Senior prosecutors in New York report that more Medicaid investigations are resulting in serious criminal charges.
In the past, many Medicaid fraud investigations could be settled by paying back money to the Medicaid program. All that has changed in recent months. Investigators are sending more cases to prosecutors for criminal prosecution. And prosecutors are pursuing felony changes more often.
The increase in criminal charges is occurring across all Medicaid agencies — the HRA Bureau of Fraud Investigation, the Medicaid Fraud Control Unit, and the Office of Medicaid Inspector General.
In most cases, the deciding factor is an “interview” with investigators. Many people think they can avoid criminal charges by talking to investigators. They think that the investigator will go easy on them if they admit to making mistakes or if they try to explain their situation.
But the opposite is true. Investigators have only one objective during an interview: They are gathering evidence to prove that you are guilty. Anything you say can and will be used against you.
Once the case is referred to a prosecutor, you will face the most serious charges. One senior prosecutor said, “If we can prove a false statement or claim was made, then we will charge the most serious felonies.” That can have devastating consequences. It can lead to a criminal record, heavy fines and penalties, and lengthy prison sentences. If you are a licensed professional, it can also result in the suspension or revocation of your license and your automatic exclusion from Medicaid and other government healthcare programs for five years.
We are still able to resolve many cases with investigators without criminal charges when we are called in early enough in the process. It is therefore critical to retain a lawyer before you speak with investigators. Your best chance of avoiding criminal charges is to convince the investigators to settle any issues before your case is sent to a prosecutor.
If you have been contacted or received a letter from an investigator, you need to get legal advice and representation before you do anything else.
To schedule a consultation with an experienced Medicaid fraud defense attorney, call John Howley, Esq. at (212) 601-2728.