Khurana
Law Firm

Medicare whistleblower lawyer

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

Medicaid and Medicare fraud cost Texas taxpayers billions of dollars annually. While the majority of medical companies and drug companies are ethical and work within the system, there are those who don’t. When scams are perpetrated, everybody loses. Medicaid and Medicare whistleblower lawyers assist healthcare professionals to submit lawsuits on behalf of the federal or state government to help report this sort of fraud.

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

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

At Khurana Law Firm, P.C., as experienced Medicare and Medicaid whistleblower lawyers, we support your brave decision to come forward to report abuse and scams in the industry. We know that stepping forward is not simple and numerous things may be at stake. When you come to us, your case is held in the strictest confidence .

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

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Whistleblower Laws in Wichita Falls, Texas

Private citizens who have knowledge of fraudulent activity against the state of Texas may have whistleblower rights under two state statutes.

 

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

 

A whistleblower may file 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 funds recovered when the state intervenes in the lawsuit. If the individual pursues the suit independent of the state, they might be granted in between 25 and 30 percent of the funds recovered.

 

A separate arrangement likewise exists that offers an award to an individual who reports deceptive activity in the Texas Medicaid program without bringing a qui tam claim. If the report leads to recovery of funds, the award is restricted to five percent of the administrative penalty imposed on the party committing the fraud.

 

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

Liability of the Defendant in Wichita Falls, Texas

The accused in a successful qui tam claim under the Texas Medicaid Fraud Prevention Act may be accountable for penalties of in between $5,500 and $11,000 per offense. If the illegal conduct caused damage to the senior, disabled, or a minor, the offender may be accountable for penalties of in between $5,500 and $15,000.

 

Statute of Limitations in Wichita Falls, Texas

The whistleblower has to file their complaint within six years of the date of the offense.

Working With an Experienced Whistleblower Lawyer

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

 

If you have evidence of Medicaid scams in Wichita Falls, Texas, you might have the right to pursue a qui tam suit and collect a monetary reward. At the Khurana Law Firm, we represent whistleblowers who help states in order to hold perpetrators accountable. Get in touch with 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 Wichita Falls, 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 Wichita Falls, 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 Wichita Falls, Texas

If you’ve become aware of potential fraud as it concerns Medicare or Medicaid in Wichita Falls, Texas, you may need the guidance of a knowledgeable whistleblower attorney, someone who can make sure that your claim is fully investigated and submitted accurately and immediately. By working with a skilled lawyer you are increasing the chance that the federal or state government will intervene, therefore increasing your chances for a reward. Reporting Medicare and Medicaid scams is a complex 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 lawyers to assist in your battle against Medicare and Medicaid fraud. After you get in touch our lawyers will evaluate your case on a confidential, no-obligation basis. If we feel that you have a valid claim, we can represent you in a qui tam claim to help report the scams and enable you to collect a reward. Because all whistleblower work is on contingency, you pay absolutely nothing up until there is a recovery. Get in touch with us today to learn how we can be of help.

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