Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars each year. Although many medical companies and drug companies are ethical and work within the legal channels, some don’t. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to submit claims on behalf of the federal or state government to report this type of fraud.

The state and federal governments place a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it depends on regular folks in Texas to come forward to report fraud. People like you.

Work with

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the industry. We know that coming forward is challenging and lots of things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Cedar Park, Texas

Private citizens who become aware 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 accountable who have submitted deceitful claims and perpetuated unlawful acts 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 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 lawsuit. If the private citizen pursues the suit independent of the state, they might be granted between 25 and 30 percent of the recovery.

 

A different provision also exists that offers an award to an individual who reports deceitful activity in the Texas Medicaid program without bringing a qui tam suit. If the report leads to the recovery, the award is limited to 5 percent of the administrative charge imposed on the entity perpetrating the fraud.

 

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

Liability of the Defendant in Cedar Park, Texas

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

 

Statute of Limitations in Cedar Park, Texas

The whistleblower has to submit their complaint within 6 years of the date of the offense.

Working With an Experienced Whistleblower Lawyer

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

 

If you have proof of Medicaid fraud in Cedar Park, Texas, you may be able 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 wrongdoers liable. Contact us today to schedule a confidential consultation to discuss your case and understand your rights and protections 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 Cedar Park, 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 Cedar Park, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Cedar Park, Texas

When you become aware of fraudulent activity that may concern Medicare or Medicaid in Cedar Park, Texas, you need the advice of a knowledgeable whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and promptly. By working with a skilled attorney you are increasing the chance that the government will step in, therefore increasing the opportunity for a financial reward. Reporting Medicaid and Medicare scams is a complicated matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam attorneys to help in your fight against Medicaid and Medicare fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you have a legitimate claim, we may represent you in a qui tam suit to report the fraud and allow you to collect a financial benefit. All whistleblower work is on contingency, you pay nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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