Bureau of Fraud Investigation Gets Tough on Medicaid Fraud

CRIMINAL PROSECUTIONS INCREASE SINCE MAYOR DE BLASIO TOOK OFFICE

The Bureau of Fraud Investigation is sending more cases to the District Attorney's office for criminal prosecution.  This raises the stakes for anyone who receives a letter from a fraud investigator at the NYC Human Resources Administration (HRA).

Every year, thousands of individuals receive letters from fraud investigators at the HRA's Bureau of Fraud Investigation.  The letters ask you to appear for an "interview" at the offices of the Bureau of Fraud Investigation at 151 West Broadway in lower Manhattan.  The letters also usually contain a list of documents you must bring to the interview, including tax returns, bank statements, and other financial documents.

The letters are sent out when a fraud investigator has determined that you might not qualify for Medicaid or Family Health Plus benefits.

In the past, if the investigator determined that you did not qualify or Medicaid or Family Health Plus benefits, they would usually ask you to pay back the cost of those benefits.  Many times, the investigators would negotiate a no-interest payment plan, and sometimes they would reduce the amount owed based on your ability to pay.  As long as you cooperated with the investigation, you could avoid any lawsuits or criminal prosecutions.

All that has changed since Mayor de Blasio took office.  The Bureau of Fraud Investigation is now referring many of the cases directly to the District Attorney's office for criminal prosecution.  In some cases, the fraud investigator will no longer even speak with you.  They will just send your case for prosecution.  The next thing you know, detectives are at your front door asking you to turn yourself in at a police station or to speak with an Assistant District Attorney.

This is a very serious change in enforcement policy.  If convicted of a felony, you could face up to five years in prison and very heavy fines.  Even a misdemeanor conviction can result in up to one year in prison and a $1,000 fine per count.  Plus, you could be ordered to pay tens of thousands of dollars in restitution and be placed on probation for a number of years.

If you receive a letter from the Bureau of Fraud Investigation, you must not ignore it.  Call an experienced Medicaid fraud attorney immediately to understand your rights and prepare your defense.

To arrange a free and confidential initial consultation, call John Howley, Esq. at (212) 601-2728 or click here to reach our office via email.

John Howley, Esq.

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