If you just received a New York Medicaid investigation letter or SNAP investigation letter from the New York City HRA fraud investigation department, you understandably have concerns. The most important thing to do is to not panic and not call the phone number on the letter.

If you would like to discuss the letter with an attorney, we at the Law Offices of Albert Goodwin are here for you. You can call us anytime at 718-509-9774. We are a private law firm. We don’t work for the government. Everything you say to us will be confidential.

Here are the most frequently asked questions with answers based on our experience with New York Medicaid fraud and SNAP food stamp fraud investigations.

Should I contact the investigator like the letter says?

Do not contact the investigator. They are trained to get you to provide incriminating information that can be used against you in court. If you talk to the investigator, they will ask to provide more information and will ask to provide documents. They will continue working the case until they build enough of a case to take to court and secure a criminal conviction.

Recently, they have also set up an online portal where they ask the targets of their investigation to send them documents. After that, if they receive enough incriminating information about their target, they may refer the case to the District Attorney’s office to prosecute in criminal court.

They may ultimately settle the case with no criminal liability. But they like to build a strong criminal case against you first. Which is something that you would rather do without.

And this is why speaking to an investigator is a bad idea. Because you will end up providing incriminating evidence against yourself.

But ignoring the investigation is also a bad idea, because it will not go away on its own, it will only get escalated to the District Attorney’s Office. That’s because even though they don’t have your testimony, they typically already have enough documentary evidence to build a successful criminal case against you.

This is why the best way to resolve a food stamp investigation is to have an attorney handle it for you. Attorneys are trained to protect your rights.

If you need an attorney, we at the Law Offices of Albert Goodwin are here for you. You can call us right away at 718-509-9774.

If an HRA investigator sees that you are not following up, they may try to contact you. You can just tell them that you cannot talk to them. There is no need to worry about disappointing the investigator. They understand that remaining silent is your right and that letting you remain silent is a part of their job.

It’s definitely not a good idea to back to them. Then you are just doing their job for them. Have an attorney follow up with them instead.

I already talked to an investigator. What happens now?

If you did already talked to an investigator, think about this: was talking to them really a good idea?

An investigator has years of training and experience that you do not have. They have many strategies at their disposal. Here are some examples:

• They can pretend to be friendly
• They can lie to you
• They can threaten you
• They will try to get you to reveal incriminating information that can be used against you by the D.A.
• They can detain you
• They can show their true face and let you know what kind of trouble you’re really in
• They can work in pairs and play good cop-bad cop
• They can make you sign a statement
• They will record everything you say
• They can testify to what you’ve said
• They have the time to be persistent

And what strategies do you have? None.

• Do not talk to the investigator
• Do not be friendly with them
• Do not cry
• Do not give them excuses
• Do not try to show them that you’re a real person, not a criminal from TV
• Do not think that if you’re honest and provide all the (incriminating) information, they will let you go
• Do not tell them you’re a single mom
• Do not beg for their sympathy
• Do not tell them you don’t have money
• Do not tell them you didn’t know
• Do not tell them the children’s father and you are “separated” in your mind
• Do not tell them someone else told you to fill out the application this way
• Do not tell them you don’t know the language
• Do not tell them the change is recent and you didn’t have the time to report it
• Do not them you had no choice
• Do not tell them it’s the government’s fault

If you continue talking to the investigators, you will crack under the pressure. Everyone does.

What kind of evidence does the HRA already have against me?

Here is the kind of evidence the investigator already has:

• Records of everyone who resides in your household
• Records of everyone’s income, from tax returns and employment records
• Records of everyone’s assets, from bank statements and deeds
• Copies of leases
• DMV records
• Records of everyone’s addresses and actual physical place or residence and employment
• Records of usage of the benefits card, including date, time and location
• Photos, videos and recordings

The HRA department of investigation is investigating me, will I go to jail?

Some people have gone to jail for Medicaid or SNAP fraud. But that does not mean that you will. What this does mean is that you should speak to an attorney immediately and discuss your legal strategy. Since Medicaid and SNAP fraud is a crime, HRA investigations can be escalated and referred to the District Attorney’s office by the HRA’s investigator. It is crucial to hire a fraud defense attorney who is familiar with criminal investigations, in order to increase your chances of a good defense.

What is the penalty for Medicaid or SNAP fraud?

New York Penal Law 155 describes the sentencing guidelines for someone committing Medicaid or SNAP fraud. The sentence depends on the total amount received. For most people, the amount received from Medicaid or SNAP is between over $3,000 and under $50,000, which according to the guidelines can carry a sentence of up to seven years in jail.

Amount Received	Degre of Welfare Fraud	Section of Penal Code	Felony Class	Penalty
In excess of $1,000 but not more than $3,000	Fourth Degree	PL 158.10	Class E Felony	up to 4 years in prison
In excess of $3,000 but not greater than $50,000	Third Degree	PL 158.15	Class D Felony	up to 7 years in prison
In excess of $50,000 but is not more than $1 million	Second Degree	PL 158.20	Class C Felony	up to 15 years in prison

Payment of Restitution

If you are prosecuted by the District Attorney’s office and get sentenced, then you will not only have to go to jail but would also have to pay back the benefits received as restitution.

Do I have to pay back the entire amount?

The important thing to remember is that the priority is to avoid criminal liability. Having said that, the amount of payback is also important. 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. Some of the ways we do that are showing a period of eligibility. The letter can be an indication of what we are dealing with.

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 avoid benefit payback, and it may be possible to keep your services and benefits. However, most investigated cases have a solid foundation and are difficult to challenge in a significant way.

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 upfront as possible. It is possible in some cases to enter into an installment agreement, with assistance from an experienced attorney. It’s easier to get low installments on Medicaid cases than on SNAP cases. If you got a letter from the HRA and you are looking for an attorney, you can contact us at attorneyalbertgoodwin@gmail.com.

How much does it cost to hire an attorney?

The fee for a Medicaid fraud or food-stamp fraud attorney to represent you during a Medicaid or SNAP food stamp investigation by the DSS/HRA would depend on your situation, which will be explained in the letter or during a meeting with the HRA investigator.

