Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars every year. Although the majority of medical companies and drug companies are honest and work within the system, some don’t. When scams are perpetrated, everybody loses. Medicare and Medicaid whistleblower attorneys can assist healthcare workers to submit suits on behalf of the federal or state government to help report this type of fraud.

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

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Pearland, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the market. understand that stepping forward is not simple and lots of 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, carefully prepare your case, for court, and work relentlessly with you and the federal or state government to assist in bringing deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Pearland, Texas

Individuals who have knowledge of deceptive 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 submitted deceitful claims and perpetuated crimes against the Texas Medicaid program.

 

A whistleblower may file a qui tam suit on behalf of the state when they have proof of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in an effective action may be rewarded an amount in between 15 and 25 percent of the funds recovered when the state intervenes in the suit. If the individual pursues the lawsuit independent of the state, they might be awarded in between 25 and 30 percent of the recovery.

 

A separate arrangement likewise exists that provides for an award to an individual who reports deceitful activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in the recovery, the award is restricted to 5 percent of the administrative charge imposed on the entity perpetrating the scams.

 

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

Liability of the Defendant in Pearland, Texas

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

 

Statute of Limitations in Pearland, Texas

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

Working With an Experienced Whistleblower Attorney

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 fraud in Pearland, Texas, you might have the right to pursue a qui tam suit 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 Pearland, 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 Pearland, 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 ATTORNEY; We are proud to represent healthcare workers in Pearland, Texas

When you become aware of deceptive activity that may concern Medicaid or Medicare in Pearland, Texas, you may need the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is completely examined and submitted accurately and without delay. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will step in, hence increasing the opportunity for a reward. Reporting Medicaid and Medicare fraud is an intricate matter –  don’t 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 lawyers to help in your battle against Medicaid and Medicare scams. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we feel you have a valid claim, we may represent you in a qui tam lawsuit to report the fraud and enable you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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