Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys fighting Medicare and Medicaid scams in Irving, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars every year. Although most medical companies and drug companies are honest and work within the system, there are those who do not. When fraud occurs, everybody can lose. Medicaid and Medicare whistleblower lawyers assist people who work in the healthcare system to file suits on behalf of the federal or state government to report these kinds of scams.

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

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the industry. We know that stepping forward is not simple and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Irving, Texas

Private citizens who know of fraudulent activity against the state of Texas may have whistleblower rights under 2 state laws.

 

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

 

A whistleblower might submit a qui tam suit 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 recovery when the state elects to participate in the claim. If the private citizen pursues the claim independent of the state, they might be awarded between 25 and 30 percent of the recovery.

 

A separate provision likewise exists that provides for an award to a person who reports deceitful activity in the Texas Medicaid program without bringing a qui tam lawsuit. If the report results in recovery of funds, the award is limited to five percent of the administrative penalty enforced on the party perpetrating the fraud.

 

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

Liability of the Defendant in Irving, Texas

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

 

Statute of Limitations in Irving, Texas

The whistleblower has to submit 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 taxpayers billions of dollars each year. To help root out this problem, the state and federal government relies on the support of whistleblowers and rewards them for their brave efforts.

 

If you have proof of Medicaid fraud in Irving, Texas, you might have the right to pursue a qui tam claim and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who assist states in order to hold wrongdoers responsible. Get in touch with us today to arrange a confidential consultation 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 Irving, 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 Irving, 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 Irving, Texas

When you become aware of potential fraud that may concern Medicaid or Medicare in Irving, Texas, you require the advice of a knowledgeable whistleblower attorney, someone who can make sure that your claim is totally examined and submitted accurately and quickly. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will intervene, hence increasing your chances for a reward. Reporting Medicare and Medicaid scams is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam legal representatives to assist in your battle against Medicaid and Medicare scams. We will review your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we may represent you in a qui tam lawsuit to help report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to learn how we can help.

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