New York City Medicaid Fraud Investigations

How to Protect Yourself from Serious Criminal Charges at the Bureau of Fraud Investigation

Every year, thousands of New Yorkers are investigated for Medicaid fraud because they were not 100% honest on their annual re-certification forms.  Some failed to disclose a promotion or a new job, others failed to disclose that their household income increased, some failed to disclose that a spouse or significant other was living with them and had an income, and others failed to disclose that they moved outside the five boroughs of New York City.

Many people do not realize that failing to disclose these types of changes is a serious crime.  As a result, hundreds of people end up in handcuffs in front of a criminal court judge facing felony charges for grand larceny and welfare fraud.

Your case does not have to end this way.  When handled properly, most investigations do not result in criminal charges.  If you received a letter from the HRA Bureau of Fraud Investigation, here are a few steps that you should take immediately to protect yourself.

Step One:  Do Not Ignore the Investigator's Letter

By the time you receive the letter, the investigator has already completed most of the investigation.  The investigator already believes that you are guilty of Medicaid fraud.  If you ignore their letter, the investigator will send your case straight to the District Attorney for criminal prosecution.  Never ignore the investigator’s letter.

Step Two:  Consult with an Experienced Medicaid Fraud Lawyer

Get advice from a lawyer before you speak to the investigator.  The Medicaid rules are very complicated.  Your lawyer can analyze your situation, explain where the problems are, identify your defenses, and help you develop a strategy for avoiding criminal charges.  You can schedule a free and confidential consultation with an experienced Medicaid fraud lawyer today by calling John Howley, Esq. at (212) 601-2728.

Step Three:  Exercise Your Right to Remain Silent

The investigator wants to “interview” you for only one reason:  to develop the evidence they need to prove that you committed Medicaid fraud.  They want you to admit that you signed the re-certification knowing that the document contained false information.  They do not care about your explanations.  Once you admit that you signed a false re-certification form, they will have an open and shut case for the District Attorney.  Let your lawyer talk to the investigator instead.  In most of the hundreds of cases we have handled, our clients never had to appear for an “interview” with the investigator.

Step Four:  Be Prepared to Pay Back Benefits if You Were Not Qualified

In New York City, Medicaid pays private health insurance companies a premium every month to provide health insurance benefits to Medicaid beneficiaries.  Even if you never used the Medicaid benefits, Medicaid may have paid thousands of dollars to a private insurance company for your benefits.  If you were not qualified for Medicaid, you may be able to avoid criminal charges by agreeing to pay back the cost of those benefits for the period when you were not qualified.  An experienced Medicaid fraud lawyer can often negotiate a payment plan with no penalties or interest.  The savings are often more than enough to cover the lawyer's fee.

To schedule a free and confidential consultation with an experienced Medicaid fraud lawyer today, call John Howley Esq. at (212) 601-2728.

John Howley, Esq.
350 Fifth Avenue, 59th Floor
New York, New York 10118
(212) 601-2728

www.JohnHowleyEsq.com