Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers fighting Medicare and Medicaid fraud in Pharr, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars annually. While many medical service providers and drug companies are ethical and work within the system, some do not. When fraud happens, everyone loses. Medicaid and Medicare whistleblower attorneys can help healthcare professionals to file claims on behalf of the federal or state government to help report this sort of fraud.

The state and federal government put a great deal 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 Medicare and Medicaid whistleblower lawyers; representing health care workers in Pharr, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your heroic choice to come forward to report abuse and scams in the market. understand that stepping forward is challenging and many 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 examine your claim, carefully prepare your case, for court, and work tirelessly with both you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in Pharr, Texas

Private citizens who know of deceptive 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 fraudulent claims and perpetuated crimes against the Texas Medicaid program.

 

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

 

A different provision also exists that offers an award to a person who reports fraudulent activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in recovery of funds, 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 agency that uses them if they report wrongdoing. This law does not afford defense for employees who work for personal companies.

Liability of the Defendant in Pharr, Texas

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

 

Statute of Limitations in Pharr, Texas

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

Working With an Experienced Whistleblower Attorney

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

 

If you have evidence of Medicaid scams in Pharr, 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 help states in holding perpetrators liable. Contact us today to set up a confidential consultation 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 Pharr, 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 Pharr, 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 Pharr, Texas

If you’ve become aware of fraudulent activity involving Medicare or Medicaid in Pharr, Texas, you require the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is completely examined and filed accurately and without delay. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will step in, thus increasing the opportunity for a financial reward. Reporting Medicare and Medicaid scams is a complex matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam legal representatives to help in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will review your case on a confidential, no-obligation basis. If we feel that you have a legitimate claim, we can represent you in a qui tam suit to report the fraud and allow you to collect a reward. All whistleblower work is on contingency, you pay absolutely nothing until there is a settlement. Get in touch with us today to to schedule a confidential consultation.

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