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If you received a letter from the New York City Department of Social Services Investigation Revenue and Enforcement Administration Bureau of Fraud Investigations with the address 151 West Broadway, New York, you should be aware that you are a target of a Health Insurance fraud investigations and you may be facing serious legal consequences. You should know what triggered the investigation and the best ways to resolve this situation.
Most people who live in New York City heard about investigations of public benefits fraud but not too many people know the details and which agencies conduct these investigations. Unlike the popular belief, it is not the police but the New York City Department of Social Services Bureau of Fraud Investigations that is responsible for most public benefits fraud in NYC. The Bureau of Fraud Investigations (BFI) is the division within the NYC Human Resources Administration that is primarily charged with investigating and referring for criminal prosecution and litigation enforcement all cases of suspected Medicaid, Food Stamps, and Welfare fraud. Each year the BFI investigates thousands of leads, mostly Medicaid Fraud and snap fraud and refers hundreds of these cases for further legal action.
The Bureau of Fraud Investigations has two offices, one is at 151 W. Broadway, New York, NY, and the other is at 250 Church Street, New York, NY. The office at 151 West Broadway is only handling medicaid fraud cases as of 2016. This includes straight Medicaid cases as well as Family Health Plus and other health care programs covered by the Medicaid program.
Most Medicaid fraud investigations are triggered because of the recipient’s financial ineligibility to receive these benefits or, put in simple terms, because the household income exceeds the limit set by the Medicaid program. The rules require every applicant as well as every recipient who renews the Medicaid application once a year to disclose all sorts of household income, which includes the spousal income, employment income, financial assistance people may be receiving from others, etc. If you work and your income is too high to qualify for Medicaid but you don’t disclose it on your application, you are committing fraud. If you are married, you need to disclose your spouse’s income even if your spouse does not live with you. Many of our client have this problem. Even if you are not married but have children together with your partner, you may be required to report the partner’s income to Human Resources Administration.
Unreported income is the most common source of Bureau of Fraud Investigations inquires.
Another common type of a case is residency. You are not allowed to receive any public benefits in New York City unless you live in one of the five NYC boroughs.
Lastly, you can’t qualify for Medicaid if you receive health insurance from your employment.
One thing to remember when you are under any investigation is that you don’t have to speak with the investigator. In fact, anything you tell the investigator will be used against you. Most people do not realize that by the time they receive the investigation letter, all the information requested in it is already in the investigator’s possession. They don’t call you in in order to discuss the case with you but in reality, the only reason the investigators want to speak with you is because their protocols require them to take your statements, which can them be used against you if you are prosecuted or if your cases goes to civil court.
The best thing you can do if you receive an investigation letter from the BFI 151 West Broadway office is call an experienced NYC Medicaid Fraud lawyer.
There are many lawyers on the Internet who claim that they handle Medicaid fraud cases, making promises and giving advice. Many lawyers have online reviews, but how do you know if they are real? How do you know which lawyer is the best one for you? We recommend not making a decision as important as hiring a lawyer for a case that could be criminal just based on the lawyer’s Internet presentations. You should be prepared to do your own research, which starts with interviewing the lawyers you are thinking of hiring. We invite you to explore our website and our Medicaid Fraud YouTube Channel for the great educational information about HRA fraud investigations we make available to the public.
We have handled literally hundreds upon hundreds of public benefits fraud cases in New York City and build a solid track record of success. If you are under investigation for Medicaid or snap fraud by the Bureau of Fraud Investigations, call us today to set up an immediate consultation.
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