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Medicaid Fraud Investigations

Medicaid Fraud Investigations

Initial Letter: If you receive Medicaid, you may receive a letter from the NYC HRA Bureau of Fraud Investigations. In the letter, you will be informed that the HRA is investigating your case. The letter will ask you to provide the Bureau with certain information, such as your tax returns, your pay stubs, and your rent receipts. And the letter will inform you of the date when you have to come in with this information to meet with the investigator. Most people get terrified at this point. 

Often, you don’t need a lawyer: Unlike a lot of other attorneys, I will tell you the truth. A lot of you do not need to hire a lawyer at this point. There are plenty of people who qualify for Medicaid and have nothing to hide from the city. An investigation may just be that – an investigation. Once you show the investigator the requested information, he or she may close the investigation and you will continue receiving your benefits. Don’t waste your money on a lawyer.

Sometimes, however, a lawyer is essential: On the other hand, there are other cases when a person was not eligible for Medicaid. This ineligibility may have been done inadvertently – your income has changed recently and you did not inform Medicaid about the change. Or you had income from a source which you did not know you had to report. Or you miscalculated or misreported your income.  In this case, Medicaid will determine the time frame during which you were not eligible for receiving the programs and will determine the amount that you owe them. If the misstatements were intentional and egregious, criminal charges may be filed.

Here is what a Medicaid Fraud lawyer does:

  1. A lawyer determines whether or not you were eligible to receive the benefits.
  2. A lawyer explains the law and the calculations to the Medicaid investigator, and often convinces the investigator that the client was eligible for the programs.
  3. A lawyer negotiates with the Medicaid investigator about the amount of money that the client owes and the timing of the repayment. 

The Law Offices of Katya Sverdlov serves clients throughout Brooklyn, Manhattan, and Queens New York.



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| Phone: 212-709-8112
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| Phone: 917-566-8151

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