What to Do if You Become a Subject of a Medicaid Fraud Investigation in NY

Many of my clients recently received Medicaid Fraud Investigation letter from Human Resources Administration, Bureau of Fraud Investigation. If you do not qualify for the Medicaid Benefit and you may have made false statements about the your income, your marital status, your living arrangements, or in other words your actions were not in accordance with legal requirements of Medicaid Benefits, you will receive a Fraud investigation letter telling you that you are under investigation for Medicaid Fraud and that you need to appear for an Interview with an Investigator.

medicaid fraud investigation

What to Do if You Become a Subject of a Medicaid Fraud Investigation in NY

Upon receipt of such letter, it is imperative that you contact an attorney IMMEDIATELY. Remember, in order to qualify for the most Medicaid programs in New York City, you have to be New York City Resident and you have to be financially eligible. Very often such cases have criminal consequences. Make sure to protect yourself and your family from being criminally charged and imprisoned for something that could be resolved by a professional attorney.

When you apply for Medicaid, you fill out an application, and you are expected to disclose all sources of income, not just from your work, but also from any other source. It may be the rental income that you have, or any gifts that you receive or any dividends from a business. Moreover, if your income or marital status changes, you are required to report all changes immediately to the Medicaid Office and not wait until your Medicaid certification expires.

If you are already a Medicaid recipient and a discrepancy with the facts of your case turn up, you will become a target of a Medicaid Fraud Investigation. If you have been a target of an Investigation, your case would be assigned to an Investigator with a Bureau of Fraud Investigation (BFI).

There are several steps or actions that they can conduct:

  • Investigation can take from weeks to months
  • Investigators gather all information they can about you
  • They may contact your employers
  • They may contact your neighbors
  • They may contact your tenants
  • They may follow you
  • They may take photos of your business, your home, and your cars
  • They may contact the DMV; verify your address and your car registration, They may use specialized search to look up property purchase and mortgage information.
  • They may use specialized search to look up property purchase and mortgage information.

At some point, the investigator will call you in for an Interview. Many people don’t know their legal rights, and in this case, how to act, if you receive a letter from Investigator. You may feel like being under pressure, you may start talk with investigator to clarify the situation, but this is the wrong way to do. Everything that you say to an Investigator, every statement that you make, the Investigator may use against you and you can be prosecuted. Besides you can assume that the Investigator has a lot of information about you. However they still want you to come in and hope to get some self-incriminating statements or get some harder to obtain documents, such as your tax returns, or any other missing pieces to build their case against you.

Important thing is, do not speak with them, you don’t have an obligation to speak with them directly. In this case you need professional help from an attorney, who has better experience and knows such cases, how to handle and protect your legal rights and, the most important thing how to avoid prosecution and all of the criminal consequences.

For example: One of our clients, who received such letter, is a very well established person. He owns a house, where he lives with his family, two cars and runs his own business. Attorney Inna Fershteyn managed to completely close the case without any financial or legal consequences for the client. Another example is when a family was investigated for Medicaid Fraud and during the interview it turned out that this is their second investigation, which is considered to be a second degree offense and can definitely become a criminal case. Attorney Inna Fershteyn settled the case so that the clients only had to pay a fine and avoided any criminal prosecutions and therefore kept their record clean.

When you call Law Office of Inna Fershteyn and Associates we will contact Investigator to shut down any communications between investigator and client, we will meet with Investigators to work out deal, and bring case to settlement before case is referred to district attorney’s office.

If you are a target of a public benefits fraud investigation, do not take any chances and call the lawyer. Your case may be relatively easy to resolve. Do not make it worse by speaking with an Investigator. You have no duty to speak with them. Protect yourself and call us today. We will answer your questions and show you what can be done.