Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower lawyers battling Medicare and Medicaid fraud in Victoria, Texas

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. While many medical companies and drug companies are honest and work within the system, some don’t. When fraud occurs, everyone loses. Medicare and Medicaid whistleblower lawyers can assist people who work in the healthcare system to file claims on behalf of the federal or state government to help report this type of fraud.

The state and federal governments place a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, the government relies on regular folks in Texas to come forward and to report fraud. People like you.

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

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and scams in the market. We know that coming forward is not easy and many things might be at stake. When you come to us, your case is kept in the strictest confidence .

With our extensive experience representing whistleblowers nationwide, we thoroughly examine your claim, diligently prepare your case, for court, and work tirelessly with you and the state of federal government to assist in bringing deceptive Medicare or Medicaid activity to justice.

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Whistleblower Laws in Victoria, Texas

Private citizens 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 parties responsible who have submitted deceptive claims and perpetuated unlawful acts 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 might be rewarded an amount in between 15 and 25 percent of the recovery when the state elects to participate in the suit. If the individual pursues the suit independent of the state, they may be granted between 25 and 30 percent of the recovery.

 

A different provision likewise exists that offers an award to a person who reports deceptive activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in recovery of funds, the award is limited to five percent of the administrative charge imposed on the entity committing the fraud.

 

The Texas Whistleblower Act safeguards public workers from retaliation from any agency that utilizes them if they report wrongdoing. This law does not provide protection for employees who work for personal businesses.

Liability of the Defendant in Victoria, Texas

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

 

Statute of Limitations in Victoria, Texas

The whistleblower must file their complaint within six years of the date of the violation.

Working With an Experienced Whistleblower Attorney

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 relies on the help of whistleblowers and rewards them for their brave efforts.

 

If you have proof of Medicaid scams in Victoria, Texas, you may have the right to pursue a qui tam suit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who help states in holding culprits accountable. Contact us today to set up a confidential consultation 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 Victoria, 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 Victoria, 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 An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Victoria, Texas

If you’ve become aware of potential fraud involving Medicare or Medicaid in Victoria, Texas, you need the guidance of an experienced whistleblower lawyer, someone who can guarantee that your claim is completely investigated and filed accurately and quickly. By dealing with a skilled lawyer you are increasing the chance that the federal or state government will step in, thus increasing the possibility for a financial reward. Reporting Medicaid and Medicare fraud is an intricate matter –  do not try to do this alone, we are here to help.

At Khurana Law Firm, P.C., we bring years of practical experience as national qui tam attorneys to help in your fight against Medicaid and Medicare fraud. After you contact us, our attorneys will review your case on a confidential, no-obligation basis. If we believe you may have a valid claim, we can represent you in a qui tam lawsuit to help report the fraud and allow you to collect a financial benefit. All whistleblower cases are on contingency, you pay nothing until there is a settlement. Contact us today to learn how we can be of help.

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