What Happens if You Are Charged with Medicaid Fraud

Medicaid fraud is a persistent issue across the country, costing state governments billions of dollars every year. It was estimated in a report by PBS that nearly one in every ten Medicaid payments are in some way erroneous and potentially fraudulent. But what exactly is it, and what are you supposed to do if you get charged with it?

Medicaid Fraud can result from an individual submitting fraudulent information on an application for Medicaid by underreporting income or resources.  However, when a local Department of Social Services audits their case files or performs a tape match using the applicant’s Social Security number, unreported bank accounts are revealed.

Medicaid fraud may also refer to cases where a medical provider has intentionally submitted an erroneous claim for compensation to Medicaid. This can include things like prescribing unnecessary medical procedures to collect compensation for them, or it can mean submitting a claim for a medical procedure or test that was never performed. Another common form is “upcoding,” which means submitting a claim for a more expensive version of a test or procedure than the one that was performed.

If you have been accused of Medicaid fraud, then you face an allegation of having submitted a claim to Medicaid for one or more of these offenses. While sometimes this can be the result of deliberate fraud, it can often be the result of human error instead. Perhaps you billed twice for the same procedure by accident or used the wrong insurance code when submitting a claim. Whatever the reason for the accusation, it is important that you obtain legal counsel to defend yourself when you have been accused of Medicaid fraud.

If you have been accused of Medicaid fraud, an experienced Medicaid fraud attorney can provide you with the legal representation and represent your interests during the Fraud investigation process. The attorneys at Hobson-Williams, P.C. have extensive experience defending clients accused of Medicaid fraud and are dedicated to securing the best outcomes possible for their clients. With offices conveniently located in Queens, Brooklyn and the Bronx, the firm is dedicated to providing high quality legal representation.  Call (718) 210-4744 to arrange a consultation.

Author: Tanya Hobson-Williams

Appointed to the bench by the Board of Trustees in 2008, and elected in 2009, Tanya Hobson-Williams was the first African-American Female Justice in the Incorporated Village of Hempstead. Tanya Hobson–Williams obtained her B.A. in Government and Politics from St. John's University and her law degree from Benjamin N. Cardozo School of Law. Tanya Hobson-Williams has an active elder law practice assisting senior citizens in obtaining Medicaid for Home Care and Nursing Home Care. She routinely lectures at senior citizen centers, assisted living facilities, law schools and counsels families on a variety of topics of concerns to families caring for the elderly.

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