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The BEST LAWYER ANYONE COULD ASK FOR!!! Todd changed our lives! He’s not JUST a lawyer representing us for a case. Todd and his office have become Family. When we entered his office in August of 2022, we entered with such anxiety, uncertainty, and so much stress. Honestly we were very lost. My husband and I felt alone. How could a lawyer who didn’t know us, know our family, know our background represents us, When this could change our lives for the next 5-7years that my husband was facing in Federal jail. By the time our free consultation was over with Todd, we left his office at ease. All our questions were answered and we had a sense of relief.

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New York Medicaid Audit Lawyer

Navigating Medicaid Audits: Protecting Your Rights and Reputation

In today’s complex world of healthcare, government-funded programs such as Medicaid are under more scrutiny than ever. With budget deficits looming for the federal government and funding being tighter than ever, government officials are determined to make sure the money associated with these programs is used in the proper manner. Because of these increasing regulations and concerns, many healthcare providers have found themselves the subject of Medicaid audits by government investigators. Unfortunately, even though many of the healthcare providers have done nothing wrong, many find themselves under investigation for possible medicaid fraud. If you find yourself in this situation and don’t know where to turn next, let us here at the law firm of Spodek Law Group assist you with this pressing legal matter.

Who Conducts Audits?

If a healthcare provider is being audited due to suspicion of fraud, numerous agencies may be involved in the investigation. Among these are the FBI, U.S. Attorney General’s Office, Department of Health and Human Services, Office of the Inspector General, and many others. Due to federal and state laws based on contractual provisions, doctors and other healthcare providers are subject to having their records reviewed by investigators from these agencies at any given moment. In addition, any provider who has entered into a contractual agreement to provide services to Medicaid patients is obligated to let the government review their records. However, despite these obligations, there are still many avenues one can take if they object to their records being confiscated and reviewed. That’s why you need the services of Spodek Law Group, since we are very familiar with the process and will work to ensure your rights to privacy and confidentiality are protected during any audits that may be conducted.

Factors Leading to an Audit

Unfortunately, Medicaid providers deal with many factors that may ultimately result in an audit being conducted regarding their activities. Some of the most common factors that may result in an audit include:

Falsifying records to justify unnecessary medical procedures
Billing for services that were never provided
Filing claims for fake services
Illegal kickbacks
Misrepresentation of procedures that were performed
Because investigators are always on the lookout for potential fraud, many healthcare providers fail to realize just how much they are at risk of being audited and subsequently accused of Medicaid fraud. Due to the complexity of Medicaid rules and regulations, many providers make honest mistakes when it comes to coding and billing for procedures they have performed. As a result, investigators will often make up their minds early on that fraud has been committed, when in fact nothing but honest mistakes by honest people have occurred. It is in these situations that you need strong legal representation, such as that which is delivered by Spodek Law Group. Having many years of experience handling these cases, we know how government investigators think. Because of this, we can immediately go to work protecting our clients from unfounded accusations and threats of fines and imprisonment. When you retain Spodek Law Group as your legal counsel, you can be assured of getting the best legal protection possible.