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 a person does not reside in the household, can the department investigation still say that they do?

Even if you claim that a person does not reside in the household, the Human Resource Administration Bureau of Fraud Investigation administration can still consider them to be a part of the household and target them as a part of the Medicaid and SNAP investigation process. We often see a person not listed as part of the household receiving a letter from the bureau of fraud investigation as well. A children’s father is considered to be a part of the household often just by virtue of being the father, and often with the following additional factors:

• spends time in the household
• married to the mother of the children
• list the household address on his tax returns
• claim children as dependents
• claims the mother of the children as a dependent
• has his name on the deed, lease or the utility bills
• provides material support for the family

Separated people living together

We live together, but I am of the opinion that we form separate households, we are two different families, why is the Department of Social Services saying that we are in one household?

The DSS/HRA in New York views everyone living in the household as being the same household, even if the people themselves don’t consider themselves that way. The Medicaid administration would be especially concerned if the people in the house are related – let’s say, grandmother or uncle. It’s different if people are just roommates. In a situation where there is a family, especially where the father of the children is not listed on an application or recertification, a fraud investigation is a frequent occurrence.

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

I got a letter from the HRA and it’s unclear. What does it actually say?

Here is the standard 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
375 Pearl Street, 22nd Floor, NY, NY 10038

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

Please provide the following documents within 12 business days of the date of this letter:

NY state ID card
Birth certificate
Marriage Certificate
Mortgage documents
School letter
Income tax documents
Pay stubs (last 4 pay stubs)
W2 or 1099
Lease or Deed to property
last six months bank account statements
Title for cars
Utility bills

To submit the documents, send us an email to the investigator’s email address and you with receive an email with a link to upload the documents. You will need to include the control number when completing the on-line form.

Cannot upload your documents to a smartphone or computer? You can mail us copies of the documents using the enclosed return envelope.

If you mail the documents to us, please call the investigator by the following date.

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

Please bring your Photo ID card, this letter and the documents above.
Bring in proof of Identity and NYC residency

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 another 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 the amount owed or, in some cases, refer you for criminal prosecution.

If our investigation finds that you were ineligible for benefits received, we will

• contact you to schedule a telephone interview and
• decide the most effective way to resolve this case

This could include:

• you being sued in civil court to recover the amount owed
• referral for a criminal prosecution, or
• a repayment agreement

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 375 Pearl Street, 22nd Floor.

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? Does 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, 7^th Floor, New York, NY 10013.

If you think that the HRA Medicaid Fraud Division is investigating you for SNAP or Medicaid fraud, contact an attorney immediately.

——–
Albert Goodwin, Esq. is an attorney who helps people who got a letter from the HRA negotiate with the investigators. He also represents clients in defending criminal charges associated with Medicaid and SNAP fraud. You can reach Albert Goodwin, Esq. at (718) 509-9774.

Plus the Five Things You Should NEVER Do in a SNAP Fraud Investigation

You’ve received a SNAP fraud investigation letter. You are worried about what’s going to happen next. The good news is that there are still ways to avoid criminal liability and jail time. But you have to act quickly and be smart about it. And you have to contact an attorney right away.

Below are some time-tested and battle-worn tactics that lawyers use every day to beat SNAP fraud investigations. Under no circumstances should you use those tactics without being represented by an experienced SNAP fraud attorney, as they can backfire if not executed correctly. You need to leave this to professionals. The risk is too great.

If you are looking for an attorney to represent you in a SNAP investigation, we at the Law Offices of Albert Goodwin are here for you. Call us right away at (718) 509-9774.

1. We go to the interview, you don’t

If the HRA already has the information, why are they asking you to come to the interview? Likely to interrogate you to get more damaging information that they can then use against you.

Do you want to be involved in a real-life reenactment of a good cop-bad cop routine?

If the HRA has sent you a SNAP 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.

The Bureau of Fraud investigation can trick you. If you carefully look at their “frequently asked questions,” you can spot the incomplete “answers” that are more harmful than helpful. For example, they say that you can come in by yourself and that you have the right to have someone appear with you. What they do not say is that you also have the option of not coming to the first hearing at all. You can have your attorney appear instead. By using that “hidden option,” you avoid the unpleasantness, waste of time and potential exposure associated with meeting with an investigator.

Do not think that you can come to the interview, and a lawyer can fix your case later if things don’t work out. Once you’re in the HRA interrogation room without a lawyer, the HRA will find ways to make matters worse for you. It’s their job.

At the same time, do not just ignore the SNAP investigation target letter. 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. If you ignore the HRA and keep them in the dark, they will refer the case to the Office of the District Attorney for criminal prosecution. Instead, have an attorney notice the Bureau of Fraud investigation and adjourn the hearing. Saves you the unpleasant meeting but keeps you out of harm’s way.

2. We do our best to prove that the allegations have no basis

Proving them wrong is easier said than done. If you’ve received a SNAP investigation letter, it is likely is that you were not eligible for SNAP and misrepresented some information or made a mistake on the SNAP application.

However, the HRA knows that they’ve set some flags too broadly. Your SNAP fraud lawyer may be able to convince the HRA that you were flagged without cause. You may be innocent of SNAP fraud. If that’s the case, they will not proceed further with the investigation.

3. We do our best to show that the District Attorney would have a hard case to prove

Your SNAP fraud attorney may be able to show the HRA that the District Attorney will not take their case. If that happens, the HRA will lose a lot of the leverage that they were planning to use. They will no longer be able to strong-arm you into settling for a large amount.

There are technical and legal reasons why evidence the HRA has obtained may not be admissible in court. Once convinced that they will have no case in the criminal court, the HRA may let you settle for pennies on the dollar, or even drop the case entirely.

4. We control the flow of information

The HRA may have had a flag go off but may have been unable to get the proof they need. Maybe that is why they are calling you in for interrogation. By not giving them the information, you may put them into a Catch 22, to your benefit.

However, this is something that you have to do the right way and with the assistance of an attorney. The last thing you want to do is lie to the HRA. Do not lie to them. They can easily escalate the investigation or refer it to the Office of District Attorney because you were lying to them. On the flip side, you may also make a mistake and provide information that would further incriminate you. This is why the best way to control the flow of information is to have an attorney handle your case.

