Every week, Medicaid recipients receive letters from the Bureau of Fraud Investigation at the NYC Human Resources Administration. The letters ask you to come in for an "interview" with a Medicaid fraud investigator. They also ask you to bring your tax returns and other documents.
Most people think the investigator wants your tax returns to verify your income. That is not the primary reason. The fact is, the investigator already has your income records. Long before you received that letter, the investigator asked your current and former employers for your payroll records. The investigator already knows how much you were paid.
The investigator wants your tax returns to get other information that will help them prove you committed fraud. Here is some of the information the investigator wants to see on your tax returns:
Your Address: New York City has the most generous Medicaid program, much more generous than New Jersey, Long Island, or Westchester. But only New York City residents are eligible for NYC Medicaid benefits. If you used a New York City address to obtain Medicaid benefits, but the address on your tax returns is outside the City, you could face serious criminal charges for fraud. You need to call an experienced Medicaid fraud attorney before you meet with the investigator or turn over any documents.
Your Marital Status: If you claimed that you were single or separated on your Medicaid application, but your tax returns were filed jointly with your spouse, you have a serious problem. Better call an experienced Medicaid fraud attorney before you see the investigator or turn over any documents.
Your Deductions: If you own a home, you probably deduct the mortgage interest you paid last year on your tax returns. There is nothing wrong with that. In fact, you may own a home and receive Medicaid if your income is low enough to qualify for benefits. The problem is when your mortgage interest deduction is suspiciously high. For example, if you claimed on your Medicaid application that you earned less than $25,000 per year, but your tax returns show that you claimed $15,000 in mortgage interest payments, the investigator will suspect that you had another source of income or financial support.
Unreported Income and Financial Support: Most people think they cannot be accused of fraud if they submitted their recent pay stubs when they applied for Medicaid. This is not true. You are required to disclose all income and financial support on your Medicaid application - including income that may not appear on your pay stubs. This is a very complicated issue. For example, if you took a lump sum payment from your IRA or 401-k, that is not considered income for purposes of Medicaid. But if you took the same amount of money from your IRA or 401-k in monthly installments, that may be considered income. Do not guess. Get advice from an expert.
These are just a few of the issues that can get you into serious trouble in a Medicaid fraud investigation. Before you meet with the investigator or turn over any documents, click here to download a free copy of our Special Report, "5 Deadly Mistakes in Medicaid Fraud Investigations."
To arrange a confidential consultation with an experienced Medicaid fraud attorney, call The Howley Law Firm today at (212) 601-2728.
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.