Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid scams in Laredo, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are honest and work within the system, some don’t. When fraud happens, everybody can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare workers to submit suits on behalf of the federal or state government to report these kinds of scams.

The state and federal governments place a great deal of trust in pharmaceutical and medical service providers. When that trust is ill-placed, it depends on regular folks in Texas to come forward and to report fraud. People like you.

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Experienced Medicare and Medicaid whistleblower lawyers; representing healthcare workers in Laredo, Texas

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the industry. We know that stepping forward is challenging and many things might be at stake. When you come to us, your case is held in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently prepare your case, for court, and work relentlessly with both you and the state of federal government to help bring deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Laredo, Texas

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

 

The Texas Medicaid Fraud Prevention Act holds those entities liable who have submitted fraudulent claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower may 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 an effective action may be rewarded an amount in between 15 and 25 percent of the recovery when the state elects to participate in the claim. If the individual pursues the lawsuit independent of the state, they might be granted in between 25 and 30 percent of the recovery.

 

A different provision also exists that offers 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 the recovery, the award is restricted to five percent of the administrative charge enforced on the party perpetrating the fraud.

 

The Texas Whistleblower Act safeguards public workers from retaliation from any company that uses them if they report wrongdoing. This law does not provide defense for workers who work for private businesses.

Liability of the Defendant in Laredo, Texas

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

 

Statute of Limitations in Laredo, Texas

The whistleblower must file their complaint within six years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

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

 

If you have proof of Medicaid fraud in Laredo, Texas, you might be able to pursue a qui tam lawsuit and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who help states in holding perpetrators accountable. Get in touch with us today to set up a confidential consultation 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 Laredo, 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 Laredo, 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 Laredo, Texas

When you become aware of deceitful activity as it concerns Medicare or Medicaid in Laredo, Texas, you may need the guidance of an experienced whistleblower lawyer, someone who can make sure that your claim is completely examined and submitted accurately and quickly. By working with a skilled lawyer you are increasing the chance that the government will intervene, therefore increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  don’t attempt 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 help in your battle against Medicaid and Medicare scams. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you may have a valid claim, we can represent you in a qui tam suit to report the scams and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to to schedule a confidential consultation.

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