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 250 Church Street, New York, you are in the process of being investigated by the bureau for possible Health Insurance Fraud 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 have heard about investigations regarding public benefits fraud. However, most people do not know or understand the details and, which agencies conduct these investigations. Most people mistakenly think that it is automatically a criminal investigation and think it is the police that investigate these allegations It is not the police. The investigators work for the New York City Department of Social Services Bureau of Fraud Investigations, and they are responsible for most public benefits fraud investigations in NYC. The Bureau of Fraud Investigations (BFI) is the division within the NYC Human Resources Administration. Their main focus and primary charge is to look into cases worth investigating. They investigate most cases, and also refer some of the more egregious cases for criminal prosecution and litigation enforcement. They handle all cases of suspected Medicaid, Food Stamps, and Welfare fraud. Each year the BFI investigates thousands of leads, mostly Medicaid Fraud and snap fraud. They have also referred hundreds of these cases for further legal action with the New York State Attorney General’s Office.
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. The office at 250 Church Street mostly handles food stamp cases, as ell as cases dealing with financial assistance programs—where the individual receives cash assistance.
Most Medicaid fraud investigations occur because of the recipient’s financial ineligibility to receive these benefits. Simply put, the household income exceeds the limit set by the Medicaid program—they make too much money to qualify. It is likely the individual filled out the form incorrectly, made an innocent mistake on their form and did not understand their full financial circumstance, or direct fraud. 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 sources. These sources can include the spousal income, employment income, as well as, financial assistance people may be receiving from others, etc. There are many sources of unearned income—such as spousal support. 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 clients do not understand this, and make an innocent mistake as they are filling out their application. 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. The partner does not have to be married to you to be financially responsible for the children he/she has with you.
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. This means, you cannot live on long island, either Nassau or Suffolk County. Similarly, if you live in westchester County, you also do not qualify.
Lastly, you can’t qualify for Medicaid if you are able to receive health insurance from your employment. If you employer offers health insurance, you cannot apply for Medicaid. It does not matter how good or bad the offered insurance plan is. If you have an option, you cannot receive Medicaid.
What should you do when you receive an investigation letter from the Bureau of Fraud Investigations
Most importantly, when you are under any form of investigation, you do not have to speak with the investigator. The letter and the investigator cannot compel you to speak. In fact, anything you tell the investigator may or will be used against you. What you might consider benign and harmless answers, may be causing you harm and causing you to admit fault. Speaking the truth in this instance will not set you free. 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 250 Church Street 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. A good Medicaid fraud lawyer will request an in person consultation from you, so he/she can better understand your situation. You should be prepared to do your own research. This research starts with interviewing the lawyers you are thinking of hiring. An in person consultation also allows the lawyer to walk through the process of defense with you.
We have handled literally hundreds upon hundreds of public benefits fraud cases in New York City and have built 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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