HRA Medicaid Fraud Letters


February 18, 2015



New York has made Medicaid and public assistance fraud a top enforcement and financial priority. New York State has estimated it is losing out on hundreds of millions of dollars by providing Medicaid and food stamps to individuals that are not eligible for the benefit. In 2013, New York recovered $851 million through Medicaid fraud investigations. In New York City, public benefits such as Medicaid and food stamps are administered through the New York City Human Resources Agency (HRA).

Medicaid and other public benefit programs are meant for the truly poor and eligibility follows federal poverty guidelines. For example, a family household of three individuals must earn under $25,000 of income to qualify. Total assets have to be evaluated including investments and real estate and will affect eligibility.

Lying on government forms is a felony crime. Intentionally accepting public benefits that you are aware you are ineligible for is a felony crime. Under reporting income and withholding assets on a government form is considered Filing a False Instrument, which a serious felony in New York State. Accepting public benefits in excess of $1,000 is considered Grand Larceny and depending on the amount obtained could lead to higher degrees of crime; for example stealing $1,000 is considered an E Felony and stealing more than $50,000 is a C Felony. The higher degrees correlate with more punishment and stricter sentencing options.

Of course government forms can be complicated and sometimes incorrect or incomplete information is submitted mistakenly. However, an individual under these circumstances could still face serious criminal liability and needs an attorney to make sure it is handled appropriately. Do not speak to an investigator on your own otherwise you take the risk of mistakenly admitting an intent to commit a crime.

HRA has increased its investigations into Medicaid recipients and has been sending targeted letters to certain recipients of public benefits asking them to appear for an interview and present personal financial documents such as tax returns, bank statements, marriage certificates, and automobile records. By the time someone has received this letter, HRA has done a substantial amount of investigation on the individual and suspects they are ineligible for Medicaid.

The goal of this meeting is to obtain documents that they could not get on their own to prove that you committed a crime. In order for the investigators to obtain the items listed in the letter on their own would require substantially more work and legal hurdles. It’s much easier if you just hand over the documents to them and making statements. However, by doing so you could be making an admission that could lead to your arrest and charged with a felony.

Filing a False Instrument and Grand Larceny are deportable offenses, meaning a conviction could lead to permanent removal from the United States of America. Our office has successfully represented individuals that have been targeted by HRA and prevented any immigration consequences from arising.

If you have received a letter from a fraud investigator working for HRA or any other government entity you have the right to be represented by an attorney and you should be. We have successfully negotiated settlements and prevented prosecution for clients that have contacted me early on in the process. We have also represented defendants in criminal court that spoke to investigators on their own and contacted me much later on. In those cases we sometimes worked out a favorable disposition in criminal court, however, its best to avoid an arrest. If you received a letter from a fraud investigator you need to contact an experienced attorney immediately. We are available to discuss your matter with an initial consultation and in full confidentiality.

“Ali Najmi did excellent work reducing my case to a minimum, helping me avoid jail time as well as giving me the opportunity to have another chance to live a law abiding life. I had quite a heavy case and Ali succeeded in defending me.”

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