How does the HRA investigate Medicaid fraud?
Firstly, he or she’s case will be targeted by Medicaid fraud investigators with the HRA. The Medicaid recipient’s employer will then receive a payroll inquiry that requests certified copies of the individual’s payroll records.
What does an HRA investigator look for in an application?
The HRA investigators will then look over all income and assets owned at the time of the individual’s application. This would include letters regarding rent from the landlord, letters from payroll, documents regarding pay rate, and letters of support from family members.
Who is owed money from the HRA?
This money is owed by current and former HRA clients and/or responsible third parties who received cash assistance or Medicaid. These include spouses of Medicaid recipients who reside in a nursing home, persons who receive "one-shot" assistance, and persons who are found to have received Medicaid incorrectly due to excess income or resources.
Who can be sued for Medicaid fraud?
These include spouses of Medicaid recipients who reside in a nursing home, persons who receive "one-shot" assistance, and persons who are found to have received Medicaid incorrectly due to excess income or resources.
What is NYC Medicaid lien?
When you ask the person or company for money, the Department of Social Services is required to also ask them for money to repay the medical bills (medical assistance or Medicaid) and money (cash assistance) DSS paid on your behalf. This is called a lien.
Do you have to pay back cash assistance in NY?
Unless you receive Supplemental Security Income (SSI), you may be required to pay back some or all the Emergency Assistance in the future.
How do I find my HRA username?
If you forget or lose your User ID, you will need to enter your information into ACCESS HRA again and create a new account. If you forget or lose your Password, you will need to correctly answer the security questions that you entered when you created your account using your email to recover the password.
How much money do you get from cash assistance NYC?
How much cash assistance you'll get in NY largely depends upon your family's income and size. New York pays a maximum of $789 a month to a family of three — one of the most generous among the contiguous 48 states and the District of Columbia.
How long will the increase in food stamps last in NY 2022?
The EA of SNAP will continue each month until the COVID-19 public health emergency is lifted in our nation. Currently, the federal public health emergency (FPHE) is in place through October 13, 2022, and is expected to be extended again.
Can I withdraw money from my HRA account?
You can't cash out your HRA. Unused HRA funds are either rolled over to be available for eligible expenses the following year or retained by your employer — and your employer can decide which of these options to allow. But you can never choose to withdrawal HRA money for unapproved use.
What are HRA benefits?
4 days agoA health reimbursement arrangement (HRA) is a benefit used to pay employees back in tax-free money for certain qualified medical expenses and health coverage premiums.
What is a HRA plan?
Health Reimbursement Arrangements (HRAs) are employer-funded group health plans from which employees are reimbursed tax-free for qualified medical expenses up to a fixed dollar amount per year. Unused amounts may be rolled over to be used in subsequent years. The employer funds and owns the arrangement.
How does NYC cash assistance work?
Your family can get cash if you are in need. The funds come on a debit card that you can use at any ATM or store where EBT cards are accepted. Requires proof of identity, where you live, income, and citizenship status. You must be a US citizen or have satisfactory immigration status to receive Cash Assistance.
Who is eligible for cash assistance?
To be eligible for this benefit program, applicants must be a resident of the state in which they apply, and a U.S. citizen, legal alien or qualified alien. You must be unemployed or underemployed and have low or very low income. You must also be one of the following: Have a child 18 years of age or younger, or.
What is cash assistance program NYC?
Cash Assistance Benefits. FA and SNA provide a cash benefit twice per month that can be used for food, utilities and housing expenses. If you are eligible for FA, you can only receive benefits for a lifetime total of five years (60 months).
How much is temporary assistance in NY?
Generally, the maximum benefit level is the standard of need in a county, which varies. For example, in Albany County, the maximum benefit level (or standard of need) is $367 per month for a single individual, or $698 per month for a household of three with children.
What does an HRA investigation letter mean?
An investigation letter from the HRA Bureau of Fraud Investigation means that you are the target of a Medicaid fraud investigation. The letter is not the beginning of the investigation. The letter is the beginning of the end of the investigation.
What does an investigator ask for in a letter?
The investigator’s letter will ask you to come in for an “interview” and to bring your tax returns and other financial records.
How long does an investigator interview last?
They will ask you detailed questions in an “interview” that sometimes lasts an hour or more. As one investigator asks the questions, the other investigator will take notes. These notes will be sent to the District Attorney if the investigators decide to recommend criminal charges.
Does the investigator compare information to the information you provided when you applied and re-certified for Medicaid benefits?
The investigator has already compared this information to the information you provided when you applied and re-certified for Medicaid benefits.
Can a lawyer be a shield?
Your lawyer can also act as a shield. Your lawyer can speak to the investigators on your behalf so you do not have to answer questions during an interrogation. In many cases, your lawyer can negotiate a settlement that avoids criminal charges or lawsuits even if you made mistakes on your application or re-certifications.
Do investigators know if you have a mortgage?
The investigator knows where you live, who lives with you, and how much you pay for your rent or mortgage. The investigator knows if you hold any licenses, own or lease a car, own any real estate, or own a business.
