Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars each year. While the majority of medical companies and drug companies are honest and work within the legal channels, some don’t. When scams are perpetrated, everybody can lose. Medicaid and Medicare whistleblower attorneys help healthcare professionals to file lawsuits on behalf of the federal or state government to report this type of fraud.

The federal and state governments put a great deal of trust in pharmaceutical and medical providers. When that trust is ill-placed, it counts on regular folks in Texas to come forward to report scams. People like you.

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower attorneys, we support your heroic decision to come forward to report abuse and scams in the market. We know that coming forward is difficult and numerous things might 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, for court, and work tirelessly with both you and the federal or state government to help bring deceitful Medicare or Medicaid activity to justice.

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Whistleblower Laws in Tyler, Texas

Private citizens who become aware of deceptive activity against the state of Texas may have whistleblower rights under two state laws.

 

The Texas Medicaid Fraud Prevention Act holds those parties responsible who have submitted deceptive claims and perpetuated unlawful acts against the Texas Medicaid program.

 

A whistleblower may file 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 a successful action may be rewarded an amount in 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 granted in between 25 and 30 percent of the recovery.

 

A separate arrangement also exists that provides for an award to a person who reports fraudulent activity in the Texas Medicaid program without bringing a qui tam suit. If the report leads to the recovery, the award is limited to 5 percent of the administrative charge imposed on the party committing the fraud.

 

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

Liability of the Defendant in Tyler, Texas

The defendant in a successful 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 unlawful conduct caused damage to the senior, disabled, or a minor, the defendant may be liable for penalties of in between $5,500 and $15,000.

 

Statute of Limitations in Tyler, 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 taxpayers billions of dollars each year. To help root out this problem, the state and federal government counts on the support of whistleblowers and rewards them for their heroic efforts.

 

If you have proof of Medicaid fraud in Tyler, Texas, you might be able to pursue a qui tam claim and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who assist states in order to hold perpetrators liable. Contact us today to arrange 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 Tyler, 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 Tyler, 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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Work With A NATIONALLY RECOGNIZED WHISTLEBLOWER LAWYER; We are proud to represent healthcare workers in Tyler, Texas

If you’ve become aware of fraud that may involve Medicaid or Medicare in Tyler, Texas, you require the advice of a skilled whistleblower attorney, someone who can ensure that your claim is completely examined and submitted accurately and immediately. By dealing with an experienced lawyer you are increasing the chance that the federal or state government will intervene, thus increasing your chances for a financial reward. Reporting Medicaid and Medicare scams is a complex matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of experience as national qui tam legal representatives to assist in your battle against Medicaid and Medicare scams. Our attorneys will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we may represent you in a qui tam claim to report the fraud and enable you to gather a financial benefit. Because all whistleblower work is on contingency, you pay nothing until there is a recovery. Contact us today to learn how we can be of help.

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