5. We do our best to show that you were eligible for at least a partial period

Just because the HRA found income does not mean that the income or asset was always there. Your SNAP fraud attorney can try to prove that you were eligible until your income grew or you’ve acquired the asset. For example, if you show that you were eligible for 4 months out of the year, you will automatically get a 1/3 reduction in the amount of the claim.

6. We do our best to show that at least some of the members of your household were eligible

Your SNAP fraud lawyer can try to show the HRA that some of the members of your household qualified for SNAP.

7. We challenge the amount of the claim

When it comes to medical costs and billing, there may be leeway in the amount that the HRA can charge for the services or insurance payments. There may be even more leeway over late fees, penalties or interest. You can look at factors such as which family members are covered and for which periods, to get to the lowest possible amount.

8. We understand what the investigators already know

The HRA is part of the government. As such, it has access to any information available about you in any government or private database. It runs many programs that assemble data about everyone and compare that data against a database of names and social security numbers of people who receive SNAP. If any information about you or members of your household that exists in any government database, assume that the HRA will have it. Think about things like W2 forms, 1099 Forms, income tax returns, bank statements, any income you get from anywhere, and any record of property ownership, even if not in New York State.

The HRA also has investigators who work in the field. You should assume that they know where you live (and who owns that house), where you work (and who owns the business), where your children go to school.

The HRA may have that information. But then again, they may not. Figuring this out with the help of an experienced attorney can make all the difference in your case.

9. We settle before the case gets escalated

The HRA sent you an investigation letter because they have evidence of SNAP fraud. They think you’ve committed a crime. They would like for you to go to jail if they had the choice. But HRA also 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. This is what we convince them is the situation. You need your SNAP 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.

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. Once that happens, it will be harder to deal with the case.

We may be able to help you get into a settlement agreement with the HRA where you may accomplish the following goals:

• pay back less than what the government has spent
• spread out the payment over seven years
• get a 25% discount on the total payment amount
• and have an agreement to not have the case referred to a civil lawsuit or criminal prosecution

Now to the things that you should never do in a SNAP fraud investigation, so as not to make your situation worse.

1. Do not ignore the SNAP investigation letter

The investigation will not just go away. The longer you wait, the worse it will get. 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.

2. Do not just show up for the interview

It’s not the time to play the hero. You may think that you are smarter then the investigators, but you cannot argue with the fact that they have more experience. Once they get you into a trap, it will be hard to get out. Once they’ve sent you a SNAP fraud investigation letter, they are likely to have compelling evidence. Don’t take the chance. Speak with a lawyer.

3. Do not lie to the investigators

There is a difference between not volunteering information and providing false information. Providing false information to the investigator can come with a severe jail sentence.

Don’t think you can fool HRA investigators. They probably already have the evidence they need. They have whatever information triggered the investigation. That’s why they have sent you an NYC fraud investigation letter. They’ve probably interviewed the institution where that information came from, such as a bank, school, place of work, or government agency. They probably already have documents that show that you are not eligible.

On the flip side, maybe the HRA does not have enough information, so they are trying to get it from you. But it is also possible that they are trying to get you to lie, to add obstruction of justice as an extra criminal charge. You don’t want to be taking those chances.

Look at the recent high-profile convictions. Most of them had to do with lying to the investigators, some even more than the underlying fraud.

You have the right to remain silent. But not to lie.

4. Do not just pay the amount the DSS HRA is asking for

Don’t let the DSS HRA scare you and intimidate you into paying them the full amount they are demanding. An attorney can use professional techniques, legal rules, and the fact that they not as emotionally invested as you are to

• try to not have you make any payment to the HRA for SNAP or SNAP, if possible
• lower the amount you’ll have to reimburse the HRA for SNAP or Snap
• Get a 25% discount
• Spread the payments into a seven-year installment plan

We have obtained excellent SNAP Fraud settlements for our clients and will do our best to do the same for you.

5. Do not handle the case yourself

If you handle the case yourself, you may end up going to jail and having a criminal record. This is something that you need to leave to the professionals.

When we handle a SNAP fraud case, we aim to avoid escalation of the case. We restrict the amount of information that the HRA receives to the bare legal minimum – as close to nothing as possible. We argue partial eligibility.

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.

These strategies help us beat the investigators at their own game and achieve reasonable outcomes for our clients. We also help you avoid making terrible mistakes, such as covering up the investigation with more fraud or ignoring the inquiry. The Investigation Revenue and Enforcement Administration Bureau of Fraud Investigation has professionals working for them. You need to have professionals working for you.

The strategies here apply to Family Health Plus and Child Health Plus investigations as well.

If you are being investigated by the DSS/HRA, contact an attorney immediately.

If you are looking for an attorney who can help you avoid escalation of a SNAP Fraud investigation, or to defend against a criminal or civil case brought against you by the HRA, call the Law Offices of Albert Goodwin at (718) 509-9774 or send us an email at attorneyalbertgoodwin@gmail.com.

Plus 5 Things that You Should Never Do in an NYC Medicaid Fraud Investigation

You’ve received an NYC Medicaid fraud investigation letter. You are worried about what’s going to happen next. Here are some time tested and battle-worn tactics that lawyers use every day to beat NYC Medicaid fraud investigations.

We recommend that you not use those tactics without being represented by an experienced Medicaid fraud attorney, as they can backfire if not executed correctly.

1. Settle Before the Case Gets Escalated

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.

If you fail to settle the case on time, the NYC 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. Once that happens, it will be harder to deal with the case.

We may be able to help you get into a settlement agreement with the HRA where you may accomplish the following goals:

• pay back less than what the government has spent
• spread out the payment over seven years
• get a 25% discount on the total payment amount
• and have an agreement to not have the case referred to a civil lawsuit or criminal prosecution

2. You Have the Option of Not Coming to the Interview but Sending Your Lawyer Instead

If the HRA already has the information, why are they asking you to come to the interview? Likely to interrogate you to get more damaging information that they can then use against you.

Do you want to be involved in a real-life reenactment of a good cop-bad cop routine?

If the NYC 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.

