Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid scams in Richardson, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. Although most medical providers and drug companies are honest and work within the legal channels, there are those who do not. When fraud happens, everyone can lose. Medicaid and Medicare whistleblower lawyers can help healthcare professionals to submit suits on behalf of the government to help report this type of fraud.

The state and federal governments place a good deal of trust in medical and pharmaceutical companies. When that trust is ill-placed, it counts on every day people in Texas to come forward and to report fraud. People like you.

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing health care employees in Richardson, Texas

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower attorneys, we support your brave decision to come forward to report abuse and fraud in the industry. We know that coming forward is not simple and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

With our substantial experience representing whistleblowers nationwide, we thoroughly investigate your claim, diligently prepare your case, for court, and work relentlessly with both you and the federal or state government to assist in bringing deceitful Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Richardson, 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 entities responsible who have sent deceptive claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower might file a qui tam claim 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 between 15 and 25 percent of the recovery when the state intervenes in the lawsuit. If the individual pursues the suit independent of the state, they may be awarded between 25 and 30 percent of the funds recovered.

 

A separate arrangement likewise exists that provides for an award to a person who reports deceptive activity in the Texas Medicaid program without bringing a qui tam lawsuit. If the report results in the recovery, the award is restricted to five percent of the administrative charge enforced on the entity committing the fraud.

 

The Texas Whistleblower Act safeguards public employees from retaliation from any agency that employs them if they report wrongdoing. This law does not afford defense for employees who work for private companies.

Liability of the Defendant in Richardson, Texas

The defendant in an effective qui tam lawsuit under the Texas Medicaid Fraud Prevention Act may be liable for penalties of in between $5,500 and $11,000 per violation. If the unlawful 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 Richardson, Texas

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

Working With an Experienced Whistleblower Attorney

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

 

If you have proof of Medicaid fraud in Richardson, Texas, you might 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 perpetrators responsible. Contact us today to set up an appointment 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 Richardson, 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 Richardson, 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 ATTORNEY; We are proud to represent healthcare workers in Richardson, Texas

If you’ve become aware of fraud that may concern Medicaid or Medicare in Richardson, Texas, you require the guidance of an experienced whistleblower attorney, someone who can ensure that your claim is totally examined and filed accurately and promptly. By working with a knowledgeable attorney you are increasing the chance that the government will intervene, hence increasing your chances for a 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 bring years of practical experience as national qui tam attorneys to assist in your fight against Medicare and Medicaid scams. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel you may have a legitimate claim, we may represent you in a qui tam claim to help report the fraud and enable you to gather a financial benefit. Because all whistleblower cases are on contingency, you pay nothing up until there is a settlement. Contact us today to to schedule a confidential consultation.

Service areas