Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Lewisville, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars each year. Although the majority of medical providers and drug companies are honest and work within the system, some do not. When fraud takes place, everybody loses. Medicare and Medicaid whistleblower lawyers help healthcare professionals to submit suits on behalf of the government to report this type of fraud.

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

Work with

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and fraud in the market. understand 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 extensive experience representing whistleblowers nationwide, we thoroughly investigate your claim, carefully prepare your case, for court, and work relentlessly with both you and the federal or state government to assist in bringing deceitful Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Lewisville, Texas

Individuals who learn of deceptive activity against the state of Texas might have whistleblower rights under two state statutes.

 

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

 

A whistleblower may submit a qui tam lawsuit on behalf of the state when they have evidence of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in a successful action might be rewarded an amount between 15 and 25 percent of the recovery when the state intervenes in the lawsuit. If the individual pursues the claim independent of the state, they may be granted between 25 and 30 percent of the funds recovered.

 

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 suit. If the report results in recovery of funds, the award is restricted to 5 percent of the administrative penalty imposed on the party perpetrating the fraud.

 

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

Liability of the Defendant in Lewisville, Texas

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

 

Statute of Limitations in Lewisville, Texas

The whistleblower must submit their complaint within 6 years of the date of the offense.

Working With an Experienced Whistleblower Lawyer

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

 

If you have evidence of Medicaid scams in Lewisville, Texas, you might have the right to pursue a qui tam lawsuit and collect a monetary 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 arrange 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 Lewisville, 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 Lewisville, Texas,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
Work With An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Lewisville, Texas

When you become aware of potential fraud involving Medicaid or Medicare in Lewisville, Texas, you need the guidance of an experienced whistleblower attorney, someone who can make sure that your claim is totally investigated and submitted accurately and immediately. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will step in, hence increasing the opportunity for a reward. Reporting Medicaid and Medicare scams is a complicated matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam legal representatives to help in your fight against Medicaid and Medicare fraud. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam claim to report the fraud and enable you to collect a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

Service areas