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New York Medicaid and SNAP DSS/HRA Investigation FAQ

You have received a New York Medicaid investigation letter or SNAP investigation letter from the New York City HRA fraud investigation department and you naturally have concerns. Here are the most frequently asked questions with answers based on our experience representing clients in New York Medicaid fraud and SNAP food stamp fraud investigations.

I am being investigated by the HRA department of investigation, will I go to jail? HRA investigations can be escalated and referred to the district attorney’s office by the HRA’s investigator if the investigator sees a violation of the law and if the NYC HRA does not get paid back by the recipient. However, in most cases there is a resolution of the case without criminal liability. It is important to have a fraud defense attorney who is familiar with criminal investigations in order to increase your chances of a good defense.

Do I have to pay back the entire amount? In some cases, especially when the total amount is very high and the beneficiary’s eligibility is questionable but plausible, reducing the amount owed for money expended by the Department of Social Services for Medicaid, Child Health Plus or SNAP benefits may be possible.

Is there a way to not pay back any benefits and to keep my services and benefits? If we can prove to the Department of Social Services that you were eligible in the first place, then it may be possible to not pay back benefits and keep your services and benefits.

Can I pay back the DSS HRA in installments? The investigation department’s priority is to collect as much as they can with as much of it up front as possible. Having said that, it is possible in some cases to enter into an installment agreement, with assistance from an experienced attorney.

How much does it cost to hire an attorney to represent me during a Medicaid or SNAP food stamp investigation by the DSS/HRA? The fee for a Medicaid fraud or food-stamp fraud attorney would depend on your individual situation.

Can I get benefits if my situation changed and I am now eligible even though I was not before? You can go to your local Medicaid or SNAP office and reapply if you have just become eligible, even if you were not eligible before.

If I do not reside in the household, can the department investigation still say that I do? If a person (usually the father of the children) does not reside in the same household but is married to the mother, or claims that he lives in the household in his tax returns, claims children or spouse as dependents even though he does not live with them, has his name on the deed to the residence, or on the utility bills, or materially supports the family, he will be a target of a medicaid and food stamp investigation process, with an uphill battle ahead.

We live together but we form separate households, we are two separate families, why is the Department of Social Services saying that we are in one household? Because the DSS/HRA in New York views everyone living in the household as being the same household, even if they people themselves don’t consider themselves that way. This is especially true if the people in the household are related – let’s say grandmother or uncle. It’s different if people are just roommates.

Is there a way to beat a Medicaid or SNAP fraud investigation? Read about the 9 ways of beating a Medicaid fraud investigation plus the 5 things you should never do in a New York City Medicaid fraud investigation. 

The investigation letter is unclear, what does it actually say? Here is the typical text of the letter in its entirety:

NYC Department of Social Services
Human Resources Administration
Office of Program Accountability

INVESTIGATION, REVENUE AND ENFORCEMENT ADMINISTRATION
Bureau of Fraud Investigation
250 Church Street, 3rd Floor, NY, NY 10013

Dear Sir or Madam:

This office is conducting an investigation that may lead to a finding that you owe money. Please read this letter completely and with care, so that you understand your rights.

This investigation is about your Supplemental Assistance Program (Snap), Medicaid or Child Health Plus (CHIP) Medical Assistance/Family Health Plus (MA/FHP) Benefits. This is based on information we have showing that you or someone in your household:

Did not report someone in your household
Did not report assets
Did not report income
Is employed and makes money you did not tell us about
Owns property you did not tell us about
Receives rental income you did not tell us about
Did not report the correct residence

We scheduled an interview for you to discuss this matter with us.

Please bring your Photo ID card, this letter and the following document(s):
Bring in proof of Identity and NYC residency
Birth certificate
Marriage Certificate
Mortgage documents
School letter
Income tax documents
Pay stubs last 4 pay stubs
Deed to property
Utility bills

If you need more time to find these documents or need to reschedule the interview, call the investigator.

IMPORTANT NOTICE

You can bring an attorney or other representative to assist you in resolving this matter. You can contact your bar association or a legal services organization to seek free legal representation.

You are entitled to interpretation assistance. Please let us know if you would like us to provide an interpreter in the language that you request.

You may answer questions or choose not to say anything. If you do answer questions, your benefits cannot be stopped or reduced just because you did not answer.

If our investigation finds that you were ineligible for benefits received, we may ask you to repay them. You do not have to sign a repayment agreement. However, if we do not come to an agreement, we may sue you in civil court to get back amount owed or, in some cases, refer you for criminal prosecution.

You may still be eligible for certain benefits now even if you were not eligible in the past. If you would like to discuss your current eligibility for Medicaid or SNAP, you can go to your local Medicaid or SNAP office.

TRAVEL INSTRUCTIONS
(By Train) No. 1 to Franklin Street; A, C, E, to Canal Street; A, E, No.2 & 3 to Chambers St.

Our Office is located at 250 Church St. between Leonard and Franklin Streets in Manhattan.

Do you have a disability or a health condition that makes it hard for you to understand this notice or to do what this notice is asking? Do this condition make it hard for you to get other services at HRA? Call us at 212-331-4640 and we can help you. You can also ask for help when you visit an HRA office. You have a right to ask for this kind of help under the law.

A letter like this can also come from 151 W Broadway, 7th Floor, New York, NY 10013.

——–
Albert Goodwin, Esq. is an attorney who helps clients negotiate with DSS HRA investigators and represents clients in defending criminal charges associated with Medicaid and SNAP Fraud. Albert Goodwin can be reached at (212) 233-1233.

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