Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicare and Medicaid fraud cost Texas taxpayers billions of dollars annually. While most medical providers and drug companies are ethical and work within the system, there are those who do not. When scams are perpetrated, everybody can lose. Medicare and Medicaid whistleblower lawyers help healthcare workers to file suits on behalf of the federal or state government to help report this type of fraud.

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

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Experienced Medicaid and Medicare whistleblower attorneys; representing health care employees in Waco, Texas

At Khurana Law Firm, P.C., as skilled Medicare and Medicaid whistleblower legal representatives, we support your heroic decision to come forward to report abuse and fraud in the market. understand that stepping forward is not easy and lots of things might be at stake. When you come to us, your case is held in the strictest confidence at all times.

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

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Whistleblower Laws in Waco, Texas

Private citizens who have knowledge 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 submitted deceptive claims and perpetuated crimes against the Texas Medicaid program.

 

A whistleblower may submit a qui tam claim 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 in between 15 and 25 percent of the recovery when the state elects to participate in the lawsuit. If the private citizen pursues the lawsuit independent of the state, they might be awarded in between 25 and 30 percent of the funds recovered.

 

A different provision likewise exists that offers an award to an individual who reports deceitful activity in the Texas Medicaid program without bringing a qui tam claim. If the report results in recovery of funds, the award is restricted to five percent of the administrative charge enforced on the party perpetrating the scams.

 

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 staff members who work for personal companies.

Liability of the Defendant in Waco, Texas

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

 

Statute of Limitations in Waco, Texas

The whistleblower has to file their complaint within 6 years of the date of the infraction.

Working With an Experienced Whistleblower Lawyer

Medicaid scams cost state and federal governments and taxpayers billions of dollars each year. To help root out this problem, the government depends on the assistance of whistleblowers and rewards them for their brave efforts.

 

If you have evidence of Medicaid scams in Waco, Texas, you might have the right to pursue a qui tam lawsuit and collect a financial reward. At the Khurana Law Firm, we represent whistleblowers who help states in order to hold culprits liable. Contact us today to set up a confidential consultation 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 Waco, 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 Waco, 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 ATTORNEY; We are proud to represent healthcare workers in Waco, Texas

When you become aware of potential fraud that may involve Medicaid or Medicare in Waco, Texas, you need the advice of a skilled whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and promptly. By dealing with a knowledgeable lawyer you are increasing the chance that the government will intervene, hence increasing the opportunity for a reward. Reporting Medicare and Medicaid scams is a complicated matter –  do not attempt 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 Medicare and Medicaid scams. Our attorneys will examine your case on a confidential, no-obligation basis. If we feel that you have a legitimate claim, we may represent you in a qui tam suit to help report the scams and enable you to gather a reward. All whistleblower work is on contingency, you pay nothing until there is a recovery. Get in touch with us today to to schedule a confidential consultation.

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