienced Whistleblower Attorney

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

 

If you have proof of Medicaid fraud in Bryan, Texas, you might be able to pursue a qui tam lawsuit and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who assist states in holding wrongdoers liable. Get in touch with us today to schedule 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 Bryan, 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 Bryan, 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 Bryan, Texas

If you’ve become aware of deceitful activity that may concern Medicaid or Medicare in Bryan, Texas, you may need the advice of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is fully examined and filed accurately and without delay. By working with a skilled lawyer you are increasing the chance that the federal or state government will step in, hence increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  don’t 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 lawyers to assist in your fight against Medicaid and Medicare fraud. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you may have a valid claim, we may represent you in a qui tam suit to help report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can help.

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