What Is Medicaid Fraud?

Since you’re browsing this website, you probably have an idea about Medicaid fraud. However, in my practice I’ve found that many clients (or prospective clients) have a very vague understanding of Medicaid fraud is and many don’t connect the term “fraud” to their circumstances.

Well, let’s define Medicaid fraud. In a nutshell, Medicaid fraud is submitting any false or inaccurate information to the government in order to obtain Medicaid services (if you are a Medicaid recipient) or get paid by Medicaid (if you are a Medicaid service provider).

Many people think that submitting a false statement is something complicated and big, but in reality, it’s pretty simple. Let’s say you’re a New York Medicaid recipient. You tell the HRA that your income is lower that it is and because of this you qualified for the program. That’s a false statement Medicaid fraud. What if you simply don’t disclose everything, without actually lying? For example, you’re asked to list your household income, including the income of your entire family, and you don’t include your spouse’s income. That’s also a false statement and fraud.

Most New York Medicaid fraud investigations start because the government finds some discrepancy between what they have on their databases and what applicants told them. A classic example is someone who applies for Medicaid claiming a low income while they are employed on the books (paying taxes, etc), which the investigators track down. Click here to see how Medicaid fraud cases are triggered.

If you have been investigated Medicaid fraud New York, please call our office today to speak with a very experienced NYC Medicaid fraud lawyer.