The NYC Bureau of Fraud investigation can trick you. If you carefully look at their “frequently asked questions,” you can spot the incomplete “answers” that are more harmful than helpful. For example, they say that you can come in by yourself and that you have the right to have someone appear with you. What they do not say is that you also have the option of not coming to the first hearing at all. You can have your attorney appear instead. By using that “hidden option,” you avoid the unpleasantness, waste of time and potential exposure associated with meeting with an investigator.

Do not think that you can come to the interview, and a lawyer can fix your case later if things don’t work out. Once you’re in the HRA interrogation room without a lawyer, the HRA will find ways to make matters worse for you. It’s their job.

At the same time, do not just ignore the Medicaid investigation target letter. 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. If you ignore the HRA and keep them in the dark, they will refer the case to the Office of the District Attorney for criminal prosecution. Instead, have an attorney notice the NYC Bureau of Fraud investigation and adjourn the hearing. Saves you the unpleasant meeting but keeps you out of harm’s way.

3. Prove that the Allegations Have No Basis

Proving them wrong is easier said than done. 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. Your Medicaid fraud lawyer may be able to convince the HRA that you were flagged without cause. You may be innocent of Medicaid fraud. If that’s the case, they will not proceed further with the investigation.

4. Show that the District Attorney Would Not Take the Case

Your Medicaid fraud attorney may be able to show the HRA that the District Attorney will not take their case. If that happens, the HRA will lose a lot of the leverage that they were planning to use. They will no longer be able to strong-arm you into settling for a large amount.

There are technical and legal reasons why evidence the HRA has obtained may not be admissible in court. Once convinced that they will have no case in the criminal court, the HRA may let you settle for pennies on the dollar, or even drop the case entirely.

5. Control the Flow of Information

Be careful with this technique; only do this with the involvement of an attorney.

The HRA may have had a flag go off but may have been unable to get the proof they need. Maybe that is why they are calling you in for interrogation. By not giving them the information, you may put them into a Catch 22, to your benefit.

However, this is something that you have to do the right way and with the assistance of an attorney. The last thing you want to do is lie to the HRA. Do not lie to them. They can easily escalate the investigation or refer it to the Office of District Attorney because you were lying to them. On the flip side, you may also make a mistake and provide information that would further incriminate you. This is why the best way to control the flow of information is to have an attorney handle your case.

6. Show That You Were Eligible for a Partial Period

Just because the HRA found income does not mean that the income or asset was always there. Your Medicaid fraud attorney can try to prove that you were eligible until your income grew or you’ve acquired the asset. For example, if you show that you were eligible for 4 months out of the year, you will automatically get a 1/3 reduction in the amount of the claim.

7. Show That At Least Some Members of Your Household Were Eligible

Your Medicaid fraud lawyer can try to show the HRA that some of the members of your household qualified for Medicaid. Your lawyer can also show that some of your family members would have qualified for other government insurance, such as Family Health Plus or Child Health Plus. This is especially true for children, who in some situations qualify for Child Health Plus even if the family is not eligible for Medicaid.

8. Challenge the Amount of the Claim

When it comes to medical costs and billing, there may be leeway in the amount that the HRA can charge for the services or insurance payments. There may be even more leeway over late fees, penalties or interest. You can look at factors such as which family members are covered and for which periods, to get to the lowest possible amount.

9. Understand What the HRA Already Knows

The HRA is part of the government. As such, it has access to any information available about you in any government or private database. It runs many programs that assemble data about everyone and compare that data against a database of names and social security numbers of people who receive Medicaid. If any information about you or members of your household that exists in any government database, assume that the HRA will have it. Think about things like W2 forms, 1099 Forms, income tax returns, bank statements, any income you get from anywhere, and any record of property ownership, even if not in New York State.

The HRA also has investigators who work in the field. You should assume that they know where you live (and who owns that house), where you work (and who owns the business), where your children go to school.

The HRA may have that information. But then again, they may not. Figuring this out with the help of an experienced attorney can make all the difference in your case.

Now to the things that you should never do in an NYC Medicaid fraud investigation, so as not to make your situation worse.

1. Do Not Ignore the NYC Medicaid Fraud investigation Letter

The investigation will not just go away. The longer you wait, the worse it will get. 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.

2. Do Not Just Show Up for the Interview

It’s not the time to play the hero. You may think that you are smarter then the investigators, but you cannot argue with the fact that they have more experience. Once they get you into a trap, it will be hard to get out. Once they’ve sent you a Medicaid fraud investigation letter, they are likely to have compelling evidence. Don’t take the chance. Speak with a lawyer.

3. Do Not Lie to the Investigators

There is a difference between not volunteering information and providing false information. Providing false information to the investigator can come with a severe jail sentence.

Don’t think you can fool HRA investigators. They probably already have the evidence they need. They have whatever information triggered the investigation. That’s why they have sent you an NYC Medicaid fraud investigation letter. They’ve probably interviewed the institution where that information came from, such as a bank, school, place of work, or government agency. They probably already have documents that show that you are not eligible.

On the flip side, maybe the HRA does not have enough information, so they are trying to get it from you. But it is also possible that they are trying to get you to lie, to add obstruction of justice as an extra criminal charge. You don’t want to be taking those chances.

Look at the recent high-profile convictions. Most of them had to do with lying to the investigators, some even more than the underlying fraud.

You have the right to remain silent. But not to lie.

4. Do Not Just Pay the Amount the DSS is Asking For

Don’t let the DSS HRA scare you and intimidate you into paying them the full amount they are demanding. An attorney can use professional techniques, legal rules, their charisma and the fact that they not as emotionally invested as you are to

• try to not have you make any payment to the HRA for Medicaid or SNAP, if possible
• lower the amount you’ll have to reimburse the HRA for Medicaid or Snap
• Get a 25% discount
• Spread the payments into a seven-year installment plan

We have obtained excellent Medicaid Fraud settlements for our clients and will do our best to do the same for you.

5. Do Not Handle the Case Yourself

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.

When we handle a Medicaid fraud case, we aim to avoid escalation of the case. We restrict the amount of information that the HRA receives to the bare legal minimum – as close to nothing as possible. We argue partial eligibility.

