In New York, fraud of various kinds can lead to criminal charges and conviction.  Such occurrences can have a severely detrimental impact on your professional and personal well-being, and so the following tips on avoidance may prove quite helpful.

The first step is to retain the best defense attorney you can find.  When your freedom is on the line, you don’t want to trust your defense to just anyone.  With a powerful legal defense, you stand a far better chance of evading or overcoming the charges brought against you.

Next, you can share the relevant details of your case with your attorney so that he can assert your rights to the greatest extent possible.

Specifically, if you are charged with fraud, you can help to provide evidence that you did not knowingly deceive anyone.  By definition, fraud involves willful deceit.  Without evidence of this mental state, you will not be convicted on fraud charges.

Typical evidence of a criminal mental state in fraud cases includes evidence that you profited from misconduct.  If there is no proof that you received a benefit from your misconduct, you may still be guilty of fraud but the prosecution will have a much harder time in proving that.

In other words, this is not to say that guilt is not possible in the absence of proof of profit.  Fraud and wrongful gain are two distinct entities; one does not require the other.  However, the presence of one in the absence of the other does make the first one harder to prove.

In a standard scenario, a New York finance executive is suspected of fraudulently misleading investors.  Without hard proof that the executive profited, the court is likely to lack anything tangible that would conclusively indicate guilt.

Wrongful profit does suggest impropriety even where misconduct is hard to see on paper.  In a recent case, a financial corporation was technically within the reporting guidelines set forth by the Federal Accounting Standards Advisory Board’s Generally Accepted Accounting Principles.  Nonetheless, charges of fraud have been considered.  Even so, since no hard proof of wrongful gain has been uncovered, the corporation in question may successfully escape prosecution.

As a note of caution, attempting to retroactively conceal wrongful profit may not be the best route to take.  This can be viewed by prosecutors as a form of money laundering, a serious crime that carries severe penalties of its own.

Instead, if you think you may have committed some type of fraud or even if you are already facing charges, you’ll want to contact an expert New York defense attorney as soon as you can.  With a highly qualified professional handling your case, you have the best chance possible of avoiding damaging prosecution.

Legal negotiations can often have a remarkable impact on pending prosecution: a persuasive defense attorney will be able to get your charges significantly reduced or even eliminated.

If you or someone you know may be struggling with a fraud issue in New York, call our New York City criminal lawyers for professional legal advice today.

“Qui Tam pro domino rege quam pro si ipso in hac parte sequitur,”

Is this French? Spanish? No, it is Latin and it means, “Who sues on behalf of the King, as well as for Himself.”

In the modern legal language, Qui Tam is simply a civil litigation that is brought forth by a private citizen, also known as the whistle blower, who is aware of fraud committed against the government through the False Claims Act. The False Claims Act provides financial incentives to whistleblowers to retain private attorneys and come forward to prosecute these allegations of fraud.

In many Qui Tam cases, lawyers representing the whistleblowers are retained on a contingency basis to ease the whistleblowers financially. This means that the lawyer will receive up to 1/3 of what the whistleblowers are rewarded with.

The fun of prosecuting a case…

Because the claim is brought forth by a citizen and not by the government, the whistleblower must be aware of all the provisions necessary to prosecute the case.

Whistleblowers would not only have to retain a skillful lawyer specializing in the expertise of white-collar crimes, but they will probably have to recruit their own witnesses and hire their own investigators.

Some of the more popular cases brought forth by Qui Tam are cases concerning:

• The preparation of false records or statements in order to get a fraudulent claim by the government, such as (Medicaid and Medicare frauds)
• The holding of government property with the intention to defraud or conceal from the government (Tax Evasion)
• The creation and delivering of a false or fraudulent receipt to the government for its property (Medicaid fraud, Tax Fraud, Section 8 Fraud etc.)

More specifically, New York State or Federal sponsored companies, non-for-profits and charities etc. that are conducting fraudulent activities are usually the companies targeted in Qui Tam cases.

If you are currently aware of a government-sponsored company committing fraudulent activities, call our office at (212) 577-6677 for professional legal advice.

An inaccurate entry in a medical record is not only detrimental to the credibility of the chart but it is also a violation of licensing accreditation standards. It is common for errors and omissions within patients’ medical chart in practice, but hospital administrators, the Office of Professional Misconduct (OPMC), Office of Professional Discipline (OPD) or the New York State Board of Education, do not overlook such incidents.

Depending on the seriousness of the case at hand, improper documentation can lead to the lost of one’s job, administrative hearings for license suspension, and/or criminal liabilities.

If the hospital believes that a healthcare provider is falsifying or altering medical records such as predating or backdating his/her signature on the medical chart when in fact on that date, the provider was not present on that day, the hospital can turn the provider in to the New York Sate Department of Health (DOH), and the OPMC for professional misconduct, or the New York City District Attorney’s Office to face criminal penalties.

