New York City

By Carol McFadden

If you have applied for Medicaid in the State of New York, and particularly in New York City, and misrepresented facts regarding your income and assets on your application, beware. You may become another target of relentless and massive hunt for fraudsters.

The new initiative that started a few years ago across the state has netted thousands of Medicaid recipients who had received Medicaid fraudulently.

As a New York Medicaid Fraud defense lawyer, I receive calls weekly from people contacted by New York City Bureau of Fraud Investigation and other agencies that routinely investigate New York Medicaid fraud. As a program recipient, you may and probably will be investigated for fraud if you lie on your Medicaid application. Usually, that has to do with concealing income and assets. Virtually every person I have dealt with who had been investigated for Medicaid fraud had indicated that their income was significantly less than it really was or that they had no assets that would have disqualified them from receiving Medicaid while they in fact had such assets. I have seen people investigated for Medicaid fraud in New York who had own substantial real estate and other assets and were clearly ineligible for the program. However, I have also seen those within income eligibility guidelines at the time of their application who failed to report their changed income.

In most cases, investigators catch you before you know of any investigation at all. They build their file before you hear from them. By the time you receive a letter from an investigative agency asking you to come to their office for an “interview” and to bring along certain documentation, the investigation is practically completed. If you receive such letter, you should seek legal advice immediately before discussing anything with investigators. If you chose to go to the interview and voluntarily submit requested information, you may be confessing to having committed a crime and your case will be soon sent to the local District Attorney’s Office for criminal prosecution. Once the investigation is completed and the case is referred to another agency for criminal prosecution, it is much more difficult and expensive to salvage the situation.

At the investigative stage of the case, the most optimal resolution of is avoiding prosecution and your chances of a favorable outcome increase dramatically if you deal with the investigative agency early and in the right way, though your attorney.