Potential Criminal Penalties for Medicaid Fraud

“Will I go to jail?” This is the number one question most people ask. The answer is, I don’t know, but none of my Medicaid fraud clients I represented in criminal courts (and I think we’re talking close to 50) went to jail.

So, what happens if you’re prosecuted for Medicaid fraud in New York criminal court?

First, let’s draw a distinction between two types of cases. There are cases where the evidence is so strong and damning that there is no real defense and there are cases that are defendable.

If your case could be defended, every effort should be taken to do so. You should not plead guilty if you are not guilty, period/

Even if your case is not defendable, there are still things that a lawyer can do to minimize your criminal exposure. If you are criminal defendant, be aware of attorneys who simply “plead you out”, meaning surrender without a fight.

So, what can you face if you’re convicted of Medicaid fraud?

Of course, the worst possible thing is jail time. Whether you go to jail for Medicaid fraud depends on a few things, including whether you have previous criminal history, how big the fraud was, whether any restitution was paid back, who the judge and the prosecutor are.

If you’ve never been arrested before and the circumstances of your case are not particularly egregious, chances are you won’t go to jail. So, the most serious outcome in many cases is having a criminal record.

Virtually all Medicaid fraud cases charged in New York courts are felonies. You can expect to be charged with Grand Larceny and Welfare fraud. A guilty plea to one of these charges results in a permanent criminal record. We can convince the DA and the judge to allow the client to plead to a reduced Misdemeanor charge. Sometimes we can even negotiate a plea bargain that will allow the client to avoid a criminal conviction and criminal record. It all depends on the case.

If you can afford to pay restitution, your chances of a favorable outcome are much better.

If you plead guilty, you can be sentenced to jail, probation, fine, conditional discharge, community service, or time served. If jail is not an option, and we can avoid probation, you will be sentenced to a conditional discharge, fine, or community service.

Being convicted of a crime has permanent negative consequences. Read on to learn more.