If you are contacted by investigators at the Medicaid Fraud Control Unit, the Office of Medicaid Inspector General (OMIG), or the HRA Bureau of Investigation, you need to speak with an experienced Medicaid fraud defense lawyer immediately.
Medicaid auditors and investigators do not conduct random audits or interviews. By contacting you, they are signaling that you are the target of a Medicaid fraud investigation. You are at risk of facing serious criminal charges. You should not try to handle this on your own.
How do you find the best Medicaid fraud defense lawyer to protect your rights? Focus on three qualifications.
Criminal Defense Experience
There is no such thing as a "routine" Medicaid audit or investigation. By the time you are contacted by investigators or receive a subpoena, the investigators have completed most of their investigation. They already believe that you have committed Medicaid fraud. Now they are trying to gather evidence to prove their case beyond a reasonable doubt.
Medicaid fraud audits and investigations are like cancers. Your chances of success are much greater if you detect and treat the problem at its earliest stages, before any criminal charges are filed. Waiting until you are formally charged with a crime before hiring a criminal defense attorney makes about as much sense as delaying a visit to the oncologist until you have reached stage four cancer.
Knowledge of Medicaid Rules and Regulations
Many good criminal defense lawyers are generalists. They use their trial skills and knowledge of criminal procedure to defend clients accused of all sorts of crimes, from assault to securities fraud to drunk driving to possession of narcotics.
You need a specialist. Your lawyer needs to combine criminal defense experience with an in-depth understanding of complex Medicaid rules and regulations that are constantly changing. In addition, your lawyer must have a background in healthcare, including the ability to read and understand patient charts.
Familiarity with Investigative Agencies
Medicaid fraud is investigated and prosecuted by a number of different government agencies. In New York, these include the Attorney General's Medicaid Fraud Control Unit, the Department of Health's Office of the Medicaid Inspector General (OMIG), and the Human Resources Administration's Bureau of Fraud Investigation.
Each of these agencies has its own policies and procedures for conducting an investigation, negotiating a resolution, and deciding whether or not criminal charges should be filed. How you approach a Medicaid fraud audit or investigation will depend on which agency is involved. Your lawyer should have experience with the specific agency involved in your case.
Begin with a Confidential Consultation
You can schedule a consultation with an experienced Medicaid fraud defense attorney by calling John Howley, Esq. at (212) 601-2728.
Mr. Howley has more than 25 years of experience representing pharmaceutical and biotech companies, hospitals, physician practice groups, individual healthcare professionals, and Medicaid beneficiaries. He has received the Gideon Champion of Justice Award from the New York State Association of Criminal Defense Lawyers, the Medal for Excellence in Advocacy from the American College of Trial Lawyers, and the Thurgood Marshall Award from the New York City Bar Association.
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.