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NYC Medicaid Fraud Lawyers

Medicaid fraud occurs when services are billed for even though they were not provided; when tests that are not necessary are performed and then billed for; when unnecessary referrals are made to a patient; or when services that should be bundled together for a lower rate are charged separately. If you have a letter from the NYC HRA that says your Medicaid eligibility is under review, it’s possible that you’re being investigated for fraud. Contact a New York Medicaid fraud attorney right away.

Receiving an HRA Letter

If you have received an HRA letter, that usually means that the investigation is open and the investigator believes you’ve committed Medicaid fraud. The letter may say that you have to meet the investigator at a specific date and time. It’s best to go to this meeting with an attorney instead of showing up alone. By the time the investigator wants to setup a meeting, they’ve already gathered evidence against you. If you don’t have an attorney to advise you, you could end up saying something that only makes the investigator’s case stronger.

You have a legal right to meeting with a Medicaid fraud attorney or retaining the attorney’s services prior to your meeting with the investigator. You do not have to answer any of the investigator’s questions, whether or not you have an attorney present, and can stay silent if you wish.

Investigation Into Medicaid Fraud

There are several ways that an investigator may gather evidence to support a Medicaid fraud case. First, they review your applications for food stamps, public assistance and Medicaid programs. They can also access information from databases like NYS Real Estate, DMV, and NYS Division of Corporations. They may go to your neighbors and ask to speak with them in order to verify your address. They may even contact your employer to find out how much you earn.

Note that the District Attorney’s office isn’t the only agency that may conduct an investigation into Medicaid fraud. The Bureau of Fraud Investigation, the NYS Office of the Welfare Inspector General or the IREA may look into Medicaid fraud, too. These agencies, along with others, often look into individuals or groups who may be committing Medicaid fraud.

Reasons for a Medicaid Fraud Case

There are several reasons why a person who received Medicaid may be investigated. Often, this happens because the Medicaid recipient doesn’t put down their full income on the Medicaid application, or they do not tell the agency when their household income increases. It’s necessary to disclose the following information:

• Your actual earned income
• The actual earned income of those you live with
• The income of anyone you have a child with
• Unearned income, which includes gifts, rental income or other types of support
• Changes in address or number of household members

Even if a Medicaid enrollment agent completed your application for you and they told you it was ready to send in, you’re still responsible for the information on that application. Signing your name means you agree with the information on the form, and if the information is incomplete, you could be convicted of perjury. The enrollment agent is not responsible for supplying correct information on the application.

When you’re investigated for fraud, there are several consequences you face, including fines and criminal charges. If you’re not a U.S. citizen, you may be facing removal or deportation. As soon as you receive a letter from the HRA, contact an experienced attorney, who may be able to find a solution for the case before it proceeds to the DA.

Criminal Proceedings

It’s not uncommon for people to face criminal charges if they were investigated for Medicaid fraud. You may be arrested and asked to stay in jail until you’re able to see a judge, which can take upwards of 24 hours. You may be facing criminal charges like possession of stolen property, welfare fraud, felony or grand larceny.

Even if the District Attorney’s office has already contacted you regarding your criminal charges, it’s still possible to negotiate a lighter sentence or avoid incarceration completely. An experienced Medicaid fraud attorney will negotiate on your behalf in order to get the best settlement possible.

Consequences of Medicaid Fraud

Criminal consequences of Medicaid fraud include time in prison, losing professional licenses or deportation. Even if you are not facing criminal charges, there are other consequences that you should know about. You may have to pay for the healthcare you or your family received when you were not actually eligible for Medicaid benefits, and these monetary charges may include interest. It’s also possible that a lien will be placed against your property or that your paychecks will be garnished.

If you’re the victim of a Medicaid fraud case, contact our New York Medicaid fraud attorneys today.

by Leonard on Spodek Law Group
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