How our expert understanding of Medicaid rules and regulations put a quick end to a fraud investigation.
Sally received a letter from the Investigation, Revenue and Enforcement Administration. An investigator wanted her to bring tax returns and bank statements to an “interview.” The letter told her to bring her financial records to the Bureau of Fraud Investigation at 375 Pearl Street, 22nd Floor, New York, NY 10038.
Sally was very worried because her bank statements showed a large deposit – more than $40,000 – that was inconsistent with the very low income she listed on her Medicaid application.
The $40,000 was also reported as “income” on her tax returns. But she did not report it as income when she recertified that she was eligible for Medicaid benefits.
Sally knew that failing to report income on a Medicaid recertification is a serious crime. She was ready to admit her guilt and ask the investigator to go easy on her.
Fortunately, she called us first.
After talking with Sally, we learned that she took the money out of her IRA because she was facing foreclosure and needed the money to save her home.
She was in luck. While the money was considered “income” for tax purposes, it was not considered income for Medicaid purposes.
Under New York Medicaid rules, a one-time withdrawal from your IRA is considered a liquidation of an asset. Withdrawals from retirement plans are only considered income if they are made on a regular basis over time.
This is just one of the many complicated rules that most people – including most lawyers – do not know.
We went to see the investigator with an IRA statement showing that this was a one-time withdrawal. The investigator literally apologized to Sally for causing unnecessary anxiety.
How should you respond to a letter from the Bureau of Fraud Investigation? First, educate yourself. Click here to download our free guide called How to Survive a Medicaid Fraud Investigation. You will learn from our experience in hundreds of Medicaid fraud investigations.
Then call us at (212) 601-2728. A experienced Medicaid fraud defense lawyer will take the time to help you understand why you are being investigated and how you can protect yourself.
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Medicaid fraud cases are often won (or lost) at the investigation stage, Before you talk to investigators, educate yourself by downloading a free copy of our special report.