Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars annually. Although most medical providers and drug companies are ethical and work within the legal channels, some don’t. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower attorneys can assist people who work in the healthcare system to submit lawsuits on behalf of the government to help report these kinds of scams.

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

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

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and scams in the market. We know that coming forward is challenging and numerous things might be at stake. When you come to us, your case is kept in the strictest confidence .

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

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Whistleblower Laws in Odessa, Texas

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

 

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

 

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

 

A different arrangement likewise exists that offers an award to a person who reports deceitful activity in the Texas Medicaid program without bringing a qui tam claim. If the report leads to recovery of funds, the award is limited to five percent of the administrative charge enforced on the entity committing the fraud.

 

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

Liability of the Defendant in Odessa, Texas

The defendant in a successful qui tam suit under the Texas Medicaid Fraud Prevention Act may be responsible for charges of between $5,500 and $11,000 per violation. If the unlawful conduct caused damage to the elderly, disabled, or a minor, the defendant may be liable for penalties of between $5,500 and $15,000.

 

Statute of Limitations in Odessa, Texas

The whistleblower has to file their complaint within six years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

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

 

If you have evidence of Medicaid fraud in Odessa, Texas, you might have the right to pursue a qui tam claim and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who assist states in order to hold perpetrators responsible. Get in touch with us today to schedule 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 Odessa, 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 Odessa, 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 Odessa, Texas

When you become aware of deceitful activity involving Medicaid or Medicare in Odessa, Texas, you need the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is completely investigated and submitted accurately and quickly. By working with an experienced lawyer you are increasing the chance that the government will step in, therefore increasing the chance for a reward. Reporting Medicaid and Medicare scams is a complicated matter –  don’t attempt 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 assist in your battle against Medicaid and Medicare fraud. We will review your case on a confidential, no-obligation basis. If we believe that you have a legitimate claim, we may represent you in a qui tam lawsuit to report the scams and allow you to gather a reward. Because all whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Contact us today to learn how we can help.

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