How to Respond to a Bureau of Fraud Investigation Letter

If you received a letter from the NYC Bureau of Fraud Investigation, then you are the target of a Medicaid fraud investigation.  The investigator already has evidence suggesting that you were not eligible for Medicaid benefits.  They are not contacting you to help you.  They are contacting you to determine whether to refer your case to the District Attorney for criminal prosecution.
 
Here is the good news.  The investigator has not yet made a final decision in your case.  You still have a chance to avoid criminal charges.  In fact, many cases are resolved with no criminal charges.  How you respond to the investigator is critical.

Your first step should be to consult with an experienced Medicaid fraud lawyer.  Your lawyer can help you figure out why you are being investigated, what defenses you have, and how to respond to the investigator.

Most Medicaid fraud investigations begin because the investigator has identified one or more of the following issues:

• Your name appears on a deed to real estate
• Your name appears on a title to one or more cars
• You failed to disclose that someone in your household has an income
• You received a raise or a new job with a higher income
• Your children go to private school
• Your employer reported that your income is higher than you disclosed to Medicaid
• You moved outside New York City and did not report your address change
• You have bank accounts, stocks, bonds, 401K or investment accounts
• You or someone in your household works for a New York City agency

​This is not a complete list.  An experienced Medicaid fraud lawyer will go over your situation in detail to understand why the investigator is targeting you and how to build your defenses.  You lawyer can also talk directly to the investigators.

The Bureau of Fraud Investigation letter will ask you to come in for an “interview” and to bring along your financial records such as tax returns, bank statements, and pay stubs.

If you go in for the “interview” alone, you will be placed in a small, windowless room with two investigators – the type of room you see the police use for interrogations on television.  The two investigators will copy all of your records.  Then they will close the door and ask you detailed questions about your employment, income, work, family, and household expenses.

You do not have to go through this alone.  In fact, if you retain a Medicaid fraud lawyer to represent you, then you may not have to answer any of the investigator’s questions at all.

Your attorney will contact the investigator for you.  He will meet with the investigators and go over their concerns.  Your attorney will help you to decide whether to cooperate with the investigators and negotiate a settlement, or whether to assert your right to remain silent.  In many cases, an experienced Medicaid fraud attorney can negotiate a financial settlement with the investigators that avoids any criminal charges, even if you lied on your Medicaid application or re-certifications.

​​John Howley, Esq. has successfully represented clients in hundreds of Medicaid fraud investigations and has more than 27 years of experience.  To schedule a free and confidential consultation with Mr. Howley, call him today at (212) 601-2728.