Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in El Paso, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. While many medical providers and drug companies are honest and work within the system, some don’t. When fraud happens, everyone loses. Medicare and Medicaid whistleblower lawyers help healthcare professionals to file suits on behalf of the federal or state government to report this sort of fraud.

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

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare workers in El Paso, Texas

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that stepping forward is difficult and numerous things might 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 examine your claim, carefully prepare your case, for court, and work tirelessly with you and the federal or state government to help bring deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in El Paso, Texas

Private citizens who become aware of deceptive activity against the state of Texas might have whistleblower rights under two state statutes.

 

The Texas Medicaid Fraud Prevention Act holds those parties responsible who have submitted fraudulent claims and perpetuated crimes against the Texas Medicaid program.

 

A whistleblower might submit a qui tam claim on behalf of the state when they have evidence of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in a successful action might be rewarded an amount in between 15 and 25 percent of the funds recovered when the state intervenes in the suit. If the individual pursues the lawsuit independent of the state, they may be granted between 25 and 30 percent of the recovery.

 

A different provision also exists that offers an award to a person who reports deceptive activity in the Texas Medicaid program without bringing a qui tam suit. If the report results in recovery of funds, the award is limited to five percent of the administrative penalty enforced on the party perpetrating the scams.

 

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

Liability of the Defendant in El Paso, Texas

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

 

Statute of Limitations in El Paso, Texas

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

Working With an Experienced Whistleblower Lawyer

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

 

If you have evidence of Medicaid fraud in El Paso, Texas, you might be able to pursue a qui tam suit and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who assist states in order to hold perpetrators liable. 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 El Paso, 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 El Paso, 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 El Paso, Texas

If you’ve become aware of fraud that may involve Medicaid or Medicare in El Paso, Texas, you may need the advice of a knowledgeable whistleblower attorney, someone who can ensure that your claim is totally examined and filed accurately and promptly. By dealing with a skilled attorney you are increasing the chance that the government will step in, therefore increasing the chance for a financial reward. Reporting Medicaid and Medicare scams is an intricate matter –  don’t attempt 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 help in your battle against Medicare and Medicaid fraud. Our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam suit to report the scams and allow you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a recovery. Contact us today to learn how we can help.

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