George FernandezGeorge Fernandez
14:16 30 Apr 24
Excellent 10 out of 10, Helped resolve my case. Jeremy explained everything and made everything easy to understand.
21:33 24 Apr 24
If you are looking for a lawyer that listens, is aggressive where needed, and holds his word above all else, Todd is the best pick. I had hired multiple attorneys prior to hiring the Spodek Group for a white collar case. The first thing that stood out to me was the cost, as anyone going through the process and dealing with the system, money was tight at that time - especially after hiring and firing multiple lawyers. The cost was not as high as others which was definitely a plus. Todd's intake process was also unlike other attorneys. He took the time to actually listen. He cared. He was trying to put himself in my shoes while I was explaining the situation to him and he really took the time to understand the whole situation. Other lawyers will give you 15 mins and send you a retainer agreement. Not Todd, I think he spent almost two hours with me as I was explaining everything.Not only was he great during the onboarding process, he was supportive and very informative through the entire plea process and eventually sentencing. After hiring him, I asked if I should hire a prison consultant, he told me to save my money as he would do everything they would. He was right and held up to his word. Later on I would hear from others that went with the prison consultants that they were a waste of money - I am glad I listened to Todd!When it came time for sentencing, two days prior to sentencing, the prosecutor tried increasing my proposed prison time by almost double - apparently a normal move. Todd and his team worked with me non-stop through the weekend prior to sentencing to ensure that I was not given additional prison time. Again, he took the time to listen and came up with a strategy to explain the case with great detail.Unfortunately, I did plead guilty as that was my best option. Todd and his whole team wrote up nearly 300 pages of a summary of what happened and why I should not be given prison time. If I breakdown the amount I spent with Todd versus the amount of work that I saw being done, I am shocked I was not charged four times as much. The other benefit was, a lot of criminal defense lawyers were just a single attorney with a paralegal or two. Todd had a team of people that I dealt with (5-7 people that I interacted with), but he was ALWAYS accessible. It would never take him more than an hour to reply unless he was in court.I was sentenced to prison and I was emotionally distraught. Todd and his team did whatever they could even after sentencing to make sure I was alright. He personally stayed in touch with my family to ensure I was doing alright and offered support to them. Most lawyers would consider the job complete at sentencing, not Todd.After prison, Todd still spent time with me to make sure I was on the right track and avoiding any potential risks in the future. He has also been giving advice on how to navigate probation etc and has not been looking at the clock for billing.Although I wish I had never been arrested in the first place, I am glad I had Todd and his team in my corner. Without them I likely would have had to spend a lot more time in prison than I did.Thank you, Todd, and the entire Spodek Law team, for helping turn what was a nightmare into a manageable situation!
Yelva Saint-PreuxYelva Saint-Preux
19:26 19 Apr 24
I am immensely grateful to the entire team at Spodek Law Group for their unwavering dedication and exceptional expertise throughout my case. From our initial consultation to the final resolution, their professionalism and tireless advocacy made all the difference. Their strategic approach and attention to detail instilled confidence in me every step of the way.Thanks to their hard work and commitment, we achieved a truly favorable outcome that exceeded my expectations. Not only did they navigate the complexities of my case with precision, but they also provided invaluable support and guidance during what was undoubtedly a challenging time. I cannot recommend Spodek Law Group highly enough, especially attorneys Todd Spodek and Claire Banks; they are beacons of excellence in the legal profession.YSP.
Katherine SunKatherine Sun
18:08 18 Apr 24
my lawyer is Alex Zhik. Efficient, patient and professional
Nun yaNun ya
17:48 18 Apr 24
Todd, Ralph and Alex are amazing. Helped my husband get from a double digit number with multiple charges to a single digit, by the time I blink he will be out. They very professional and help with all your needs. They dealt with my anxiety and worry very well and they understand that your family member needs to get home as soon as possible.
Keisha ParrisKeisha Parris
20:45 15 Mar 24
Believe every single review here about Alex Z!! From our initial consultation, it was evident that Alex possessed a profound understanding of criminal law and a fierce dedication to his clients rights. Throughout the entirety of my case, Alex exhibited unparalleled professionalism and unwavering commitment. What sets Alex apart is not only his legal expertise but also his genuine compassion for his clients. He took the time to thoroughly explain my case, alleviating any concerns I had along the way. His exact words were “I’m not worried about it”. His unwavering support and guidance were invaluable throughout the entire process. I am immensely grateful for Alex's exceptional legal representation and wholeheartedly recommend his services to anyone in need of a skilled criminal defense attorney. Alex Z is not just a lawyer; he is a beacon of hope for those navigating the complexities of the legal system. If you find yourself in need of a dedicated and competent legal advocate, look no further than Alex Z.
Taïko BeautyTaïko Beauty
16:26 15 Mar 24
I don’t know where to start, I can write a novel about this firm, but one thing I will say is that having my best interest was their main priority since the beginning of my case which was back in Winter 2019. Miss Claire Banks, one of the best Attorneys in the firm represented me very well and was very professional, respectful, and truthful. Not once did she leave me in the dark, in fact she presented all options and routes that could possibly be considered for my case and she reinsured me that no matter what I decided to do, her and the team will have my back and that’s exactly what happened. Not only will I be liberated from this case, also, I will enjoy my freedom and continue to be a mother to my first born son and will have no restrictions with accomplishing my goals in life. Now that’s what I call victory!! I thank the Lord, My mother, Claire, and the Spodek team for standing by me and fighting with me. Words can’t describe how grateful I am to have the opportunity to work with this team. I’m very satisfied, very pleased with their performance, their hard work, and their diligence.Thank you team!
K MarK Mar
01:37 25 Jan 24
I recently had Spodek Law Group represent me for a legal matter in NYC and I am thoroughly impressed with their services.Alex Zhik secured the best possible outcome for my case.It was a seamless journey from the initial consultation to the resolution of my legal matter. From the moment I spoke to Todd about my case, his enthusiasm to help was evident, setting a positive tone for the entire experience. The efficiency and professionalism displayed by the team is commendable.A particularly noteworthy aspect of their service is their user-friendly portal to upload your documents/evidence. This not only simplified the process, but showcases their commitment to streamline the client experience.Lastly, in an industry where legal fees can often be a concern, I found their pricing to be very reasonable, making needing legal assistance feel accessible and stress-free.I am grateful for their support and wouldn't hesitate to turn to them again in the future.

