Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Frisco, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars each year. While the majority of medical companies and drug companies are ethical and work within the legal channels, some don’t. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower lawyers can assist healthcare workers to file claims on behalf of the government to help report this sort of fraud.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and scams in the industry. understand that stepping forward is challenging and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, 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 Frisco, Texas

Individuals who become aware of fraudulent activity against the state of Texas might have whistleblower rights under 2 state statutes.

 

The Texas Medicaid Fraud Prevention Act holds those parties responsible who have submitted deceptive 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 proof of Medicaid fraud. Under the Texas Medicaid Fraud Act, the whistleblower in a successful action might be rewarded an amount between 15 and 25 percent of the funds recovered when the state elects to participate in the lawsuit. If the private citizen pursues the suit independent of the state, they may be awarded in between 25 and 30 percent of the funds recovered.

 

A different provision likewise exists that provides for an award to an individual who reports fraudulent activity in the Texas Medicaid program without bringing a qui tam claim. If the report leads to recovery of funds, the award is restricted to 5 percent of the administrative penalty enforced on the party perpetrating the scams.

 

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

Liability of the Defendant in Frisco, Texas

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

 

Statute of Limitations in Frisco, Texas

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

Working With an Experienced Whistleblower Attorney

Medicaid fraud 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 brave efforts.

 

If you have proof of Medicaid scams in Frisco, Texas, you may be able to pursue a qui tam claim and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who help states in order to hold wrongdoers accountable. Get in touch with us today to arrange a confidential consultation 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 Frisco, 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 Frisco, 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 ATTORNEY; We are proud to represent healthcare workers in Frisco, Texas

If you’ve become aware of potential fraud that may concern Medicaid or Medicare in Frisco, Texas, you may need the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is fully investigated and filed accurately and immediately. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, hence increasing the opportunity for a financial reward. Reporting Medicare and Medicaid scams is a complex matter –  do not 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 legal representatives to assist in your battle against Medicare and Medicaid scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we may represent you in a qui tam lawsuit to report the fraud and enable you to gather a reward. Because all whistleblower cases are on contingency, you pay nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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