Can you talk to an HRA investigator about Medicaid fraud?
The bottom line is: Never talk to an investigator from the HRA Bureau of Fraud Investigation without first consulting with an experienced Medicaid fraud lawyer.
Why am I being investigated for Medicaid fraud?
One of the first questions clients ask is: Why am I being investigated? The answer is usually one or more of the following red flags: Unreported Income: Most Medicaid fraud investigations start because the investigators discover that your income is higher than you reported on your application or re-certification forms.
What happens if you get a raise for medicaid?
Changes in Income: If you qualified for Medicaid benefits when you first applied, but you started a new job or received a raise after you applied, then your income may be too high to qualify for benefits. You were supposed to tell Medicaid when you got the raise or new job. If you continued to report a lower income year after year, you could face serious criminal charges.
Can you get medicaid if you have a bank account?
Unexplained Bank Accounts or Other Assets: You may have money in the bank and still qualify for Medicaid benefits. You may also own a home and still qualify for Medicaid benefits. That is not the issue. The issue is: How did you get the money in the bank, or how can you afford mortgage payments, if you have an income low enough to qualify for Medicaid benefits? The investigators will want to see evidence of where the money came from.
Why do HRA investigators investigate?
The NYC HRA investigators begin an investigation because of inconsistencies in your bank or property records or tax returns, or a phone call from a Medicaid fraud whistleblower (a person who reports people that they suspect are guilty of committing Medicaid fraud).
What information does the HRA have?
The HRA has access to databases containing information about your employment, education, property, and banking records. In the event that the information you provided on your application/recertification does not match the information listed in the databases, you will be targeted for Medicaid fraud investigation.
What to do if you receive an HRA letter?
If you received an HRA Fraud investigation letter, you should immediately hire an experienced medicaid fraud attorney who will represent you in your Medicaid fraud investigation case. Such attorney will first meet with you and evaluate your cases and charges against you and then gather all relevant documents and go through the investigation process which will no longer require your presence as you will be represented by an attorney. It will be necessary for you to sign a HIPPA release and letter of representation when you hire medicaid fraud attorney to represent you in NY.
What is Medicaid fraud?
In simple terms, Medicaid fraud is the misuse of federal Medicaid funds and benefits. It can be committed by both providers and beneficiaries.
Why do you need a medicaid fraud lawyer?
It is highly recommended that you hire an experienced medicaid fraud attorney in order to avoid incriminating yourself and thereby undermining your case with any sensitive information you disclose. A qualified medicaid investigation lawyer will help you go through the investigation process as smoothly as possible while safeguarding your interests. NY top medicaid fraud attorney usually knows how not to disclose any self-incriminating information, while providing all the appropriate documents required by the investigators and reducing any charges against you.
How long does Medicaid fraud last?
Medicaid fraud investigations usually last from 2 weeks to 3 months, but can go on indefinitely depending on the case.
What is the purpose of the BFI hearing?
The purpose of this hearing is to attempt to ban you from receiving benefits for a specific period of time.
Why did the HRA send me an investigation letter?
The HRA sent you an investigation letter because they have evidence of Medicaid fraud. The HRA has an incentive to settle cases. Does the State of New York get money from processing you and opening up a criminal case, or even sending you to jail? No. You need your Medicaid fraud defense attorney to convince the HRA that what’s done is done, and the best move for them is to give you a break and help you cut a deal with them.
What happens if HRA sends you a Medicaid fraud letter?
If the HRA has sent you a Medicaid fraud investigation letter, they have much to gain from you coming to the interview. It would be to their advantage for you to dig yourself into a deeper hole and to land yourself into further trouble. A successful interrogation will give them the option to refer your case to the District Attorney’s office for a ready criminal prosecution with all the evidence already in their hands and will provide them with the negotiating advantage to demand more money from you.
What happens if you receive a Medicaid investigation letter?
If you’ve received a Medicaid investigation letter, it is likely is that you were not eligible for Medicaid and misrepresented some information or made a mistake on the Medicaid application. However, the HRA knows that they’ve set some flags too broadly.
How to negotiate with HRA?
You need to find an attorney with the charisma to negotiate with people. You need a lawyer who is respectful and can relate to the overworked and underappreciated HRA investigators and their staff. You need someone who is a tough negotiator, but also someone who knows when to stop pushing. After all, the HRA thinks that they’ve caught you with your hand in the cookie jar.
What happens if you ignore the HRA letter?
If you ignore the letter, the HRA will escalate your case and will refer it to the District Attorney’s office for criminal prosecution. You need to take the chance you have and make the best of it.
What happens if you don't show up for Medicaid hearing?
Do not wait until the date of the hearing. If you fail to show up or send an attorney, they will escalate your case for criminal prosecution.
What happens if you fail to settle a fraud case?
If you fail to settle the case on time, the Bureau of Fraud Investigations can escalate the matter by referring it to the District Attorney’s Office for criminal prosecution. Also, they can refer your case or to a private law firm working for the government, which will sue you in for money civil court.