Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Georgetown, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars each year. While many medical service providers and drug companies are honest and work within the legal channels, there are those who don’t. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower attorneys can help healthcare workers to file suits on behalf of the government to report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Georgetown, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave choice to come forward to report abuse and fraud in the market. understand that stepping forward is hard and numerous 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 completely examine your claim, carefully prepare your case, for court, and work relentlessly with both you and the federal or state government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Georgetown, Texas

Individuals who become aware of deceptive activity against the state of Texas might have whistleblower rights under two state laws.

 

The Texas Medicaid Fraud Prevention Act holds those parties responsible who have sent deceitful 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 proof 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 funds recovered when the state intervenes in the claim. If the private citizen pursues the suit independent of the state, they might be granted between 25 and 30 percent of the recovery.

 

A different arrangement likewise exists that provides for an award to an individual who reports deceitful activity in the Texas Medicaid program without bringing a qui tam lawsuit. If the report results in the recovery, the award is limited to 5 percent of the administrative penalty imposed on the party committing the fraud.

 

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

Liability of the Defendant in Georgetown, Texas

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

 

Statute of Limitations in Georgetown, Texas

The whistleblower must 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 Texas taxpayers billions of dollars each year. To help root out this fraud, the state and federal government relies on the support of whistleblowers and rewards them for their heroic efforts.

 

If you have proof of Medicaid fraud in Georgetown, Texas, you might have the right to pursue a qui tam suit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who assist states in order to hold culprits accountable. Get in touch with us today to set up an appointment in order 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 Georgetown, 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 Georgetown, 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 Georgetown, Texas

If you’ve become aware of potential fraud involving Medicare or Medicaid in Georgetown, Texas, you may need the advice of a skilled whistleblower lawyer, someone who can guarantee that your claim is fully investigated and filed accurately and quickly. By working with a knowledgeable lawyer you are increasing the chance that the government will step in, therefore increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam lawyers to assist in your battle against Medicaid and Medicare scams. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you have a legitimate claim, we can represent you in a qui tam lawsuit to report the scams and enable you to gather a reward. All whistleblower cases are on contingency, you pay nothing until there is a recovery. Contact us today to learn how we can be of help.

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