Defensible cases and difficult ones
There are two kinds of cases. In some, the evidence is so strong that there's no real defense. Others can be defended.
If your case can be defended, every effort should be made to defend it. You should not plead guilty if you're not guilty, period.
Even when a case can't be won outright, a lawyer can still do a lot to reduce your criminal exposure. Be wary of attorneys who simply "plead you out" without a fight.
Will I go to jail?
Whether you go to jail for Medicaid fraud depends on several things: whether you have a criminal history, how large the fraud was, whether restitution has been paid, and who the judge and prosecutor are.
If you've never been arrested and the facts aren't especially egregious, jail is less likely. In many cases, the most serious consequence is a criminal record.
What you can be charged with
Virtually all Medicaid fraud cases charged in New York courts are felonies. Expect charges such as grand larceny and welfare fraud. A guilty plea to one of these charges results in a permanent criminal record.
Depending on the case, it may be possible to convince the DA and the judge to accept a plea to a reduced misdemeanor charge, or even a plea bargain that avoids a criminal conviction and record altogether. If you can afford to pay restitution, your chances of a favorable outcome are much better.
Possible sentences
If you plead guilty, you can be sentenced to jail, probation, a fine, a conditional discharge, community service or time served. If jail is off the table and probation can be avoided, the sentence is usually a conditional discharge, a fine or community service.
A criminal conviction has permanent consequences beyond the sentence, including for non-citizens and licensed professionals.
Common questions
Is Medicaid fraud a felony in New York?
Usually, yes. Medicaid fraud cases in New York courts are typically charged as felonies such as grand larceny and welfare fraud. Depending on the case, charges can sometimes be reduced to a misdemeanor or resolved without a criminal conviction.
Will I go to jail for Medicaid fraud?
It depends on your criminal history, the amount involved, whether restitution was paid, and the judge and prosecutor. First-time defendants in cases that aren't especially egregious are less likely to go to jail.