Khurana
Law Firm

Medicare whistleblower lawyer

Whistleblower and qui tam lawyers fighting Medicare and Medicaid fraud in Temple, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. Although most medical companies and drug companies are honest and work within the system, some do not. When fraud takes place, everybody loses. Medicaid and Medicare whistleblower attorneys assist healthcare workers to file claims on behalf of the federal or state government to help report these kinds of scams.

The federal and state governments put a great deal of trust in medical and pharmaceutical companies. 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 Temple, 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 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 at all times.

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

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Whistleblower Laws in Temple, Texas

Individuals who know of fraudulent 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 deceptive claims and perpetuated unlawful acts against the Texas Medicaid program.

 

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

 

A separate provision also exists that offers an award to an individual who reports fraudulent 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 penalty imposed on the party perpetrating the fraud.

 

The Texas Whistleblower Act protects public staff members from retaliation from any agency that uses them if they report wrongdoing. This law does not provide protection for employees who work for personal companies.

Liability of the Defendant in Temple, Texas

The accused 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 damage to the senior, handicapped, or a minor, the defendant may be accountable for charges of between $5,500 and $15,000.

 

Statute of Limitations in Temple, Texas

The whistleblower must submit their complaint within 6 years of the date of the infraction.

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 state and federal government counts on the help of whistleblowers and rewards them for their heroic efforts.

 

If you have evidence of Medicaid fraud in Temple, 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 order to hold culprits liable. Get in touch with us today to schedule 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 Temple, 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 Temple, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Temple, Texas

If you’ve become aware of fraudulent activity involving Medicaid or Medicare in Temple, Texas, you may need the advice of an experienced whistleblower lawyer, someone who can ensure that your claim is totally investigated and filed accurately and immediately. By working with a skilled lawyer you are increasing the chance that the government will step in, thus increasing your chances 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 prior experience as national qui tam legal representatives to help in your fight against Medicaid and Medicare scams. We will review your case on a confidential, no-obligation basis. If we feel that you may have a legitimate claim, we can represent you in a qui tam lawsuit to help report the scams and enable you to collect a financial benefit. All whistleblower cases are on contingency, you pay nothing up until there is a recovery. Contact us today to to schedule a confidential consultation.

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