Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid fraud in Denton, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. Although the majority of medical providers and drug companies are ethical and work within the system, there are those who do not. When fraud takes place, everyone loses. Medicare and Medicaid whistleblower lawyers can help healthcare workers to submit claims on behalf of the federal or state government to report these kinds of scams.

The federal and state government put a good deal of trust in medical and pharmaceutical providers. When that trust is ill-placed, the government depends on regular folks in Texas to come forward and to report scams. People like you.

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and scams in the market. We know that coming forward is hard and numerous 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 completely investigate your claim, diligently prepare your case, for court, and work relentlessly with you and the federal or state government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Denton, Texas

Individuals who know of fraudulent activity against the state of Texas might have whistleblower rights under two state laws.

 

The Texas Medicaid Fraud Prevention Act holds those entities responsible who have submitted deceitful 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 fraud. 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 elects to participate in the lawsuit. If the private citizen pursues the claim independent of the state, they may be granted in between 25 and 30 percent of the funds recovered.

 

A separate provision likewise exists that offers an award to a person who reports fraudulent activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in the recovery, the award is limited to five percent of the administrative penalty imposed on the entity perpetrating the fraud.

 

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

Liability of the Defendant in Denton, Texas

The accused in an effective qui tam claim under the Texas Medicaid Fraud Prevention Act may be accountable for charges of between $5,500 and $11,000 per infraction. If the unlawful conduct caused harm to the senior, disabled, or a minor, the defendant may be responsible for charges of between $5,500 and $15,000.

 

Statute of Limitations in Denton, Texas

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

Working With an Experienced Whistleblower Lawyer

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

 

If you have evidence of Medicaid fraud in Denton, Texas, you might have the right to pursue a qui tam lawsuit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who help states in holding wrongdoers liable. Get in touch with us today to set up an appointment 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 Denton, 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 Denton, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Denton, Texas

If you’ve become aware of potential fraud that may concern Medicaid or Medicare in Denton, Texas, you may need the guidance of a skilled whistleblower attorney, someone who can guarantee that your claim is completely examined and submitted accurately and quickly. By working with a skilled lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing the chance for a financial reward. Reporting Medicare and Medicaid scams is a complicated 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 lawyers to assist in your fight against Medicaid and Medicare fraud. After you contact us, our attorneys will examine your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we can represent you in a qui tam lawsuit to report the fraud and allow you to gather 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 help.

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