Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in McKinney, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. While the majority of medical providers and drug companies are ethical and work within the legal channels, there are those who do not. When fraud takes place, everyone can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare professionals to file suits on behalf of the federal or state government to report this type of fraud.

The state and federal government put a lot of trust in medical and pharmaceutical service providers. When that trust is ill-placed, it counts on regular folks in Texas to come forward and to report fraud. People like you.

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in McKinney, Texas

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the market. We know that coming forward is not easy and lots of things might be at stake. When you come to us, your case is kept in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we thoroughly examine your claim, carefully prepare your case, and work relentlessly with you and the state of federal government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in McKinney, Texas

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

 

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

 

A whistleblower might file a qui tam suit on behalf of the state when they have evidence of Medicaid fraud. Under the Texas Medicaid Fraud Act, the whistleblower in an effective action might be rewarded an amount in between 15 and 25 percent of the funds recovered when the state elects to participate in the suit. If the private citizen pursues the suit independent of the state, they may be granted in between 25 and 30 percent of the recovery.

 

A different provision likewise exists that offers an award to an individual who reports deceptive activity in the Texas Medicaid program without bringing a qui tam claim. If the report leads to the recovery, the award is restricted to 5 percent of the administrative penalty imposed on the party committing the fraud.

 

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

Liability of the Defendant in McKinney, Texas

The defendant in a successful qui tam suit under the Texas Medicaid Fraud Prevention Act may be liable for charges of between $5,500 and $11,000 per infraction. If the unlawful conduct caused harm to the senior, handicapped, or a minor, the offender might be accountable for charges of in between $5,500 and $15,000.

 

Statute of Limitations in McKinney, Texas

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

Working With an Experienced Whistleblower Lawyer

Medicaid scams cost federal and state governments and Texas taxpayers billions of dollars each year. To help root out this problem, 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 McKinney, 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 help states in order to hold perpetrators liable. Get in touch with us today to schedule a confidential consultation 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 McKinney, 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 McKinney, 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 McKinney, Texas

If you’ve become aware of fraud that may involve Medicare or Medicaid in McKinney, Texas, you need the advice of an experienced whistleblower attorney, someone who can ensure that your claim is completely investigated and filed accurately and quickly. By dealing with a knowledgeable attorney you are increasing the chance that the federal or state government will step in, thus increasing your chances for a reward. Reporting Medicare and Medicaid fraud is a complex matter –  don’t try 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 lawyers to help in your fight against Medicaid and Medicare scams. Our attorneys will review your case on a confidential, no-obligation basis. If we feel that you have a legitimate claim, we may represent you in a qui tam lawsuit to report the scams and enable you to collect a reward. All whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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