These strategies help us beat the investigators at their own game and achieve reasonable outcomes for our clients. We also help you avoid making terrible mistakes, such as covering up the investigation with more fraud or ignoring the inquiry. The Investigation Revenue and Enforcement Administration Bureau of Fraud Investigation has professionals working for them. You need to have professionals working for you.

The strategies here apply to Family Health Plus and Child Health Plus investigations as well.

See our most Frequently Asked Questions about the NYC DSS/HRA fraud investigations. 

If you are being investigated by the DSS/HRA, contact an attorney immediately.

If you are looking for an attorney who can help you avoid escalation of an NYC Medicaid Fraud investigation, or to defend against a criminal or civil case brought against you by the HRA, call the Law Offices of Albert Goodwin at (212) 233-1233.

If you are lying about income to get Medicaid, you will eventually get caught. Medicaid is run by the government, and the government frequently cross-references their Medicaid recipient databases with databases that contain people’s income, assets, and household information. As such, there are multiple signals that can get you caught lying about income to get Medicaid.

Some of these databases include

• IRS tax filings
• Payroll tax filings from your employer
• Register of Deeds
• Declarations of Corporations
• Marriage Records
• Birth Records
• Utility Bills
• Records of Using Medicaid

IRS tax filings can include form 1040 and the like, and they can show that your income exceeds Medicaid limits. An IRS tax filing can also show that the father is supporting the children when the father declares the children as his dependents. Payroll tax filings that your employer files with the IRS, which includes form W2 and the like, can also show income.

Register of Deeds has records of your property ownership, which can indicate that you are receiving rental income or that you are a part of a household.

A Declaration of Corporation can get you caught lying about income to get Medicaid because it indicates that you are receiving business income, including cash income, that you are not reporting to Medicaid.

A Marriage Certificate or Birth Certificate can indicate that you have a household member, typically the husband, whom you have not mentioned to Medicaid as a part of your household. If he is married to you or is the father of the children, Medicaid can argue that you were lying about income to get Medicaid by not mentioning him.

Using Medicaid outside of the state you are receiving it in can indicate that you don’t qualify for Medicaid in that state. For example, if you are using New York Medicaid in Florida, it can be a sign that you are not a New York resident and are lying to New York Medicaid.

If any of those databases receive a hit, the computer will alert the DSS IREA BFI (Department of Social Services Bureau of Fraud Investigations). A supervisor will review the signal and if appropriate, assign your case to a human investigator. The investigator then will start an investigation to determine whether or not you are actually lying about income to get Medicaid. If they determine that you are lying, they will gather enough evidence to secure a criminal conviction.

People can also get caught lying about income to get Medicaid when a fraud investigator is sent out to their residence or place of employment in order to conduct surveillance and investigation. The department of fraud investigation can send out an investigator when your file gets cross-referenced in a database or looks suspicious for another reason.

After the Medicaid Fraud investigator has conducted the investigation and gathered all the evidence they can, they will then send you a letter asking you to come in for an interview. By that point, they typically have enough evidence for a criminal conviction and are just trying to get you to admit that you have committed Medicaid Fraud.

At a Medicaid fraud investigator interview, there is a difference between not volunteering information and providing false information. Providing false information to the investigator can come with a serious jail sentence.

Don’t think you can fool HRA investigators. They probably already have the evidence of you lying about income to get Medicaid. They have whatever information triggered the investigation. That’s why they have sent you a Medicaid fraud investigation letter. They’ve probably interviewed the institution where that information came from, such as a bank, school, place of work, or government agency. They probably already have documents that show that you are not eligible. Once the build the case, they will then call you in for a meeting, sending out a letter similar to the one below. We recommend that you speak to a Medicaid/SNAP fraud lawyer if you receive a letter from the HRA.

On the flip side, maybe the HRA does not have enough information about you lying about income to get Medicaid, so they are trying to get it from you. But it is also possible that they are trying to get you to lie, to add obstruction of justice as an extra criminal charge. You don’t want to be taking those chances.

Look at the recent high-profile convictions. Most of them had to do with lying to the investigators, some even more than the underlying fraud.

You have the right to remain silent. But not to lie to Medicaid investigators.

People get caught lying about income to get Medicaid every day. If you received a letter from the HRA DSS IREA BFI, speak to a Medicaid Fraud lawyer today. You can call Albert Goodwin, Esq. at (212) 233-1233.

Here is a summary of what can happen if you get caught lying to Medicaid:

• You will get an investigation letter from the DSS HRA Bureau of Fraud Investigations
• You will have to pay back the money you’ve received from the DSS
• You can go to jail for up to seven years
• You can have a fraud felony on your record
• You can be disqualified from ever receiving Medicaid again
• You will lose your Medicaid benefits

If you are caught lying to Medicaid and need a Medicaid fraud attorney, you can send us an email at attorneyalbertgoodwin@gmail.com or call us at 718-509-9774.

You Will Likely be Investigated

New York HRA DSS Bureau of Fraud Investigations catches up with people eventually. If you are caught lying to Medicaid about your income, you are likely to receive a letter asking you to meet with the investigators. If you get a letter from the investigator, speak to a Medicaid/SNAP fraud attorney right away.

In Some Cases, You Can go to Jail

Lying to Medicaid can be considered insurance fraud. A person is guilty of insurance fraud in the third degree when he commits a fraudulent insurance act and thereby wrongfully takes, obtains or withholds property with a value in excess of three thousand dollars. Insurance fraud in the third degree is a class D felony. ^[1]

Getting caught can mean going to jail for up to seven years. For a class D felony, the maximum prison term shall be fixed by the court, and shall not exceed seven years; ^[2] The minimum period shall be fixed by the court and specified in the sentence and shall be not less than one year nor more than one-third of the maximum term imposed. ^[3]

Many people who get caught lying to Medicaid have extenuating circumstances. Some people did not understand the Medicaid application. Some people were told by insurance agents that it’s ok to fill out the application that way. Some people thought that for whatever reason, they don’t have to list their husband and his Medicaid application. This is something that a judge may or may not consider to be extenuating circumstances in applying the “nature and circumstances” clause to impose a sentence that is less than one year.

