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A letter from the NYC Bureau of Fraud Investigation is usually your first indication that you are under investigation for Medicaid fraud. You should respond to that letter the way you would respond to any serious criminal investigation – by getting an understanding of your legal rights before you say anything. Failing to respond properly could result in a judgment against you for tens of thousands of dollars in restitution, felony criminal charges, exclusion or disqualification from participating in the Medicaid program in the future, loss of professional licenses and, if you are not a U.S. citizen, deportation. Your case does not have to end that way. Here are some very important rights that you should exercise before talking to anyone at the Bureau of Fraud Investigation. Your Right to an Attorney You have the right to consult with an attorney, to have an attorney present whenever the investigators try to “interview” (that is, interrogate) you, and to have the attorney communicate with the investigators on your behalf. Your attorney can ask questions, get evidence from the investigator, develop your defenses, explain your side of the story, and negotiate with the investigators to avoid criminal charges. Many clients ask, “But won’t the investigator think I’m guilty if I hire an attorney?” Stop. The investigator already believes that you are guilty. The investigator already has at least some evidence to prove that you are guilty. Having an attorney shows that you are taking the investigation seriously and often makes the process easier for everyone involved – you and the investigator. Your Right to Review the Evidence Against You My first step in any Medicaid fraud investigation is to ask the investigator to provide me with certain documents. At the Bureau of Fraud Investigation, I always ask for my client’s application and re-certifications for Medicaid benefits. In most cases, the application and re-certifications were signed three, four, five or more years ago. My client should not guess. We need to know exactly what is written on the documents before we say anything to the investigators. My second step is to ask the investigator what the problems are. Sometimes the investigator is looking at one issue, while my client was concerned with a different issue. We do not want to start talking about our defenses until we know what the problems are. Your Right to Remain Silent Medicaid is not allowed to terminate your benefits just because you refuse to answer a Medicaid fraud investigator’s questions. You have the absolute right to remain silent. Whether or not you provide information to the investigator will depend on a number of factors. What evidence do they have against you already? Do they intend to refer your case to the District Attorney for criminal prosecution? Are they willing to consider a financial settlement with no criminal charges? Are their questions legitimate? Or are they asking for documents and information that you are not required to provide? If the investigator intends to refer your case for criminal prosecution, then there is no reason to give him any information. Any information you provide will be used against you. On the other hand, you may want to cooperate with the investigator if it will help settle the investigation without criminal charges. An experienced Medicaid fraud lawyer can talk directly to the investigator, protect your rights, get the evidence you need, develop a strategy, decide whether or not to cooperate with the investigation and, in most cases, negotiate a settlement that avoids criminal charges . . . even if you are guilty. The first step is an initial consultation. To schedule a free and confidential consultation with an experienced Medicaid fraud attorney, call John Howley, Esq. today at (212) 601-2728.
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John Howley, Esq.
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