Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Carrollton, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. Although many medical service providers and drug companies are honest and work within the legal channels, there are those who do not. When fraud takes place, everyone loses. Medicaid and Medicare whistleblower lawyers can help healthcare professionals to file lawsuits on behalf of the government to help report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower lawyers; representing health care workers in Carrollton, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and fraud in the market. We know that stepping forward is challenging 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 extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work relentlessly with both you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Carrollton, Texas

Private citizens who have knowledge of deceitful activity against the state of Texas might have whistleblower rights under two state laws.

 

The Texas Medicaid Fraud Prevention Act holds those parties responsible who have submitted fraudulent 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 evidence of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in an effective action may be rewarded an amount between 15 and 25 percent of the recovery when the state intervenes in the lawsuit. If the private citizen pursues the lawsuit independent of the state, they might 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 suit. If the report leads to recovery of funds, the award is limited to 5 percent of the administrative penalty imposed on the entity perpetrating the fraud.

 

The Texas Whistleblower Act protects public employees 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 Carrollton, Texas

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

 

Statute of Limitations in Carrollton, Texas

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

Working With an Experienced Whistleblower Lawyer

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

 

If you have evidence of Medicaid fraud in Carrollton, Texas, you may be able to pursue a qui tam suit and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who assist states in holding wrongdoers accountable. Get in touch with us today to set up 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 Carrollton, 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 Carrollton, 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 LAWYER; We are proud to represent healthcare workers in Carrollton, Texas

When you become aware of deceptive activity as it concerns Medicare or Medicaid in Carrollton, Texas, you require the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is fully investigated and filed accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the federal or state government will intervene, thus increasing the possibility for a financial reward. Reporting Medicaid and Medicare scams is a complex matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam legal representatives to assist in your battle against Medicaid and Medicare scams. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam lawsuit to report the scams and allow you to collect a reward. All whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

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