Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam attorneys battling Medicare and Medicaid fraud in San Angelo, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. While many medical service providers and drug companies are honest and work within the legal channels, there are those who do not. When scams are perpetrated, everyone loses. Medicaid and Medicare whistleblower lawyers can assist healthcare workers to file lawsuits on behalf of the federal or state government to help report this sort of fraud.

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

Work with

Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare employees in San Angelo, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave decision to come forward to report abuse and fraud in the market. understand that coming forward is hard and many things might be at stake. When you come to us, your case is held in the strictest confidence .

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 assist in bringing fraudulent Medicare or Medicaid activity to justice.

schedule a
confidential consultation

Whistleblower Laws in San Angelo, Texas

Individuals who know of deceitful activity against the state of Texas might have whistleblower rights under 2 state laws.

 

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

 

A whistleblower may submit 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 in between 15 and 25 percent of the recovery when the state intervenes in the suit. If the private citizen pursues the suit independent of the state, they may be granted 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 five percent of the administrative charge imposed on the party perpetrating the fraud.

 

The Texas Whistleblower Act safeguards public workers from retaliation from any company that employs them if they report wrongdoing. This law does not afford protection for staff members who work for private companies.

Liability of the Defendant in San Angelo, Texas

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

 

Statute of Limitations in San Angelo, 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 state and federal governments and 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 evidence of Medicaid fraud in San Angelo, Texas, you may be able to pursue a qui tam suit and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who assist states in order to hold culprits liable. Contact us today to set up an appointment 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 San Angelo, 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 San Angelo, 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 A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in San Angelo, Texas

When you become aware of fraud that may concern Medicare or Medicaid in San Angelo, Texas, you require the advice of an experienced whistleblower attorney, someone who can make sure that your claim is totally examined and filed accurately and without delay. By dealing with a knowledgeable lawyer you are increasing the chance that the federal or state government will step in, hence increasing the chance for a financial reward. Reporting Medicaid and Medicare 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 practical experience as national qui tam attorneys to assist in your fight against Medicaid and Medicare scams. After you get in touch our lawyers will examine your case on a confidential, no-obligation basis. If we believe that you may have a legitimate claim, we can represent you in a qui tam claim to report the fraud and allow you to gather a reward. All whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to learn how we can be of help.

Service areas