Our New York City criminal defence firm represents New Yorkers facing Medicaid fraud, Family Health Plus fraud, or Health care fraud criminal charges.

Our clients are both Medicaid recipients as well as providers such as doctors, dentists, clinics, nursing home managers, pharmacists, home care providers, and ambullette transportation business owners who have been accused of administrative or criminal violations of any of the New York Medicaid rules.

Our New York City Medicaid fraud defense lawyers will be glad to review your case with you. Remember, when you are subject to investigation, it is always in your best interest to talk to an experienced attorney before discussing your case with investigators.

How one may be charged with Medicaid or Family Health Plus fraud in New York City

There are two categories of people who are investigated and prosecuted for Medicaid fraud: benefits recipients and providers.

If you are a recipient, you may be guilty of Medicaid fraud for the following:

  • Providing false information on the Medicaid application (lying or concealing information about income, assets, etc.)
  • Altering or forging prescriptions
  • Re-selling medicine and products obtained through the program
  • Receiving services for which you are not eligible by means of intentional misrepresentation
  • Allowing another person to use your Medicaid card to obtain services
  • Receiving and using several Medicaid Cards.

If you are a Medicaid services provider, you could be investigated for the following

  • Billing Medicaid for services that have never been provided
  • Filing claims for fake services and medical conditions
  • Filing claims for fake and staged car accidents
  • Coverage claims for non-existent illnesses
  • Filing claims for medical care coverage for staged, fraudulent auto accident injuries
  • Illegal fee sharing
  • Billing for services provided by unlicensed personnel in violation of Medicaid rules.

What to do if you are investigated for Medicaid Fraud or Family Health Plus Fraud in New York City

In many cases, clients first learn that they are the target of a Medicaid fraud investigation when they receive a letter from NYC Human Resources Administration.

Medicaid eligibility rules are clear and strict. You are not eligible to receive Medicaid or Family Health Plus in New York City unless you live in New York City. You also are inelligible if your income is too high, depending on your family size. Finally, between 2006 and 2010 you would be inelligible for Medicaid in NYC if your family assets exceeded $20,000, which includes any real property other than the primary residence.

The New York City Bureau of Fraud Investigation and the Division of Claims and Collections, both located at 250 Church Street in Manhattan, as well as other agencies routinely investigate matters related to fraudulent receiving of Medicaid benefits in New York City. Lately, there has been a substantial increase of criminal prosecutions of individuals who received health benefits illegaly.

If you receive a letter from an investigative agency asking you to come to their office for an “interview” and to bring along certain documentation, you should seek legal advice immediately before discussing anything with the investigators.

If you go to the interview and voluntarily submit requested documentation you may be implicating yourself and confessing to having committed a crime and in the event your case is referred to the local District Attorney’s Office for criminal prosecution or to the NYC Legal Department for civil litigation, any information your provide will be used against you.

If HRA decides to press charges, the case will be referred ro the District Attorney’s Office and the receipient will be indicted for several felony charges including grand larceny, Medicaid Fraud, and other charges. Many clients found out that they had been targeted only upon receiving a call from the DA’s Detective Squad instructing them to surrender to the DA’s Office and face the charges.

We have helped countless individuals investigated for Medicaid Fraud in New York. In many cases, our lawyers have been successful in preventing criminal charges to be filed in the first place! If you or someone you know is contacted by investigators in regards to Medicaid fraud, do not be part of the statistics – call us today for a confidential consultation.

What if you are a service provider

If you are a provider of Medicaid-sponsored services, you may also receive a letter or a call from an investigating agency requesting an interview or asking you to submit your files to them for examination. If this happens, call an experienced New York Medicaid fraud attorney right away.

If you are a provider investigated for fraudulent Medicaid related activities, you may receive written communication from a variety of governmental agencies from the Office of the Attorney General to the Office of Inspector General to the U.S. Government Accountability Office. On some occasions, agents may simply raid your office and seize your files and computers. When you realize that you are subject to a governmental investigation, talk to us before talking to the investigators!

If you are under investigation, the “do-it-yourself” approach is wrong. How the case in handled in the investigative stage often determines the outcome, including the likelihood of whether criminal charges are filed against you.

That is why a consultation with an attorney is absolutely critical before you discuss anything with the investigators.

Your chances of a favorable outcome increase dramatically if you begin you defense in a Medicaid fraud case or health care fraud case early – hopefully before indictment. The government has already invested considerable time and resources in gathering evidence and building the case against you. They are ahead of the game and the sooner your defense team gets involved the better your chances. You need an experienced and dedicated legal team of New York City Medicaid fraud lawyers to beat the fraud investigators at their own game.

What to expect if criminal charges are filed against you for Medicaid Fraud in New York City.

Medicaid fraud in New York City is actively investigated and prosecuted. If your case is not properly handled administratively at the early investigative stage, criminal charges are likely to be brought. You may be accused of several felonies including grand larceny, false filing, fraud, etc. You will pay restitution and fines, be banned from receiving or participating in Medicaid, have a criminal record, and may even go to prison.

New York City Medicaid criminal defense attorneys

If you have been accused of Medicaid fraud in NYC, you need the expertise and dedication of our New York City Medicaid fraud attorneys. As soon as you discover that you are under investigation for Medicaid or health care fraud, call our criminal defense attorneys immediately. If you are a health care provider, you have too much to lose if you are convicted of Medicaid fraud, and that includes your professional license.

Joseph Potashnik and his colleagues, all skilled New York City Medicaid fraud lawyers, will review your case, investigate circumstances surrounding the accusations, and do all that is possible to either dismiss or reduce the charges – or negotiate an acceptable deal.