Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars annually. Although the majority of medical providers and drug companies are honest and work within the legal channels, there are those who don’t. When fraud happens, everybody can lose. Medicaid and Medicare whistleblower lawyers can assist healthcare professionals to file lawsuits on behalf of the government to help report these kinds of scams.

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

Work with

Experienced Medicaid and Medicare whistleblower lawyers; representing healthcare employees in Round Rock, Texas

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and scams in the industry. We know that stepping forward is hard and lots of things might be at stake. When you come to us, your case is held in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we completely examine your claim, diligently prepare your case, for court, and work tirelessly with you and the state of federal government to assist in bringing fraudulent Medicaid or Medicare activity to justice.

schedule a
confidential consultation

Whistleblower Laws in Round Rock, Texas

Private citizens who have knowledge of fraudulent activity against the state of Texas may have whistleblower rights under 2 state laws.

 

The Texas Medicaid Fraud Prevention Act holds those entities liable who have submitted deceitful claims and perpetuated crimes 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 an effective action might be rewarded an amount in between 15 and 25 percent of the funds recovered when the state intervenes in the suit. If the private citizen pursues the lawsuit independent of the state, they might be granted between 25 and 30 percent of the funds recovered.

 

A different provision likewise exists that offers an award to an individual who reports deceptive activity in the Texas Medicaid program without bringing a qui tam suit. If the report results in the recovery, the award is limited to 5 percent of the administrative charge enforced on the entity perpetrating the fraud.

 

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

Liability of the Defendant in Round Rock, Texas

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

 

Statute of Limitations in Round Rock, Texas

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

Working With an Experienced Whistleblower Lawyer

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

 

If you have evidence of Medicaid fraud in Round Rock, Texas, you may have the right to pursue a qui tam lawsuit and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who help states in order to hold wrongdoers accountable. Contact us today to schedule 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 Round Rock, 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 Round Rock, 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
WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Round Rock, Texas

If you’ve become aware of fraud that may concern Medicare or Medicaid in Round Rock, Texas, you need the advice of an experienced whistleblower lawyer, someone who can guarantee that your claim is totally investigated and filed accurately and immediately. By dealing with a skilled attorney you are increasing the chance that the federal or state government will step in, hence increasing the possibility for a reward. Reporting Medicare and Medicaid scams is a complex matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of experience as national qui tam legal representatives to assist in your fight against Medicaid and Medicare fraud. We will examine 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 claim to report the scams and allow you to collect a reward. All whistleblower work is on contingency, you pay absolutely nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

Service areas