It is important for health care professionals to know that a medical record should never be altered once a lawsuit has been instituted (in both criminal and civil lawsuits). The provider should be cautious when making new additions to the record once treatment of the patient in question has been completed, since such changes can be interpreted as an alteration to medical record.

Inaccurate documentation of medical records is common in practice, but it is also one of the reasons why health care professionals are so frequently penalized in administrative and sometimes criminal proceedings. When handling matters related to the OPMC, OPD, DOH or the NYS Board of Education, the provider should seek an experienced medical license or criminal defense attorney because he/she might say something that is self-incriminating without knowing.

At Joseph Potashnik & Associates, we have a panel of some of the most skilled New York State criminal defense and medical license defense attorneys specializing in such areas of professional misconduct and healthcare fraud.

If you are being investigated or arrested for falsifying or altering medical records in New York, then call our office at (212) 577-6677 to get professional legal advice.

Worker’s compensation fraud is a type of insurance fraud which focuses on selling and receiving unauthorized and non-admitted worker’s compensation insurance coverage.

How one may be charged with worker’s compensation fraud in New York City?

Worker’s compensation fraud cases are generally investigated by the Office of the Inspector General’s Investigation Unit. There are three categories of people who are investigated and prosecuted for worker’s compensation fraud: employees, employers and health care providers.

Employees

Employees who knowingly and intentionally lie about an injury for the purpose of obtaining, or help another obtain workers’ compensation benefits to which they are not originally entitled to are committing worker’s compensation fraud.

But the Office of the Inspector General will not treat every single misrepresentation on the employee’s claim as fraud, unless the misrepresentation is significant to the claimed injury and to the determination of workers’ compensation benefits.

Employers

An employer who knowingly lies about their employees in order to obtain workers ’ compensation coverage for a premium price that is less than what the employer would otherwise be obligated to pay is committing worker’s compensation fraud.

Health Care Providers

A health care provider who knowingly submits a material misrepresentation about medical treatment to the Worker’s Compensation Board or to the insurance carrier for payment is committing worker’s compensation fraud.

Misrepresentations identified as fraud by the Office of Inspector General includes:

• Billing for exams of patients who were never examined
• Billing for treatment of patients who were never treated
• Duplicate billing in order to receive payment from different insurance carriers for the same medical treatment
• Billing follow-up exams as “first exams” to receive greater payment from the carrier
• Bundling unnecessary medical services with necessary services
• Misrepresenting the true code for the medical treatment provided

In many cases, clients first learn that they are the target of a worker’s compensation fraud investigation when they are contacted by the Office of Inspector General. In such cases, one should seek legal advice before speaking to them.

If you are recently being investigated or charged for worker’s compensation fraud in New York, then call our office at (212) 577-6677 to get professional legal assistance.

Within every six months prior to the expiration date of the physician’s registration period, the physician must report updated information for inclusion in the Department of Health Physician Profile and as a condition of registration renewal under Article 131 of the State Education Law.

When compiling the physician profiles, the Department of Health (DOH) collects information from various sources such as the National Practitioner Data Bank (NPDB), the New York State licensing boards and the American Medical Association.

In addition, the DOH sends a survey to individual physicians six months prior to the expiration date of their physician’s registration period, asking them to give thirteen items of mandatory information and six items of optional information.

Some of the mandatory items that the physicians must supply within the survey are:

• Medicare and/or Medicaid provider enrollment;
• any criminal convictions within the most recent ten years;
• any non-confidential professional disciplinary action taken within the most recent ten years
• any current limitation of the license to a specified area;
• any loss or involuntary restriction of hospital privilege or failure to renew professional privileges at hospitals within the last ten years. Reasons may be related to the quality of patient care, restriction of hospital privileges due to pending disciplinary case, and removal of medical staff membership; and
• any medical malpractice court judgments and arbitration awards, and all malpractice settlements within the most recent ten years.

What sanctions might a physician face for lying on a DOH survey?

Physicians, who have recently faced a criminal conviction, malpractice court judgment, or any other professional misconduct, may feel compelled to lie on their DOH surveys. Most of the time, it is due to the fact that the DOH must disclose to the public the updated professional profile. While as harmful as that is to a professional’s career, it is wise to not lie on the DOH survey.

A physician who knowingly lies under the profiling law is guilty of professional misconduct and may be subject to investigation or discipline by the Office of Professional Medical Misconduct (OPMC).

A physician who fails to disclose mandatory profile information or to update it may also be investigated or disciplined by the OPMC.

If you are a health care professional who is currently being investigated or facing sanctions by the OPMC, then call our office at (212) 577-6677 to get professional legal assistance.

