Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in San Marcos, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars every year. Although the majority of medical service providers and drug companies are honest and work within the system, some do not. When fraud happens, everyone can lose. Medicare and Medicaid whistleblower lawyers help healthcare professionals to file suits on behalf of the government to report this sort of fraud.

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 regular folks in Texas to come forward to report fraud. People like you.

Work with

Experienced Medicare and Medicaid whistleblower lawyers; representing health care workers in San Marcos, Texas

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower legal representatives, we support your brave choice to come forward to report abuse and scams in the industry. We know that coming forward is hard and numerous things may be at stake. When you come to us, your case is kept in the strictest confidence .

With our comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, carefully prepare your case, and work relentlessly with you and the state of federal government to help bring fraudulent Medicaid or Medicare activity to justice.

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Whistleblower Laws in San Marcos, Texas

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

 

The Texas Medicaid Fraud Prevention Act holds those entities responsible who have sent deceptive claims and perpetuated crimes against the Texas Medicaid program.

 

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

 

A different provision also exists that offers 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 recovery of funds, the award is limited 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 utilizes them if they report wrongdoing. This law does not provide protection for workers who work for private businesses.

Liability of the Defendant in San Marcos, Texas

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

 

Statute of Limitations in San Marcos, Texas

The whistleblower has to file 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 problem, the government depends on the help of whistleblowers and rewards them for their brave efforts.

 

If you have proof of Medicaid scams in San Marcos, Texas, you may be able 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 accountable. Contact us today to arrange an appointment to discuss your case and understand your rights and protections 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 Marcos, 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 Marcos, 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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WORKING WITH A NATIONALLY RECOGNIZED WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in San Marcos, Texas

When you become aware of fraud that may concern Medicare or Medicaid in San Marcos, Texas, you require the guidance of a knowledgeable whistleblower lawyer, someone who can make sure that your claim is fully examined and submitted accurately and immediately. By working with an experienced attorney you are increasing the chance that the federal or state government will step in, thus increasing the chance for a financial reward. Reporting Medicare and Medicaid scams is an intricate matter –  do not try 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 Medicare and Medicaid scams. After you contact us, our attorneys will evaluate your case on a confidential, no-obligation basis. If we believe you have a legitimate claim, we may represent you in a qui tam claim to help report the scams and allow you to collect a financial benefit. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Contact us today to to schedule a confidential consultation.

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