Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys battling Medicare and Medicaid scams in Mission, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. While many medical service providers and drug companies are honest and work within the system, some do not. When fraud happens, everyone loses. Medicare and Medicaid whistleblower attorneys help healthcare workers to file suits on behalf of the federal or state government to help report these kinds of scams.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the industry. understand that coming forward is hard and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Mission, Texas

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

 

The Texas Medicaid Fraud Prevention Act holds those parties responsible who have submitted deceptive 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 might be rewarded an amount in between 15 and 25 percent of the funds recovered when the state elects to participate in the claim. If the individual pursues the claim independent of the state, they might be awarded between 25 and 30 percent of the recovery.

 

A separate arrangement likewise exists that offers an award to an individual who reports deceptive activity in the Texas Medicaid program without bringing a qui tam suit. If the report results in recovery of funds, the award is limited to five percent of the administrative penalty enforced on the entity perpetrating the fraud.

 

The Texas Whistleblower Act protects public employees from retaliation from any agency that uses them if they report wrongdoing. This law does not afford defense for workers who work for private businesses.

Liability of the Defendant in Mission, Texas

The offender in an effective qui tam lawsuit under the Texas Medicaid Fraud Prevention Act may be accountable for penalties of between $5,500 and $11,000 per infraction. If the illegal conduct caused harm to the elderly, disabled, or a minor, the accused might be liable for penalties of between $5,500 and $15,000.

 

Statute of Limitations in Mission, Texas

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

Working With an Experienced Whistleblower Lawyer

Medicaid fraud cost federal and state 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 heroic efforts.

 

If you have evidence of Medicaid scams in Mission, Texas, you might have the right to pursue a qui tam suit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who assist states in holding perpetrators responsible. Contact us today to arrange an appointment in order 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 Mission, 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 Mission, 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 Mission, Texas

When you become aware of deceitful activity involving Medicaid or Medicare in Mission, Texas, you need the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and quickly. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will intervene, hence increasing the chance for a reward. Reporting Medicare and Medicaid scams is a complex matter –  don’t attempt 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 lawyers to help in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we may represent you in a qui tam lawsuit to help report the fraud and enable you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can be of help.

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