Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in Flower Mound, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars each year. While most medical service providers and drug companies are ethical and work within the system, there are those who do not. When fraud occurs, everyone can lose. Medicare and Medicaid whistleblower attorneys help healthcare professionals to file claims on behalf of the government to help report this type of fraud.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and scams in the market. understand that stepping forward is not easy 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 deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in Flower Mound, Texas

Individuals who know of deceitful activity against the state of Texas may have whistleblower rights under 2 state statutes.

 

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 might be rewarded an amount in between 15 and 25 percent of the recovery when the state elects to participate in the claim. If the private citizen pursues the claim independent of the state, they may be awarded in between 25 and 30 percent of the funds recovered.

 

A separate arrangement also exists that offers an award to a person who reports deceitful activity in the Texas Medicaid program without bringing a qui tam suit. If the report leads to recovery of funds, the award is restricted to 5 percent of the administrative charge imposed on the party committing the fraud.

 

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

Liability of the Defendant in Flower Mound, Texas

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

 

Statute of Limitations in Flower Mound, Texas

The whistleblower has to file their complaint within six years of the date of the offense.

Working With an Experienced Whistleblower Attorney

Medicaid scams cost federal and state 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 brave efforts.

 

If you have proof of Medicaid scams in Flower Mound, 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 assist states in holding perpetrators responsible. Contact us today to arrange 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 Flower Mound, 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 Flower Mound, 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 Flower Mound, Texas

If you’ve become aware of fraudulent activity that may involve Medicaid or Medicare in Flower Mound, Texas, you need the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is totally investigated and submitted accurately and immediately. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, therefore increasing your chances for a reward. Reporting Medicaid and Medicare fraud is an intricate matter –  don’t try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam attorneys to help in your battle against Medicaid and Medicare scams. We will examine your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we can represent you in a qui tam claim to help report the fraud and enable you to gather a financial benefit. All whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Contact us today to to schedule a confidential consultation.

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