If the court, having regard to the nature and circumstances of the crime and to the history and character of the defendant, is of the opinion that a sentence of imprisonment is necessary but that it would be unduly harsh, the court may impose a definite sentence of imprisonment and fix a term of one year or less. ^[4]

What is the penalty for Medicaid or SNAP fraud? New York Penal Law 155 describes the sentencing guidelines for someone committing Medicaid or SNAP fraud. The sentence depends on the total amount received. For most people, the amount received from Medicaid or SNAP is between over $3,000 and under $50,000, which according to the guidelines can carry a sentence of up to seven years in jail.

Amount Received	Degre of Welfare Fraud	Section of Penal Code	Felony Class	Penalty
In excess of $1,000 but not more than $3,000	Fourth Degree	PL 158.10	Class E Felony	up to 4 years in prison
In excess of $3,000 but not greater than $50,000	Third Degree	PL 158.15	Class D Felony	up to 7 years in prison
In excess of $50,000 but is not more than $1 million	Second Degree	PL 158.20	Class C Felony	up to 15 years in prison
In excess of $1 million	First Degree	PL 158.25	Class B Felony	up to 25 years in prison

Restitution. If you are prosecuted by the District Attorney’s office and get sentenced, then you will not only have to go to jail but would also have to pay back the benefits received as restitution.

You Can End Up with a Fraud Felony on Your Record

One of the things that can happen when you get caught lying to Medicaid is you can have a permanent record of a fraud felony. This can be a substantial problem in obtaining employment and maintaining or receiving a professional license. Most companies would not want to hire a person who has been convicted of fraud.

You Will Lose Your Medicaid Benefits

It should come as no surprise that they will cut off your benefits as soon as you get caught lying to Medicaid since you did not qualify for the benefits in the first place.

You can be Disqualified from Medicaid for Life

There could come a time in your life when you would genuinely need Medicaid and will qualify for it. But because of your record of lying to Medicaid, they may have a permanent disqualification on your record, meaning that you will be barred for life from receiving Medicaid for life.

Medicaid Can Sue You to get their Money Back

Not only can Medicaid refer your case to the District Attorney’s office to file criminal charges, but they can also sue you and obtain a judgment against you. Once Medicaid obtains the judgment, they can use it to garnish your paycheck, garnish your bank account, seize your assets such as vehicles and real estate and seize your tax refunds. They will use the power of the government and the courts to recoup the money they’ve spent on your insurance premium payments before you got caught lying to Medicaid.

What do I Do if I Got Caught Lying to Medicaid?

The first step you should take is this: speak with an experienced Medicaid fraud attorney. Do not take the chance of meeting with the investigators on your own. They are trained to obtain information against you that they can later use to their advantage in criminal prosecution and in civil court.

We at the Law Offices of Albert Goodwin are here for you. We have offices in New York, NY, Brooklyn, NY and Queens, NY. You can call us at 718-509-9774 or send us an email at attorneyalbertgoodwin@gmail.com.

[1] New York Penal Code 176-20

[2]New York Penal Code 70 (2)(e).

[3]New York Penal Code 70 (3)(b).

[4]New York Penal Code 70 (4).

If you are lying to Medicaid, you will eventually get caught. There are multiple signals that can get you caught lying to Medicaid. Medicaid is run by the government, and the government frequently cross-references its Medicaid recipient databases with databases that contain people’s income, assets, and household information.

Some of these databases include

• IRS tax filings
• Payroll tax filings from your employer
• Register of Deeds
• Declarations of Corporations
• Marriage Records
• Birth Records
• Utility Bills
• Records of Using Medicaid

IRS tax filings can include form 1040 and the like, and they can show that your income exceeds Medicaid limits. An IRS tax filing can also show that the father is supporting the children when the father declares the children as his dependents. Payroll tax filings that your employer files with the IRS, which includes form W2 and the like, can also show income.

Register of Deeds has records of your property ownership, which can indicate that you are receiving rental income or that you are a part of a household.

A Declaration of Corporation can get you caught lying to Medicaid because it indicates that you are receiving business income, including cash income, that you are not reporting to Medicaid.

A Marriage Certificate or Birth Certificate can indicate that you have a household member, typically the husband, whom you have not mentioned to Medicaid as a part of your household. If he is married to you or is the father of the children, Medicaid can argue that you were lying to Medicaid by not mentioning him.

Using Medicaid outside of the state you are receiving it in can indicate that you don’t qualify for Medicaid in that state. For example, if you are using New York Medicaid in Florida, it can be a sign that you are not a New York resident and are lying to New York Medicaid.

If any of those databases receive a hit, the computer will alert the DSS IREA BFI (Department of Social Services Bureau of Fraud Investigations). A supervisor will review the signal and if appropriate, assign your case to a human investigator. The investigator then will start an investigation to determine whether or not you are actually lying to Medicaid. If they determine that you are lying, they will gather enough evidence to secure a criminal conviction.

People can also get caught lying to Medicaid when a fraud investigator is sent out to their residence or place of employment in order to conduct surveillance and investigation. The department of fraud investigation can send out an investigator when your file gets cross-referenced in a database or looks suspicious for another reason.

After the Medicaid Fraud investigator has conducted the investigation and gathered all the evidence they can, they will then send you a letter asking you to come in for an interview. By that point, they typically have enough evidence for a criminal conviction and are just trying to get you to admit that you have committed Medicaid Fraud.

At a Medicaid fraud investigator interview, there is a difference between not volunteering information and providing false information. Providing false information to the investigator can come with a serious jail sentence.

Don’t think you can fool HRA investigators. They probably already have the evidence of you lying to Medicaid. They have whatever information triggered the investigation. That’s why they have sent you a Medicaid fraud investigation letter. They’ve probably interviewed the institution where that information came from, such as a bank, school, place of work, or government agency. They probably already have documents that show that you are not eligible.

On the flip side, maybe the HRA does not have enough information about you lying to Medicaid, so they are trying to get it from you. But it is also possible that they are trying to get you to lie, to add obstruction of justice as an extra criminal charge. You don’t want to be taking those chances.

