Each year, thousands of NYC residents are investigated by NYC HRA for public benefits fraud. An investigation dealing with Medicaid recipient fraud or Food Stamp fraud begins when a target letter is mailed to you via first class mail or is hand-delivered to you. The letter may state that it is from the Human Resource Administration, Department of Social Services, and the letter may state that is from the Investigation Revenue and Enforcement Administration, Bureau of Fraud Investigation. Regardless of where or who it is from, it is important not to ignore this letter.

The Human Resource Administration (HRA) is an organization that provides assistance and benefits to over 3 million New Yorkers. This assistance or benefit appears in the form of food stamps, Medicaid, home care, child support enforcement, and many other programs. The Bureau of Fraud Investigation’s purpose is to investigate fraud and the abuse of the HRA programs.

The Investigation Revenue and Enforcement Administration also investigate welfare and Medicaid fraud. The investigators here apply a two-prong method in detecting fraud in social service programs. Firstly, the investigators may detect fraud prior to the applicant receiving any benefits. Secondly, the investigators may detect fraud during the period in which the recipient utilizes social services or renews their application.

Target letters, like the one you’ve received, is sent out in large numbers every year. By the time you’ve received your letter an investigation into your finances, your application, or renewal is well underway. It is important to mention that the investigators are not just looking at paper documents in their investigation. It is highly probably that the investigator has been to your house and taken pictures of your car, home, spoken to your employer, and spoken to your neighbors. In short, the investigator already has all the information and most of the documents listed on your target letter and the real reason behind sending you that letter is not to learn something new about your household financial situation and financial resources but to get you to make statements to the investigators. If you speak with the investigator, you will likely admit facts that can be used against you if the investigation is moved on to the District Attorney’s  Office for criminal prosecution.

It is easier to understand Medicaid fraud on a spectrum. On the one end of the spectrum you’ve disclosed everything you’re supposed to and have been found eligible. On the other end of the spectrum, you’ve lied about your income or resources or assets, and so technically speaking, you have committed fraud in order to obtain a services from a public benefits program. This is how the Bureau of Fraud Investigations is looking at this situation.  However, often times, you fall somewhere in this spectrum. Where you fall in this spectrum will determine your options when facing an investigation.

It is important to seek legal counsel once you’ve received this target letter. You should never speak with the investigator without speaking to a competent NYC Medicaid fraud lawyer such as the one you will find in our firm.  In fact, most people don’t realize that they don’t even have to speak with investigators. An experienced attorney will be able to determine where you fall in this spectrum and form a defense strategy for you. For example, an attorney can help you avoid civil charges, reduce the claim amount you owe, and more importantly, avoid criminal charges.

A dedicated attorney will take the time to understand the circumstances surrounding the investigation. We have many dedicated years defending individuals from Medicaid fraud investigations. Our NYC Medicaid fraud lawyers have represented hundreds of clients facing the NYC Bureau of Fraud Investigations. We have established a great success rate with NYC Medicaid Fraud cases. We take the time and great sensitivity towards our clients and fight to obtain the best possible resolution for our clients. If you have any questions about the NYC Bureau of Fraud Investigations or Medicaid Fraud, or would like to schedule a consultation with one of our attorneys, please call our office at (212)-577-6677 today.