Allegations of Medicaid recipient fraud are common in New York City along with the rest of the United States, in no small part because whistleblowers can receive financial compensation if their tip turns out to be accurate. If you believe you’re being investigated for Medicaid recipient fraud or you’re currently dealing with a fraud charge, it’s in your best interest to contact a New York City criminal defense attorney who can help you get the best result.
What Happens with a Medicaid Recipient Fraud Case?
New York has a fraud investigation department that handles cases of potential Medicaid fraud. There are a few steps to any Medicaid fraud case.
There could be many reasons for why the department would choose to investigate you. They may have received a tip from one of those aforementioned whistleblowers, or they may have gotten ahold of information that conflicts with something in your original Medicaid application, such as proof of income that’s higher than the amount you listed.
In the first stage of the case, the fraud department will gather evidence against you. It may even send investigators to monitor you during the day. If you know about the potential Medicaid fraud charges at this time, it’s a good idea to get in touch with a lawyer already. A lawyer can advise you on what to do and ensure that any investigators follow the law.
The next stage of the case will be when the fraud department notifies you of a potential case of Medicaid fraud, usually with a letter that it mails to you. The letter will ask you to come talk to the fraud department and bring in certain documents, which will vary depending on the case. The documents requested can give you some indication of what evidence the fraud department has compiled against you.
After the meeting date, whether you attend or not, the fraud department will decide how to proceed with your case. It may come to a settlement agreement with you, or it could send the case over to the district attorney for prosecution.
How Can You Be Punished for Medicaid Fraud?
Since Medicaid is a program for people with low incomes, it’s considered a type of welfare, and that means in New York City, Medicaid fraud is filed under the broader category of welfare fraud, which has five degrees, the least severe being a class A misdemeanor and the most severe being a class B felony. The degree of your welfare fraud depends on how much you obtained in Medicaid benefits through the fraud.
Every case is different, and the circumstances of your case will determine what penalties you can receive. Any degree of welfare fraud has the possibility of time in jail and financial penalties. You could also end up disqualified from ever receiving Medicaid benefits again if you’re found guilty.
Although jailtime is possible with Medicaid fraud, it’s rare and probably won’t happen unless you fraudulently obtained a very high amount of benefits or have several prior offenses. A fine or restitution is much more likely. A lawyer can help you negotiate the best deal to potentially avoid jailtime and get a lower fine amount.
How Can You Defend Yourself Against Charges of Medicaid Fraud?
One of the biggest mistakes people make when they’re charged with Medicaid recipient fraud is going in without figuring out their defense first. The fraud department loves this, and their goal is for you to come in, answer everything they ask and give them all the documents they requested. If you do that, you may voluntarily give them all the evidence they need against you.
Your defense starts the moment you learn there’s a case being built against you. You and your lawyer should go over the information you provided in your Medicaid application and see if any of it is no longer accurate. It’s your responsibility to keep that information updated with any life changes, such as a marriage or a new job.
If you’ve received a letter from the fraud department, you and your lawyer can use their requested documents to get an idea of the case being built against you. Your lawyer can then look for potential issues with the case and advise you on how to handle the situation. They can also accompany you to the meeting, tell you when you shouldn’t answer a question and represent you if the district attorney gets the case.
Our New York City law firm is full of experienced criminal defense lawyers who know how to handle charges of Medicaid recipient fraud. We can analyze your case, help you build your defense strategy and either try to get the charges dropped or negotiate a favorable deal for you.
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