Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid scams in Grapevine, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. Although most medical companies and drug companies are honest and work within the legal channels, some don’t. When fraud takes place, everybody can lose. Medicaid and Medicare whistleblower attorneys assist people who work in the healthcare system to submit claims on behalf of the federal or state government to report this sort of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Grapevine, Texas

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and fraud in the market. We know that coming forward is hard and lots of things might be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our substantial experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work tirelessly with both you and the federal or state government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Grapevine, Texas

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

 

The Texas Medicaid Fraud Prevention Act holds those parties accountable who have sent deceitful claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower might file a qui tam claim on behalf of the state when they have proof of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in a successful action may be rewarded an amount in between 15 and 25 percent of the recovery when the state intervenes in the claim. 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 separate arrangement likewise exists that provides for an award to an individual who reports deceptive activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in recovery of funds, the award is restricted to 5 percent of the administrative penalty imposed on the entity perpetrating the scams.

 

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 employees who work for private businesses.

Liability of the Defendant in Grapevine, Texas

The accused in a successful qui tam suit under the Texas Medicaid Fraud Prevention Act might be accountable for penalties of in between $5,500 and $11,000 per infraction. If the illegal conduct caused damage to the elderly, handicapped, or a minor, the accused might be accountable for charges of between $5,500 and $15,000.

 

Statute of Limitations in Grapevine, Texas

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

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 fraud, the state and federal government depends on the support of whistleblowers and rewards them for their heroic efforts.

 

If you have proof of Medicaid fraud in Grapevine, Texas, you may 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 liable. Get in touch with us today to schedule 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 Grapevine, 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 Grapevine, 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 LAWYER; We are proud to represent healthcare workers in Grapevine, Texas

When you become aware of fraudulent activity as it concerns Medicare or Medicaid in Grapevine, Texas, you need the advice of a knowledgeable whistleblower attorney, someone who can ensure that your claim is totally examined and filed accurately and immediately. By working with a skilled lawyer you are increasing the chance that the federal or state government will step in, thus 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 bring years of experience as national qui tam legal representatives to help in your battle against Medicaid and Medicare fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we feel you have a valid claim, we can represent you in a qui tam lawsuit to help report the fraud and allow you to collect a reward. Because all whistleblower work is 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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