Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Fort Worth, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. Although the majority of medical providers and drug companies are honest and work within the legal channels, there are those who do not. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower lawyers assist people who work in the healthcare system to file suits on behalf of the federal or state government to help report this sort of fraud.

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

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Experienced Medicare and Medicaid whistleblower lawyers; representing health care employees in Fort Worth, Texas

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the market. We know 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 substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently and carefully prepare your case, and work tirelessly with you and the state of federal government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Fort Worth, Texas

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

 

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

 

A whistleblower may 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 a successful action might be rewarded an amount in between 15 and 25 percent of the recovery when the state elects to participate in the lawsuit. If the private citizen pursues the lawsuit independent of the state, they might be granted between 25 and 30 percent of the funds recovered.

 

A different provision likewise exists that offers an award to an individual who reports deceitful activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in the recovery, the award is restricted to 5 percent of the administrative penalty imposed on the party committing the scams.

 

The Texas Whistleblower Act protects public workers from retaliation from any agency that uses them if they report wrongdoing. This law does not afford defense for employees who work for personal companies.

Liability of the Defendant in Fort Worth, Texas

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

 

Statute of Limitations in Fort Worth, Texas

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

Working With an Experienced Whistleblower Lawyer

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

 

If you have evidence of Medicaid fraud in Fort Worth, Texas, you may 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 holding wrongdoers accountable. Get in touch with us today to arrange 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 Fort Worth, 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 Fort Worth, 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 ATTORNEY; We are proud to represent healthcare workers in Fort Worth, Texas

If you’ve become aware of fraudulent activity that may involve Medicare or Medicaid in Fort Worth, Texas, you require the guidance of a skilled whistleblower lawyer, someone who can make sure that your claim is completely investigated and filed accurately and immediately. By working with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, therefore increasing the chance for a financial reward. Reporting Medicaid and Medicare scams is a complex matter –  do not 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 battle against Medicaid and Medicare fraud. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we may 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 nothing up until there is a recovery. Get in touch with us today to learn how we can be of help.

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