How to Respond to a Medicaid Fraud Letter from the HRA Bureau of Fraud Investigation

The HRA Bureau of Fraud Investigation sends out thousands of letters every year asking people to come in for an “interview” with Medicaid fraud investigators.  The “interviews” are conducted at three locations:  250 Livingston Street in Brooklyn, 151 West Broadway in Manhattan, and 250 Church Street in Manhattan.

If you received a letter asking you to come in for an “interview,” it means that you are the target of a Medicaid fraud investigation.  What you do next will have serious consequences.

Why do Medicaid fraud investigators want to “interview” me?

You may be called in for an interview by the Bureau of Fraud Investigation for any number of reasons.  The most common reasons are:

• you failed to report all your income
• you failed to report the income of someone who lives with you
• your income changed 
• you have car or mortgage payments that seem high for your income
• your employer offers health insurance benefits
• you receive unemployment, SSI disability, or other government benefits 
• your address changed
• you moved out of New York City

What do the Medicaid fraud investigators know about me?

You would be surprised and maybe even shocked to find out how much the Medicaid fraud investigators already know about you.  Using sophisticated data matches and data analytics, the Bureau of Fraud Investigation has matched you and everyone who lives with you against credit reports, car registration records, car loans, property and mortgage records, marriage and birth records, employment records, bank records, and other government databases.

By the time the investigators contact you, they have already obtained payroll records from your employer, they have been to your home to see who lives there, they have taken pictures of your home and the people who live with you, and they have spoken with your neighbors and employer.

The “interview” with Medicaid fraud investigators is not the beginning of the investigation.  It is the beginning of the end of the investigation.  Anything you say during the “interview” can and will be used against you.

What will happen if I refuse to meet with the Medicaid fraud investigators?

If you fail to show up for the “interview,” the HRA may close your case and stop your benefits.  

The Bureau of Fraud Investigation will also send your case to the lawyers for legal action.  The investigators may refer your case to the District Attorney for criminal prosecution.  The usual charges are Welfare Fraud and Grand Larceny, which are felonies.  The government’s lawyers may also file a civil lawsuit to force you to pay back tens of thousands of dollars in Medicaid benefits.

What will happen if my case is referred to the District Attorney?  

If your case is referred to the District Attorney, then you will be arrested, handcuffed, fingerprinted, and held in a jail cell while detectives run a “rap sheet” to find out if you have any prior convictions.  Then you will be brought before a judge for an arraignment on serious criminal charges.  The judge will decide whether to make you post bail or release you on your own recognizance.

If you are found guilty of Medicaid fraud, the penalties are severe;

• you could go to jail
• you could be ordered to pay fines and court costs
• you could be ordered to pay back tens of thousands of dollars in benefits
• you could be prevented from getting any government benefits in the future
• you could lose a real estate, accounting, medical, law, or other license
• you could be deported if you are not a citizen

How can I protect myself?

The best way to protect yourself in a Medicaid fraud investigation is to consult with an experienced Medicaid fraud lawyer immediately.  Talk to a lawyer before you speak with the investigators.

​Your lawyer will review your tax returns and other financial records.  He will talk with you about your particular circumstances.  He will identify the problem areas and help you develop explanations or defenses.

Most importantly, your lawyer can meet with the investigators to find out why they are looking at you, what they already know, and whether they are willing to negotiate a settlement that will avoid any civil lawsuits or criminal charges.  In most cases, our clients never have to meet with the investigators or answer any questions.  We can negotiate with the investigators for you.

Start with a Free and Confidential Consultation

You need to deal with the investigator’s letter right away.  Start with a free and confidential consultation with a Medicaid fraud defense lawyer.  We will review your situation and help you understand your options.  If you choose to retain us, our fees are reasonable and we offer payment plans.

Do not delay.  Do not wait for detectives to show up at your door to arrest you.  Call our office today at (212) 601-2728 to speak with an experienced Medicaid fraud defense lawyer.