Medicaid fraud is a crime vigorously investigated and prosecuted in New York State. It is the job of the Office of the Medicaid Inspector General to represent the interests of taxpayers, medicaid recipients, and medical providers and to go after those who abuse the medicaid program. In fact, New York State has a very active campaign to encourage the public to report claims of waste or abuse of the medicaid program http://ag.ny.gov/comments-mfcu.
What is medicaid fraud?
According to New York Penal Law §177.00, medicaid fraud is defined as the act of defrauding a health plan, by willingly providing false, inaccurate or misleading information or documents with the specific intent of receiving payment or benefits for which that person or entity would not otherwise be entitled to receive.
Is medicaid fraud a serious crime?
Yes. Medicaid fraud can be classified as a misdemeanor or felony depending greatly on the circumstances of the case. Each State has its own strict laws regarding medicaid fraud, but medicaid fraud is also a Federal crime subjecting defendants to sentencing under more severe Federal laws. The medicaid program is run both by the State and Federal government and willful and/or intentionally defrauding this program can result in State and Federal charges being brought against a defendant, concurrently.
Can I go to jail?
Yes. A charge of medicaid fraud can lead to incarceration. Therefore, it is imperative that you speak with an experienced medicaid fraud criminal lawyer as soon as possible in order to immediately implement a strategy to prevent you from facing incarceration. Among your lawyers primary objectives should be to ensure that your rights are diligently defended, so that incarceration is not an option.
Are there other penalties or legal aspects associated with medicaid fraud?
Yes. A conviction of medicaid fraud can have other negative ramifications or legal aspects, including but not limited to restitution wherein the court requires a defendant to pay back the money or value of the benefits illegally obtained. Also, if you are a patient who has been convicted of medicaid fraud you may be permanently removed from participation in the medicaid program regardless of your legitimate future need or eligibility.
If you are a doctor, healthcare provider or insurer who has been convicted of medicaid fraud your professional licenses can be revoked or suspended, and you can be permanently restricted from participating in the medicaid program, and in many cases you can be restricted from ever participating in any State or Federally funded or run benefits program.
How can a medicaid fraud criminal lawyer help my case?
If you have been accused of medicaid fraud you need to speak with a lawyer right away. Delay in consulting with an experienced criminal defense attorney can result in serious-irreparable damage to your case. If you have been charged with medicaid fraud, that means that the District Attorney and/or Attorney General has already gathered enough information to determine that the charges against you are justified. Therefore, if you have been charged with medicaid fraud you will need an attorney on your side who will immediately get engaged in your case, in order to actively pursue your defense and seek a quick disposition or dismissal of your charges.
What are possible defenses?
It is important to remember that a required element to prove fraud, is a showing that the person or entity who is accused of the fraud acted with specific and willful intent to commit the fraudulent activity. It is imperative that you openly share all details and facts regarding your case with your attorney so that he or she can begin exploring affirmative defenses or mitigating factors that will help resolve your case.
What are possible mitigating factors?
Mitigating factors in your case can be evidence or information given to the court in order to lessen the charge or reduce penalties. For example, your attorney can present supporting evidence showing that the alleged fraud was the result of mistake or inadvertent error. Other mitigating factors your lawyer can explore is evidence that shows mental incapacity, retardation or an addiction to illegal substances or alcohol that lead to you engaging in the fraudulent activity. Whatever defense best suits your case, is a strategy that you must establish with your attorney.
Charges of medicaid fraud should be taken very seriously. The State and Federal government have all of the legal resources to pursue their charges against you. If you have been accused of medicaid fraud it is critical that you have all of the legal resources available to you in order to protect your rights and best interest.
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