Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers battling Medicare and Medicaid fraud in Sugar Land, Texas

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars every year. While the majority of medical companies and drug companies are honest and work within the legal channels, there are those who do not. When fraud takes place, everybody can lose. Medicare and Medicaid whistleblower attorneys can assist healthcare workers to submit claims on behalf of the federal or state government to report this sort of fraud.

The federal and state governments place a great 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 to report scams. People like you.

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Experienced Medicare and Medicaid whistleblower attorneys; representing healthcare workers in Sugar Land, Texas

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your brave choice to come forward to report abuse and fraud in the industry. understand that coming forward is hard and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Sugar Land, Texas

Private citizens who have knowledge of deceitful activity against the state of Texas might have whistleblower rights under two state laws.

 

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

 

A whistleblower may submit a qui tam lawsuit on behalf of the state when they have proof of Medicaid scams. Under the Texas Medicaid Fraud Act, the whistleblower in a successful action may be rewarded an amount 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 different provision also exists that provides for an award to an individual 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 limited to five percent of the administrative charge imposed on the entity perpetrating the scams.

 

The Texas Whistleblower Act protects public workers from retaliation from any agency that employs them if they report wrongdoing. This law does not afford defense for staff members who work for personal businesses.

Liability of the Defendant in Sugar Land, Texas

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

 

Statute of Limitations in Sugar Land, Texas

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

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 fraud, the state and federal government depends on the assistance of whistleblowers and rewards them for their brave efforts.

 

If you have proof of Medicaid fraud in Sugar Land, Texas, you may be able to pursue a qui tam claim and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who assist states in holding perpetrators responsible. Get in touch with 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 Sugar Land, 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 Sugar Land, 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 LAWYER; We are proud to represent healthcare workers in Sugar Land, Texas

If you’ve become aware of potential fraud as it concerns Medicaid or Medicare in Sugar Land, Texas, you require the guidance of a knowledgeable whistleblower lawyer, someone who can ensure that your claim is fully investigated and filed accurately and quickly. By working with a skilled attorney you are increasing the chance that the government will step in, therefore increasing the opportunity for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  don’t attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of prior experience as national qui tam lawyers to help in your fight against Medicare and Medicaid scams. We will review your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we may represent you in a qui tam claim to help report the scams and enable you to gather a reward. Because all whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to learn how we can help.

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