Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in New Braunfels, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars every year. Although the majority of medical companies and drug companies are ethical and work within the system, there are those who don’t. When fraud occurs, everybody can lose. Medicaid and Medicare whistleblower attorneys can assist healthcare workers to file suits on behalf of the government to report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in New Braunfels, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and fraud in the market. We know that coming forward is difficult and lots of things may 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 completely investigate your claim, carefully prepare your case, and work tirelessly with you and the federal or state government to assist in bringing deceptive Medicaid or Medicare activity to justice.

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Whistleblower Laws in New Braunfels, Texas

Private citizens who become aware of fraudulent activity against the state of Texas may have whistleblower rights under two state laws.

 

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

 

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

 

A separate 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 lawsuit. If the report leads to recovery of funds, the award is limited to 5 percent of the administrative penalty enforced on the party committing the scams.

 

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

Liability of the Defendant in New Braunfels, Texas

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

 

Statute of Limitations in New Braunfels, Texas

The whistleblower has to submit their complaint within six years of the date of the offense.

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 problem, the state and federal government counts on the support of whistleblowers and rewards them for their heroic efforts.

 

If you have proof of Medicaid scams in New Braunfels, Texas, you may be able to pursue a qui tam suit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who help states in order to hold perpetrators accountable. Get in touch with us today to set up a confidential consultation 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 New Braunfels, 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 New Braunfels, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in New Braunfels, Texas

If you’ve become aware of fraud that may involve Medicare or Medicaid in New Braunfels, Texas, you may need the guidance of a knowledgeable whistleblower attorney, someone who can guarantee that your claim is fully examined and submitted accurately and without delay. By working with an experienced attorney you are increasing the chance that the government will intervene, hence increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not try 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 fight against Medicaid and Medicare scams. Our attorneys will review your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam lawsuit to report the scams and allow you to collect a financial benefit. Because all whistleblower cases are on contingency, you pay nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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