Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. While most medical service providers and drug companies are honest and work within the system, there are those who do not. When fraud happens, everybody loses. Medicare and Medicaid whistleblower lawyers can assist healthcare workers to file claims on behalf of the federal or state government to report this type of fraud.

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

Work with

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

At Khurana Law Firm, P.C., as skilled 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 hard and lots of things might 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 examine your claim, carefully prepare your case, for court, and work tirelessly with both you and the federal or state government to help bring deceptive Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Plano, Texas

Private citizens who learn of deceptive activity against the state of Texas might have whistleblower rights under 2 state statutes.

 

The Texas Medicaid Fraud Prevention Act holds those entities accountable who have sent fraudulent claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower may submit a qui tam lawsuit on behalf of the state when they have evidence 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 elects to participate in the claim. If the private citizen pursues the claim independent of the state, they may be awarded in between 25 and 30 percent of the recovery.

 

A separate provision also 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 leads to the recovery, the award is restricted to 5 percent of the administrative penalty imposed on the party perpetrating the fraud.

 

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

Liability of the Defendant in Plano, Texas

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

 

Statute of Limitations in Plano, Texas

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

Working With an Experienced Whistleblower Lawyer

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 depends on the help of whistleblowers and rewards them for their heroic efforts.

 

If you have proof of Medicaid fraud in Plano, Texas, you may have the right to pursue a qui tam claim and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who help states in holding wrongdoers 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 Plano, 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 Plano, Texas,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

Call now to
Report Medical fraud
We are here to help
Work With An Experienced WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Plano, Texas

When you become aware of potential fraud as it concerns Medicaid or Medicare in Plano, Texas, you need the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is totally examined and submitted accurately and immediately. By working with a knowledgeable lawyer you are increasing the chance that the federal or state government will step in, hence increasing your chances for a reward. Reporting Medicare and Medicaid scams is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of prior experience as national qui tam lawyers to assist in your fight against Medicaid and Medicare scams. We will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam claim to help report the fraud and allow you to gather a reward. All whistleblower work is on contingency, you pay nothing up until there is a settlement. Get in touch with us today to learn how we can help.

Service areas