Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid scams in Longview, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. While the majority of medical service providers and drug companies are honest and work within the system, some do not. When fraud occurs, everybody can lose. Medicare and Medicaid whistleblower lawyers help people who work in the healthcare system to file claims on behalf of the government to help report this type of fraud.

The federal and state government place a good 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 Longview, Texas

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic decision to come forward to report abuse and fraud in the industry. We know that coming forward is not simple 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 extensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently and carefully prepare your case, for court, and work tirelessly with both you and the state of federal government to assist in bringing fraudulent Medicare or Medicaid activity to justice.

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Whistleblower Laws in Longview, Texas

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

 

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

 

A whistleblower might 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 a successful action may be rewarded an amount between 15 and 25 percent of the recovery when the state intervenes in the claim. If the individual 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 a person who reports fraudulent activity in the Texas Medicaid program without bringing a qui tam suit. If the report results in the recovery, the award is restricted to five percent of the administrative penalty enforced on the entity perpetrating the fraud.

 

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

Liability of the Defendant in Longview, Texas

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

 

Statute of Limitations in Longview, Texas

The whistleblower must file their complaint within 6 years of the date of the violation.

Working With an Experienced Whistleblower Lawyer

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

 

If you have proof of Medicaid fraud in Longview, Texas, you might have the right to pursue a qui tam claim and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who assist states in holding wrongdoers liable. Contact us today to arrange 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 Longview, 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 Longview, 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Longview, Texas

When you become aware of deceptive activity that may concern Medicaid or Medicare in Longview, Texas, you need the advice of an experienced whistleblower lawyer, someone who can make sure that your claim is fully examined and filed accurately and promptly. By dealing with an experienced lawyer you are increasing the chance that the government will step in, thus increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is a complex matter –  don’t 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 lawyers to assist in your fight against Medicaid and Medicare scams. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we believe you may have a legitimate claim, we can represent you in a qui tam lawsuit to report the fraud and enable you to collect a reward. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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