How Are Audits Determined?

One of the most confusing aspects of Medicaid audits is understanding the factors investigators use to determine which practices get audited and which ones do not. In our many years of handling these cases, it has always been frustrating to find out that those who are being audited often are not even aware of what is happening. By using these practices, the government is essentially taking away the rights of those they are accusing of wrongdoing. In many cases, auditing agents will subpoena bank records, review billing information, and speak with employees or patients. In extreme cases, they may even go undercover to visit your office in an attempt to get the provider to conduct illegal activities on them. If all else fails, federal agents may choose to raid the office and seize files, computers, and other information. If any of this happens to you, don’t attempt to go it alone. Contact us here at Spodek Law Group as soon as possible, so that we can work with you and ensure investigators are following the rules when doing their job. In most cases, we have found that investigators have already determined guilt prior to conducting a raid or using other investigative methods. However, we still go by the guiding principle that a person is innocent until proven guilty. Therefore, rather than stand by and let investigators do as they please, we instead force them to follow whatever rules are necessary prior to leveling any charges against you or your staff.

To Do or Not to Do?

When you find yourself the recipient of a Medicaid audit, there are many things you should and should not do in order to protect your rights and your reputation. For starters, you should contact us here at Spodek Law Group immediately. By letting investigators know from the start you have legal representation that has considerable experience in these matters, the investigators will in many cases back off briefly for fear of violating the victim’s constitutional rights. In addition to retaining us as your legal counsel, there are several things you should never do while under investigation. These can include:

Discussing the case with anyone except your attorney
Instructing patients or staff to lie to investigators
Altering any documents associated with the audit
Allowing anyone who does not have a warrant to review or confiscate records
When being the subject of a Medicaid audit, it’s always better to begin your defense as soon as possible. In almost any case, the government has a head start on you, and has spent considerable time and money in an attempt to find you guilty. Rather than sit back and let them dictate the outcome of your case, let us here at Spodek Law Group launch our own offensive. We too can gather files and records to examine, and will often do so in order to have expert witnesses examine them and reach their own conclusions. Here at Spodek Law, we believe a good offense is the key to winning these cases, and will do everything possible to make sure that’s what happens.

Contact Us Soon

If you find yourself and your practice being audited for Medicaid fraud, there is no time to waste. Investigators are determined to find you guilty, send you to prison, and get on to the next case. Fortunately, when you have us as your legal team, we won’t let that happen. Just like the government investigators, we will also examine records, speak with employees and patients, and do numerous other things on your behalf to keep your personal and professional life together during this ordeal

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