Medicaid fraud investigations are often resolved by negotiating a settlement agreement with the investigator. In many cases, an experienced Medicaid fraud lawyer is able to avoid criminal charges and civil lawsuits, even when the client is technically guilty of Medicaid fraud.
But a large number of investigations result in criminal prosecutions. This can result in restitution orders, fines, probation, and even prison sentences. In addition, a conviction means a criminal record that will make it difficult for you to obtain employment in the future.
The possible penalties and consequences for Medicaid fraud are:
Restitution Orders. If you are found guilty of Medicaid fraud, you may be required to make restitution by paying back benefits for any time period when you were not eligible. The restitution may be part of a settlement with the investigator, or it may be the result of a court case. In either event, an experienced Medicaid fraud lawyer can save you money by negotiating the best possible restitution agreement.
Civil Judgments. The Bureau of Fraud Investigation has the authority to refer your case for civil litigation. This means that a lawsuit will be brought against you. The lawsuit can result in a judgment requiring you to pay money back to Medicaid. It can also harm your credit score because the lawsuit and judgment will show up on your credit reports.
Liens and Garnishment of Wages. If you fail to pay a civil judgment, the government may place a lien on your home, garnish your wages, freeze your bank accounts, and take other action to collect the money from you. You should consult with a lawyer as early in the process as possible to avoid these collection efforts.
Disqualification from Medicaid. A finding that you committed Medicaid fraud can result in the loss of Family Health Plus or Medicaid benefits. You may also be disqualified from receiving such benefits in the future.
Criminal Prosecution. The Bureau of Fraud Investigation may refer your case to the District Attorney for criminal prosecution. You will be asked to report to the District Attorney's office where you will be handcuffed and processed by a detective. The processing includes having your fingerprints and mugshot taken. Depending on how busy the detectives are, you could spend the night in jail.
Fines, Prison, and Probation. If convicted of Medicaid fraud, the punishment often includes a restitution order, a monetary fine, and mandatory court fees amounting to tens of thousands of dollars. In very serious cases of Medicaid fraud, you can be sentenced to prison and/or probation.
How to Protect Your Rights
The investigator has asked you to come in for an "interview" because he or she already believes that you are guilty of Medicaid fraud. Anything you say to the investigator may be used against you in civil litigation or a criminal prosecution.
The best way to protect your rights and avoid terrible consequences is to consult with an experienced Medicaid fraud lawyer as soon as possible. After reviewing your particular situation, your lawyer may be able to convince the investigator that you did, in fact, qualify for Family Health Plus or Medicaid benefits.
Even if the investigator determines that you were not eligible for benefits, your lawyer can often negotiate a settlement agreement that avoids any lawsuits, arrests, or criminal prosecutions. Your lawyer may also be able to negotiate a settlement that reduces the amount of restitution and allows you to pay in installments with no penalties or interest.
To schedule a free and confidential consultation with an experienced Medicaid fraud lawyer, call John Howley, Esq. at (212) 601-2728 or complete the request form on this page.