Each year in New York State, thousands of people are investigated for potential Medicaid fraud. This process can often cause serious interruptions to the lives of those being investigated. It can be a scary process, with the prospects of jail or prison time looming over the heads of everyone who is forced to comply with such investigations.
The recent uptick in Medicaid fraud investigations has been a response to a surge in Medicaid fraud, not just in the state of New York, but throughout the entire country. It is estimated that in the United States, Medicaid fraud is responsible for more than $140 billion each year in losses. This makes it a major source of losses to the healthcare system and an epidemic problem. As a result, the heat is being turned up on those who even appear as if they may be skirting the rules of the Medicaid system.
One result of this has been an explosion in the number of cases that the court systems across the country process. Unfortunately, people who had no real intention of doing anything wrong often end up caught in the wide net that is cast by these sustained governmental efforts to stomp out Medicaid fraud wherever it is found.
Regardless of whether or not you have actually committed a crime relating to Medicaid fraud, the single most important thing you can do, should you find yourself the target of a Medicaid fraud investigation, is to put yourself in contact with a qualified and experienced lawyer. Hiring the right lawyer can make the difference between prison time and having the case against you dismissed.
The Human Resources Agency investigates all cases of potential Medicaid fraud
That’s right, the same agency that handled such things as distributing food stamps and providing babies with enough food to get by is also in charge of investigating major cases of Medicaid fraud. This is almost unique among criminal investigations in New York State, as nearly all crimes are investigated by sworn law enforcement officers. However, if you are the target of a Medicaid fraud investigation, the first clue you will get that you are under watch will likely be a bureaucratic-sounding letter on disarmingly plain HRA letterhead.
Don’t let that fool you. If you have gotten a request from the Human Resources Administration to come in for an interview regarding Medicaid benefits, you are currently being investigated for serious Medicaid fraud. This means that the investigators have probably spent tens of hours and have accumulated a great deal of potential evidence against you. They know far more about you and your case than they will let on.
Furthermore, these investigators, while not sworn detectives, might as well be. They are trained in eliciting incriminating responses from suspects and have collectively spent hundreds of man-years handling thousands of fraud cases. You do not stand a chance against these professionals and should hire a lawyer at once.
Usually, you are not under any legal obligation to cooperate with these HRA investigators. Not doing so may result in charges being brought against you faster. But if you’re already under investigation and it’s reached the point where you are being solicited for an interview, the chances are high that they would have brought charges anyway. The upside to attending such an interview is virtually zero, while the risks are enormous. The only move you should consider is getting a competent lawyer on your side as soon as possible.
Don’t give the investigators or prosecutors the rope to hang you
For the same reason you should not talk to police without a lawyer, you should never talk to an HRA investigator by yourself. But if you follow this simple advice and hire a good lawyer as early in the process as possible, the chances that your case will have a favorable outcome are very good.
This is because, without self-incriminating statements and outright confessions, Medicaid fraud cases can be extremely difficult to prove. This not only means that you will have a better chance at trial and will often get a lighter sentence due to mitigating factors, it also means that prosecutors will think long and hard about wasting hundreds of man-hours and thousands of dollars taking a case to court that they will be very likely to lose in the end. This is where a good lawyer can really pay off. The mere presence of a solid attorney who specializes in cases of Medicaid fraud is often enough for a prosecutor to decide not to take the case to trial, at almost any cost. This can give rise to particularly good plea bargaining opportunities, usually involving no jail time or community service and much reduced restitution amounts.
By following these simple pieces of advice, your Medicaid fraud case can almost always be resolved in a way that doesn’t involve crushing restitution or any jail time.