Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in College Station, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars each year. While most medical service providers and drug companies are honest and work within the legal channels, there are those who do not. When fraud occurs, everyone 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 this sort of fraud.

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

Work with

Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare employees in College Station, Texas

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

With our extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, and work tirelessly 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 College Station, Texas

Private citizens who have knowledge of fraudulent activity against the state of Texas might have whistleblower rights under 2 state statutes.

 

The Texas Medicaid Fraud Prevention Act holds those entities responsible who have sent deceptive claims and perpetuated crimes against the Texas Medicaid program.

 

A whistleblower may file a qui tam lawsuit on behalf of the state when they have proof of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in an effective 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 lawsuit independent of the state, they might be awarded between 25 and 30 percent of the recovery.

 

A different provision also exists that provides for an award to a person 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 enforced on the entity perpetrating the fraud.

 

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

Liability of the Defendant in College Station, Texas

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

 

Statute of Limitations in College Station, Texas

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

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 problem, the government relies on the support of whistleblowers and rewards them for their brave efforts.

 

If you have proof of Medicaid scams in College Station, Texas, you might be able to pursue a qui tam lawsuit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who help states in holding culprits responsible. Contact us today to set up 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 College Station, 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 College Station, 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 LAWYER; We are proud to represent healthcare workers in College Station, Texas

If you’ve become aware of potential fraud that may involve Medicaid or Medicare in College Station, Texas, you require the guidance of an experienced whistleblower lawyer, someone who can guarantee that your claim is fully investigated and submitted accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the federal or state government will intervene, hence increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is a complex matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam legal representatives to assist in your fight against Medicaid and Medicare scams. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we may represent you in a qui tam claim to report the scams and enable you to collect a financial benefit. All whistleblower cases are on contingency, you pay nothing until there is a recovery. Contact us today to learn how we can be of help.

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