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JOHN HOWLEY, ESQ.
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How Two Clients Responded to the Bureau of Fraud Investigation with Different Results

9/6/2016

 
Two of my clients had exactly the same problem at the Bureau of Fraud Investigation, but with very different results.

One client, I’ll call her Sarah (not her real name), was working part time when she first applied for Medicaid.  Her income was low, so she qualified for benefits.  A few months later, she was hired full time.  She did not notify Medicaid that her income had increased.  Worse, when she received re-certification forms, Sarah sent them back every year without telling Medicaid that her income had increased.

Three years later, Sarah received a letter from the Bureau of Fraud Investigation.  The investigators wanted Sarah to come in for an “interview,” and they wanted to see her tax returns and bank statements.  Sarah immediately came to my office for a free and confidential consultation.  

After going through Sarah’s tax returns and bank statements, I went to meet with the investigators.  Sarah did not come with me, so the investigators could not ask her any questions.  I did not bring any documents.  Before saying or giving anything to the investigators, I wanted them to tell me what they already knew.

We were able to settle the investigation by having Sarah pay back some of the benefits she received after her income increased.  The investigators agreed to a small monthly payment with no penalties and no interest.

Another client, I’ll call her Linda (not her real name), was not so lucky.  Linda also applied for Medicaid when she was working part time, and she continued receiving benefits after she became a full-time employee.  But when Linda received the letter from the Bureau of Fraud Investigation, she went to see the investigators by herself.

Two investigators put Linda in a small room with no windows.  They demanded to see her tax returns and bank statements.  Then they interrogated her for an hour.  When they were done, the investigators sent Linda’s case to the District Attorney for criminal prosecution.  Linda did not call me until after she was arrested and charged with a felony for stealing Medicaid benefits.

If you received a letter from the Bureau of Fraud Investigation, you should consult with a lawyer to protect your rights.  The initial consultation is free and confidential.

Schedule a consultation today by calling our law offices at (212) 601-2728.

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BREAKING NEWS

NY Prosecutors Get Tough on Medicaid Fraud
More investigations are resulting in criminal prosecutions, and more prosecutors are charging the most serious felonies.  This means a criminal record and possible jail time.  Click here to read more....


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  • About John Howley
  • Healthcare Fraud
    • Medicare & Medicaid Fraud Whistleblower Rewards
    • Healthcare Whistleblower Rewards
    • Types of Medicare & Medicaid Fraud >
      • Ambulance Fraud
      • Beneficiary Not Eligible
      • Dental Fraud
      • False Price Reports
      • Kickbacks
      • Medical Documentation Problems
      • Prescription Fraud
      • No Medical Necessity
      • Off-Label Marketing
      • Self-Referrals or Stark Law Violations
      • Services Not Provided
      • Unlicensed or Unqualified Provider
      • Upcoding, Unbundling, and Double-Billing
  • Contact Us