Medicaid fraud in the United States is a serious crime. It is estimated that Medicaid fraud costs a massive $140 billion each year in the United States. That is money that comes directly out of the taxpayer’s pocket and accounts for a significant portion of the entire national budget.
For this reason, the pressure has been on state and federal governments to crack down on the waste cause by this out-of-control form of fraud. In the state of New York, Medicaid fraud investigations are handled by the Human Resources Administration, which has been given broad latitude and a hefty budget to go after the worst cases of Medicaid fraud in the state. If you find yourself in the sites of Medicaid fraud investigators, it is imperative that you contact a competent law firm as quickly as possible. Medicaid fraud cases are often extremely complex. You need someone on your side with the knowledge, skill and experience to ensure that your case has the best possible outcome.
If you receive a letter from the Human Resources Administration, you’re under investigation
If you live in the state of New York and you receive a letter from the Human Resource Administration, make no mistake, you are under suspicion of having committed Medicaid fraud. Although these letters are often worded in banal-sounding language, once the letter is sent, it is a strong indication that you are already under investigation by an agent, and they have likely already spent a good deal of time amassing evidence against you. In short, if you are summoned to a so-called interview with the Human Resource Administration, one of its investigators strongly believes that you have committed fraud.
You are not required to go to the interview
It is important to know that, should you receive a letter requesting that you show up for an interview, you are not legally required to do so. You should instead immediately contact a competent lawyer and have them handle any interaction with the investigators.
There are many resources available on why you should never talk to the police without a lawyer present. In the case of talking to Medicaid fraud investigators, it is no different. There are three main reasons why you should not talk to fraud investigators or any other people in authority once you have been targeted for investigation in Medicaid fraud. Remember, once you receive a letter from the Human Resource Administration, no matter how nicely it’s worded, you are under investigation for fraud, and an agent does believe that you have committed a serious crime.
Let’s look at why you should not talk to the investigator or police without a competent lawyer present.
- They are deliberately trying to trap you. The investigators for the HRA are trained professionals who already believe that you have committed a crime. They will use tricks to get you to contradict yourself and admit things that you otherwise may not have admitted to. They will use everything you say against you and, because you are not under arrest, they are not required to inform you that the real purpose of the meeting is to gather self-incriminating information.
- Talking to investigators never helps you. In certain situations it may become necessary to talk to investigators. But these situations should be handled by your lawyer, who has thousands of hours of experience dealing with the process. If you are getting requests for interviews with investigators, they have found evidence against you already. Engaging with them, without the help of an attorney, has no upside potential at all but many serious risks.
- You can’t beat investigators at their own game. HRA investigators are highly trained professionals working on teams that have hundreds of years of collective experience. There is no way you can outsmart them. The best you can do is to put on a good defense.
The stakes are high
Medicaid fraud is a serious crime. In New York State, the maximum penalties may be up to 25 years in prison. Most cases, especially those involving recipients, are much less serious and involve mitigating factors, such as innocent mistakes being made on forms or the inability of the recipient to understand the complex maze of laws that governs their eligibility for benefits. However, Medicaid fraud is still a serious crime that can result in hefty fines and jail time.
If you have been formally accused of Medicaid fraud or find yourself under investigation, it is absolutely crucial that you hire a good lawyer who specializes in Medicaid fraud. Medicaid fraud cases can often be successfully negotiated and jail time avoided. This is particularly true of those who do not have extensive criminal histories.