Steps followed during a Human Resource Administration (HRA) investigation on a Medicaid Fraud Case What happens from when you are identified for possible Medicaid Fraud up to the case closure? Find out here...

The following guide will provide you with a detailed yet brief overview of a Human Resource Administration fraud investigation by the BFI (Bureau of Fraud Investigation).

Step one

Your case is targeted for a Medicaid fraud investigation by Human Resources Administration investigators.

Step two

The BFI will send a payroll inquiry form asking for certified copies of payroll information to your employer.

Step three

HRA agents make a field visit to your place of work, home or any other place they might get leads or reliable information crucial in their investigation.

Step four

A thorough investigation is conducted into your assets and income during the time of application including all the supporting documents sent together with your application.

Step five

Investigators from Human Resources Administration retrieve financial records such as credit card statements, bank statements, Federal and New York state Taxes, and of course the payroll for the Medicaid, benefit recipient.

Step six

An investigator from Human Resources Administration conducts an extensive New York record check. This includes Hack licenses, DCA licenses, DBA’s businesses, liens, cars, real estate records, and so much more.

Step seven

A claim detail report is made with details of the benefits paid out for both you and your household’s behalf right from the initial receipt date.

Step eight

A target letter hand delivered by HRA agent or sent to you via first class mail.

Step nine

The date and the time of interview are scheduled for you. During the time of the initial interview or subsequent interviews, you can end up making incriminatory statements and whatever you say may be used against you in future. You, therefore, need a Medicaid fraud lawyer to represent you to avoid such scenarios.

Step ten

There are basically three scenarios depending on how the case progresses: A criminal case may be filed by the local DA’s (District Attorney) office. A civil lawsuit may also be brought by the New York Corporate Counsel or an administrative resolution be arrived at without finding any fault and restitution.

Remember, if you are a target of such a fraud investigation, talk to us at Spodek Law Group PC to avoid implicating yourself. Get free consultation from us today. Call (212) 300-5196 NOW.