Elder abuse is the intentional acts by a caregiver or a “trusted” individual that lead to, or may lead to, harm of a vulnerable elder. Police and prosecutors define elder abuse as any crime or violation involving a victim who is sixty years of age or older.  There are many forms of elder abuse, but the most prevalent and the most prosecuted form would be financial abuse.

Financial Abuse is financial exploitation of the elderly and it is shown through indications of misappropriations of an elder person’s money, property, or resources by a trusted individual or institution.  The alleged financial exploiter is usually identified as a close family member, relative, a friend, or a care provider.

In many instances, the alleged individual would have would have misused the trust gained by the elderly and may have persuaded the elderly to sign a durable power of attorney, which enables the individual to gain control of the elderly person’s income and assets for personal gain.

Within each county, an elder abuse unit is created to address the needs and concerns of older crime victims within that jurisdiction. The Elder Abuse Unit in New York usually works with the New York City Police Department, Adult Protective Services Agency (APS), the New York City Department for the Aging, medical professional and social services agencies, to led aggressive investigations and prosecutions of elder abuse crimes.

There is no specific definition of financial abuse/financial exploitation of an elderly person within the New York Penal Law. Instead, the defendant may face charges of Scheme to Defraud, Forgery, and Falsifying Records, for financial exploitation of an elderly person.

The investigations of Elder Abuse in New York should not be taken lightly. It is advisable for the alleged person to speak with an attorney at the onset of such investigations.

If you are recently being investigated or charged for Financial Exploitation then call our office at (212) 577-6677 to get professional legal assistance.

Anita Haines, a New York City Housing Authority (NYCHA) Community Center Director was arrested and charged with Grand Larceny in the Third Degree and Forth Degree, Criminal Possession of  Stolen Property in Third, Fourth and Fifth Degree, Official Misconduct and Petit Larceny for allegedly defrauding the NYCHA by stealing $4,775 of tenants’ fees.

Between January 2008 and April 2010, 12 tenants paid Haines a total of $4775 to rent the community center or to attend summer camp ran by NYCHA. It was alleged that Haines never reported the payments to the NYCHA and had pocketed that payments without permission or authority.

If convicted, Haines faces a maximum penalty of more than 12 years of imprisonment.

Te-Hu Tsuei, aka “Peter” a self proclaimed New York State licensed immigration attorney and sometimes an experienced immigration law paralegal, has been arrested and charged with multiple counts of Grand Larceny, Scheme to Defraud, Unauthorized Practice of Law and violating various subsections of the Immigration Assistance Services Law.

Between November 2007 and May 2009, Tsuei allegedly defrauded two Chinese immigrants by falsely introducing himself as a licensed immigration attorney or an experienced immigration law paralegal and assuring them that they can qualify for a U-Visa when they are not.

The victims claimed that Tsuei charged them over $6,000 each for processing their applications. However, Tsuei was neither a New York State licensed attorney nor was he authorized by the Federal Board of Immigration Appeals to provide legal services. By May 2009, Tsuei’s “law office” in New York City was shut down and the victims were unable to reach him after losing $6000.

Tsuei’s case remains ongoing.

If convicted, Tsuei faces a maximum penalty of more than 12 years in prison.

Spiros Moshopoulos, Tommy Skiada, and Daniella Radulescu, New York City residents, were charged with a total of 714 counts of fraud; each of the defendants were variously charged with grand larceny, criminal possession of stolen property, money laundering, promoting gambling, tampering with a witness, conspiracy and scheme to defraud. It was alleged that the three defendants operated a bingo hall in Queens, New York and illegally siphoned funds from charity organizations.

The bingo hall allegedly used various inactive charities under the name of Romanian Orthodox Church of Sts. Constantine & Helen to generate funding and charities by conducting various bingo games. But under Moshopoulos’, Skiada’s and Radulescu’s conspiracy, the funding generated through the bingo games were purportedly used to enrich their own pockets. An approximate total of $830,000 charitable funding was allegedly stolen by the three defendants.

If convicted, each of the three defendants faces more 10 years in prison.

James Smyth, a New York City Deputy Sheriff, was arrested and charged with Grand Larceny, falsifying business records and petit larceny for allegedly embezzling more than $13,000 from the New York City Deputy Sheriffs’’ Association while serving as the union’s treasurer.

Between February 2008 and January 2009, Smyth allegedly wrote eight unauthorized union checks to himself from three of the union accounts. In efforts to conceal his embezzlement of approximately $13,000, Smyth purportedly created false records of expenditures for the union. Investigation revealed that some of expenditures Smyth listed were never acquired by the union.

If convicted, Smyth faces a maximum penalty of more than 10 years in prison. The defendant is currently suspended from his duties without pay.