Look at the recent high-profile convictions. Most of them had to do with lying to the investigators, some even more than the underlying fraud.

You have the right to remain silent. But not to lie to Medicaid investigators.

People get caught lying to Medicaid every day. If you received a letter from the HRA DSS IREA BFI, speak to a Medicaid Fraud lawyer today. You can call Albert Goodwin, Esq. at (212) 233-1233.

If you are lying on a Medicaid application, you will eventually get caught. There are multiple signals that can get you caught lying to Medicaid. Medicaid is run by the government, and the government frequently cross-references their Medicaid recipient databases with databases that contain people’s income, asset and household information.

Some of these databases include

• IRS tax filings
• Payroll tax filings from your employer
• Register of Deeds
• Declarations of Corporations
• Marriage Records
• Birth Records
• Utility Bills
• Records of Using Medicaid

If you are being accused of Medicaid fraud and you are looking to consult with an attorney, you can send us an email at attorneyalbertgoodwin@gmail.com or call us at 718-509-9774.

IRS tax filings can include form 1040 and the like, and they can show that your income exceeds Medicaid limits. An IRS tax filing can also show that the father is supporting the children, when the father declares the children as his dependents. Payroll tax filings that your employer files with the IRS, which includes form W2 and the like, can also show income.

Register of Deeds has records of your property ownership, which can indicate that you are receiving rental income or that you are a part of a household.

A Declaration of Corporation can get you caught lying on a Medicaid application because it indicates that you are receiving business income, including cash income, that you are not reporting to Medicaid.

A Marriage Certificate or Birth Certificate can indicate that you have a household member, typically the husband, whom you are not including on the Medicaid application as a part of your household. If he is married to you or is the father of the children, Medicaid can argue that you were lying on the Medicaid application by not including him.

Using Medicaid outside of the state you are receiving it in can indicate that you don’t qualify for Medicaid in that state. For example, if you are using New York Medicaid in Florida, it can be a sign that you are not a New York resident and are lying on the Mediciad application.

If any of those databases receive a hit, the computer will alert the DSS IREA BFI (Department of Social Services Bureau of Fraud Investigations). A supervisor will review the signal and if appropriate, assign your case to a human investigator. The investigator then will start an investigation to determine whether or not you are actually lying on the Medicaid application. If they determine that you are lying, they will gather enough evidence to secure a criminal conviction.

People can also get caught lying on a Medicaid application when a fraud investigator is sent out to their residence or place of employment in order to conduct surveillance and investigation. The department of fraud investigation can send out an investigator when your application gets cross-referenced in a database or looks suspicious for another reason.

After the Medicaid Fraud investigator has conducted the investigation and gathered all the evidence they can, they will then send you a letter asking you to come in for an interview. By that point, they typically have enough evidence for a criminal conviction, and are just trying to get you to admit that you have committed Medicaid Fraud.

At a Medicaid fraud investigator interview, there is a difference between not volunteering information and providing false information. Providing false information to the investigator can come with a serious jail sentence.

Don’t think you can fool HRA investigators. They probably already have the evidence of you lying on the Medicaid application. They have whatever information triggered the investigation. That’s why they have sent you a Medicaid fraud investigation letter. They’ve probably interviewed the institution where that information came from, such as a bank, school, place of work, or government agency. They probably already have documents that show that you are not eligible.

On the flip side, maybe the HRA does not have enough information of you lying on the Medicaid application, so they are trying to get it from you. But it is also possible that they are trying to get you to lie, to add obstruction of justice as an extra criminal charge. You don’t want to be taking those chances.

Look at the recent high-profile convictions. Most of them had to do with lying to the investigators, some even more than the underlying fraud.

You have the right to remain silent. But not to lie to Medicaid investigators.

People get caught lying on a Medicaid application every day. If you received a letter from the HRA DSS IREA BFI, speak to a Medicaid Fraud lawyer today. We at the Law Offices of Albert Goodwin are here for you. We have offices in New York, NY, Brooklyn, NY and Queens, NY. You can call us at 718-509-9774 or send us an email at attorneyalbertgoodwin@gmail.com.

As a lawyer who deals with people accused of HRA DSS Medicaid and SNAP fraud, I frequently hear people claim that a man is not a part of the household. Here are some of the frequently asked questions and the relevant HRA DSS Medicaid and SNAP rules.

Q: My husband does not live in the house. He lives in his own house, or with his girlfriend, or by his father, mother, parents or aunt or uncle. Is he a part of the household?

A: As long as you are married, he is a part of the household even if he lives somewhere else. Some people who claim that they live apart are actually not being truthful. Some people are telling the truth. To the investigators, it does not matter. Besides, in a typical Medicaid or Food Stamp fraud investigation, the HRA DSS investigators already have records of the husband living in the house – video footage of the husband entering and exiting the house, perhaps his GPS location, interviews with the neighbors etc. Sometimes, even interviews with the husband himself where he admits he lives in the house! But that is not even the point. As long as you are married, he is a part of the household no matter where he lives.

Q: My husband only lives in the house part-time. He’s there sometimes, and he even sleeps over sometimes, but a lot of the time (most of the time) he is not in the house. Does that mean that his income does not count for our Medicaid or SNAP (Food Stamp) eligibility?

A: As long as you are married, he is part of the household no matter where he lives.

Q: My husband and I are separated. And I listed on the application that we are separated. How is that fraud?

A: There is a lot of confusion about what being separated means. Legally, you are not separated until you get a judgment of separation, which is a legal document similar to a divorce. Nothing else is legally separation. So, not living together – living together but not talking – being married but having an open marriage – all of those things are not legal separation. As far as DSS HRA representatives and the bureau of fraud investigation are concerned, no legal separation means no separation at all.

Q: Me and my husband are legally separated. Does that mean that he is not a part of the household?

A: Real legal separations are rare, because people can usually get a divorce for the same money. I for one have not seen one. But if one does happen, then yes, the two parties would be in a separate household. Unless they have children together.

Q: The father of my children and I are not married. Is he a part of the household?

