The short definition
Medicaid fraud is submitting false or inaccurate information to the government to get Medicaid services, if you're a recipient, or to get paid by Medicaid, if you're a provider.
It doesn't take a big lie
Most people picture something elaborate. In practice it's simple. If you tell the Human Resources Administration (HRA) your income is lower than it really is, and you qualify for Medicaid because of that, you've made a false statement.
Leaving something out counts too. If the application asks for your entire household's income and you don't include your spouse's income, that is also a false statement, even though you never told an outright lie.
How investigations start
Most New York Medicaid fraud investigations begin when the government finds a mismatch between what's in its databases and what you said on your application. A classic example is someone who reports a low income while working on the books and paying taxes. Investigators can trace that income through payroll and tax records.
If you're being investigated for Medicaid fraud in New York, call us at (212) 577-6677 to speak with an experienced Medicaid fraud lawyer.
Common questions
Is it Medicaid fraud if I just left something off my application?
It can be. Leaving out required information, such as a spouse's income or a household member, is treated as a false statement even if you never wrote anything untrue.
What is the most common reason Medicaid fraud investigations start in New York?
Most start when government databases don't match the application, for example when payroll or tax records show more income than the applicant reported.