Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Corpus Christi, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars every year. While most medical providers and drug companies are honest and work within the legal channels, some don’t. When scams are perpetrated, everybody can lose. Medicaid and Medicare whistleblower lawyers can help healthcare professionals to submit suits on behalf of the government to help report this sort of fraud.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and fraud in the industry. understand that coming forward is challenging and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we completely examine your claim, carefully prepare your case, for court, and work relentlessly with you and the federal or state government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Corpus Christi, Texas

Individuals who become aware of deceptive activity against the state of Texas may have whistleblower rights under two state statutes.

 

The Texas Medicaid Fraud Prevention Act holds those entities accountable who have sent deceitful claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower might submit 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 might be rewarded an amount in between 15 and 25 percent of the funds recovered when the state intervenes in the claim. If the private citizen pursues the lawsuit independent of the state, they may be granted in between 25 and 30 percent of the funds recovered.

 

A different provision also exists that provides for an award to a person who reports fraudulent activity in the Texas Medicaid program without bringing a qui tam suit. If the report results in recovery of funds, the award is restricted to 5 percent of the administrative penalty enforced on the party perpetrating 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 defense for employees who work for personal businesses.

Liability of the Defendant in Corpus Christi, Texas

The offender in a successful qui tam lawsuit under the Texas Medicaid Fraud Prevention Act might be accountable for charges of between $5,500 and $11,000 per violation. If the unlawful conduct caused damage to the elderly, disabled, or a minor, the accused may be liable for charges of between $5,500 and $15,000.

 

Statute of Limitations in Corpus Christi, Texas

The whistleblower has to file their complaint within 6 years of the date of the violation.

Working With an Experienced Whistleblower Attorney

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

 

If you have proof of Medicaid fraud in Corpus Christi, Texas, you may have the right to pursue a qui tam claim and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who help states in holding culprits responsible. Get in touch with us today to schedule 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 Corpus Christi, 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 Corpus Christi, 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 Corpus Christi, Texas

When you become aware of fraud as it concerns Medicaid or Medicare in Corpus Christi, Texas, you may need the advice of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is completely investigated and filed accurately and quickly. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will step in, therefore increasing the possibility for a financial reward. Reporting Medicare and Medicaid fraud is an intricate matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam attorneys to assist in your battle against Medicare and Medicaid scams. Our attorneys will review 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 lawsuit to help report the scams and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to learn how we can be of help.

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