Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Conroe, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. While the majority of medical providers and drug companies are ethical and work within the legal channels, some do not. When fraud happens, everybody loses. Medicare and Medicaid whistleblower attorneys can assist people who work in the healthcare system to submit lawsuits on behalf of the federal or state government to report these kinds of scams.

The federal and state government place a good deal of trust in medical and pharmaceutical service providers. When that trust is ill-placed, the government relies on private citizens in Texas to come forward and to report fraud. People like you.

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is difficult and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Conroe, Texas

Individuals who become aware of fraudulent 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 deceitful claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower might file 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 funds recovered when the state elects to participate in the suit. If the private citizen pursues the suit independent of the state, they may be granted 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 lawsuit. If the report leads to recovery of funds, the award is restricted to 5 percent of the administrative penalty imposed on the party 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 employees who work for private businesses.

Liability of the Defendant in Conroe, Texas

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

 

Statute of Limitations in Conroe, Texas

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

Working With an Experienced Whistleblower Attorney

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

 

If you have evidence of Medicaid scams in Conroe, 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 holding perpetrators responsible. Contact us today to set up an appointment 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 Conroe, 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 Conroe, 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 Conroe, Texas

When you become aware of deceitful activity that may concern Medicare or Medicaid in Conroe, Texas, you may need the advice of a knowledgeable whistleblower attorney, someone who can guarantee that your claim is totally investigated and filed accurately and without delay. By working with an experienced lawyer you are increasing the chance that the federal or state government will step in, hence increasing the chance for a financial reward. Reporting Medicare and Medicaid scams is a complex matter –  don’t attempt 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 attorneys to assist in your fight against Medicare and Medicaid scams. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we may represent you in a qui tam suit to help report the scams and allow you to gather a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to to schedule a confidential consultation.

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