Do Not Ignore a Letter from the HRA Bureau of Fraud Investigation
A letter from the HRA Bureau of Fraud Investigation must be taken seriously. While the vast majority of investigations are settled or dismissed, a significant number result in very serious criminal charges.
If the investigator determines that you lied on your application or re-certifications for Medicaid benefits, then your case may be referred to the District Attorney for criminal prosecution. The possible charges include Welfare Fraud and Grand Larceny.
If convicted, you could be sentenced to up to 15 years in prison. The possible sentence depends on how much Medicaid paid for your benefits.
If Medicaid paid more than $3,000 for your benefits, then you could be charged with Grand Larceny in the Third Degree. That is a class “D” felony and could result in a prison sentence of up to seven years.
If Medicaid paid more than $50,000 for your benefits, then you could be charged with Grand Larceny in the Second Degree. That is a class “C” felony and could result in a prison sentence of up to fifteen years.
Many people assume that Medicaid did not spend much money on their insurance because they did not see a doctor very often. This is not a correct assumption.
Medicaid pays a premium each month to a private insurance company that provides your health insurance. That is why your Medicaid card has the name of a private insurance company on it, such as Healthfirst, HealthPlus, MetroPlus, or UnitedHealthcare. Whether or not you actually used the health insurance, Medicaid paid a premium to that company every month.
The premiums are expensive. For a single person, the Medicaid premiums are between $350 and $500 per month, depending on your age and the years you were covered. For a family of four, the premiums can be more than $1,500 per month. In addition, Medicaid pays a surcharge for certain procedures such as surgery or the delivery of a child in the hospital.
Here’s the bottom line: If you had Medicaid benefits for at least one year, then Medicaid paid at least $3,000 for your benefits. If the investigator refers your case to the District Attorney, you will be charged with felonies that could result in a prison sentence. You could also be fined and ordered to pay back all of the benefits you received.
Do not take any chances. If you received a letter from an investigator at the HRA Bureau of Fraud Investigation, you should consult with a lawyer immediately to protect your rights. As noted above, most cases can be settled by simply paying back some benefits even if you were not 100% truthful on your application and re-certifications. Getting an experienced Medicaid fraud lawyer on your side is the first step in avoiding a catastrophe.
John Howley, Esq. has successfully defended hundreds of clients in investigations by the HRA Bureau of Fraud Investigation. Call him today at (212) 601-2728 to schedule a free and confidential consultation.