If you received a letter from the Bureau of Fraud Investigation at 151 West Broadway in Manhattan, then you are a target of a Medicaid fraud investigation. You may be facing very serious legal consequences that could include criminal charges. Anything you say to the investigators can and will be used against you.
Before you do anything else, you should consult with an experienced Medicaid fraud lawyer to understand your options. John Howley, Esq. has more than 25 years of experience representing hundreds of individuals, just like you, before fraud investigators. To schedule a free and confidential consultation with Mr. Howley, call him at 212-601-2728 before you talk to the investigators.
In the meantime, here is some basic information about the Bureau of Fraud Investigation and their “interview” process at 151 West Broadway.
What is the HRA Bureau of Fraud Investigation at 151 West Broadway?
The Bureau of Fraud Investigation is part of the NYC Human Resources Administration (HRA). It is responsible for investigating Medicaid fraud in New York City. The investigators at 151 West Broadway are responsible for investigating thousands of cases of Medicaid fraud every year. They are very experienced and aggressive investigators.
Why am I being investigated by the Bureau of Fraud Investigation?
Most Medicaid fraud investigations begin for one or more of the following reasons: (1) your household income is too high; (2) you do not live permanently in New York City; or (3) you can obtain health insurance from your employer.
Income Too High: Most Medicaid fraud investigations begin because the investigators discovered that your total household income is too high. The Medicaid rules require that you “re-certify” for benefits every year. In that re-certification, you must disclose all of your income and all of the income of anyone else who lives in the same household with you. This includes employment income, spousal income, financial assistance you receive from family and friends, unemployment benefits, and income from a business or sideline such as selling on eBay or Amazon.com. If you are married, then you must also disclose all of your spouse’s income, even if you do not live together.
Residence Outside New York City: New York City has one of the most generous Medicaid programs in the entire country. As a result, some people are tempted to keep their New York City Medicaid benefits even if they move outside the City. This is a major problem. You are not allowed to collect Medicaid benefits from New York City unless you live in one of the five boroughs. Your permanent residence (usually the residence that you list on your tax returns and other tax documents) is what counts.
Employer-Provided Health Insurance: You are not allowed to receive Medicaid benefits if you could receive health insurance from your employer. It does not matter if your employer requires you to pay part of the health insurance premiums or if the premiums are too expensive. If your employer offers health insurance, then you and your family do not qualify for Medicaid benefits.
What does the Medicaid fraud investigator know about me?
The investigator may know more about you than you do. By the time you receive their letter, the investigator has already visited your home and taken pictures. If you or anyone who lives with you owns a car or home, the investigator already has the car registration and property documents showing how much the car or home are worth, how much they cost, and what the monthly payments are. If you or someone who lives with you works for someone else, the investigator already has all of the payroll records.
What will happen if I was not qualified for benefits?
If the Medicaid fraud investigators can prove that you intentionally lied on your re-certifications, then they will send your case to the District Attorney for criminal prosecution. The District Attorney usually brings felony charges that can result in prison sentences of up to five years. On the other hand, if the investigators cannot prove that you acted intentionally, or if you simply made mistakes, then they will offer you a chance to settle the case by paying back benefits you received when you were not eligible.
How should I respond to a letter from the Bureau of Fraud Investigation?
You should immediately seek help from a Medicaid fraud lawyer. If you go to 151 West Broadway for an “interview” with the investigators, you will be placed in a small, windowless room with two investigators. They will close the door. Then, one of the investigators will cross-examine you while the other one takes notes. They are not there to help you. They are there to gather evidence. Anything you say to the investigators can and will be used against you.
How can an experienced Medicaid fraud lawyer help me?
The process begins with a free and confidential consultation. John Howley, Esq. will personally review your unique situation. He will help you understand the issues, develop a strategy, and decide how best to respond to the investigators. If you decide to retain Mr. Howley, then he will meet personally with the investigators in an effort to negotiate a resolution and avoid criminal charges. In most cases, you will never have to speak with the investigators or answer any questions.
How do I get started?
Call John Howley, Esq. at 212-601-2728 to schedule your free and confidential consultation.