A: DSS HRA rules about children’s fathers who are not married to the children’s mothers are complicated. In many cases, an unmarried domestic partner is a part of the household when you have children together. Things such as living together, claiming children as dependents on an income tax and contributing to the family’s budget can easily tip the scale towards being considered a part of the household.

Exception: If you are a victim of domestic abuse or domestic violence, under certain circumstances your husband or partner is not a part of your household.

The examples here apply to Family Health Plus and Child Health Plus investigations as well.

If you are being investigated for New York City HRA DSS Medicaid or SNAP (foodstamp) fraud, do not delay, contact an attorney immediately. My name is Albert Goodwin and I can be reached at (212) 233-1233 or by email here.

If you just received a letter from the Suffolk County Department of Social Services Office of Special Investigations, you understandably have concerns. The letter can be about Medicaid investigation or SNAP investigation. The most important thing to do is to not panic and not call the phone number on the letter but speak to an attorney instead.

If you would like to discuss the letter with an attorney, we at the Law Offices of Albert Goodwin are here for you. You can call us anytime at 718-509-9774.

Here are the most frequently asked questions with answers based on our experience with Medicaid fraud and SNAP food stamp fraud investigations.

Should I contact the investigator like the letter says?

Do not contact the investigator. They are trained to get you to provide incriminating information that can be used against you in court. If you talk to the investigator, they will ask to provide more information and will ask to provide documents. They will continue working the case until they build enough of a case to take to court and secure a criminal conviction.

Recently, they have also set up an online portal where they ask the targets of their investigation to send them documents. After that, if they receive enough incriminating information about their target, they may refer the case to the District Attorney’s office to prosecute in criminal court.

They may ultimately settle the case with no criminal liability. But they like to build a strong criminal case against you first. Which is something that you would rather do without.

And this is why speaking to an investigator is a bad idea. Because you will end up providing incriminating evidence against yourself.

But ignoring the investigation is also a bad idea, because it will not go away on its own, it will only get escalated to the District Attorney’s Office. That’s because even though they don’t have your testimony, they typically already have enough documentary evidence to build a successful criminal case against you.

This is why the best way to resolve a food stamp investigation is to have an attorney handle it for you. Attorneys are trained to protect your rights.

If you need an attorney, we at the Law Offices of Albert Goodwin are here for you. You can call us right away at 718-509-9774.

If a Department of Social Services investigator sees that you are not following up, they may try to contact you. You can just tell them that you cannot talk to them. There is no need to worry about disappointing the investigator. They understand that remaining silent is your right and that letting you remain silent is a part of their job.

It’s definitely not a good idea to back to them. Then you are just doing their job for them. Have an attorney follow up with them instead.

I already talked to an investigator. What happens now?

If you did already talked to an investigator, think about this: was talking to them really a good idea?

An investigator has years of training and experience that you do not have. They have many strategies at their disposal. Here are some examples:

• They can pretend to be friendly
• They can lie to you
• They can threaten you
• They will try to get you to reveal incriminating information that can be used against you by the D.A.
• They can detain you
• They can show their true face and let you know what kind of trouble you’re really in
• They can work in pairs and play good cop-bad cop
• They can make you sign a statement
• They will record everything you say
• They can testify to what you’ve said
• They have the time to be persistent

And what strategies do you have? None.

• Do not talk to the investigator
• Do not be friendly with them
• Do not cry
• Do not give them excuses
• Do not try to show them that you’re a real person, not a criminal from TV
• Do not think that if you’re honest and provide all the (incriminating) information, they will let you go
• Do not tell them you’re a single mom
• Do not beg for their sympathy
• Do not tell them you don’t have money
• Do not tell them you didn’t know
• Do not tell them the children’s father and you are “separated” in your mind
• Do not tell them someone else told you to fill out the application this way
• Do not tell them you don’t know the language
• Do not tell them the change is recent and you didn’t have the time to report it
• Do not them you had no choice
• Do not tell them it’s the government’s fault

If you continue talking to the investigators, you will crack under the pressure. Everyone does.

What kind of evidence does the Department of Social Services already have against me?

Here is the kind of evidence the investigator already has:

• Records of everyone who resides in your household
• Records of everyone’s income, from tax returns and employment records
• Records of everyone’s assets, from bank statements and deeds
• Copies of leases
• DMV records
• Records of everyone’s addresses and actual physical place or residence and employment
• Records of usage of the benefits card, including date, time and location
• Photos, videos and recordings

The Department of Social Services office of special investigations is investigating me, will I go to jail?

Some people have gone to jail for Medicaid or SNAP fraud. But that does not mean that you will. What this does mean is that you should speak to an attorney immediately and discuss your legal strategy. Since Medicaid and SNAP fraud is a crime, Department of Social Services office of special investigations can be escalated and referred to the District Attorney’s office by the Department of Social Services investigator. It is crucial to hire a fraud defense attorney who is familiar with criminal investigations, in order to increase your chances of a good defense.

What is the penalty for Medicaid or SNAP fraud?

New York Penal Law 155 describes the sentencing guidelines for someone committing Medicaid or SNAP fraud. The sentence depends on the total amount received. For most people, the amount received from Medicaid or SNAP is between over $3,000 and under $50,000, which according to the guidelines can carry a sentence of up to seven years in jail.

Amount Received	Degre of Welfare Fraud	Section of Penal Code	Felony Class	Penalty
In excess of $1,000 but not more than $3,000	Fourth Degree	PL 158.10	Class E Felony	up to 4 years in prison
In excess of $3,000 but not greater than $50,000	Third Degree	PL 158.15	Class D Felony	up to 7 years in prison
In excess of $50,000 but is not more than $1 million	Second Degree	PL 158.20	Class C Felony	up to 15 years in prison

Payment of Restitution

If you are prosecuted by the District Attorney’s office and get sentenced, then you will not only have to go to jail but would also have to pay back the benefits received as restitution.

Do I have to pay back the entire amount?

The important thing to remember is that the priority is to avoid criminal liability. Having said that, the amount of payback is also important. 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. Some of the ways we do that are showing a period of eligibility. The letter can be an indication of what we are dealing with.

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 avoid benefit payback, and it may be possible to keep your services and benefits. However, most investigated cases have a solid foundation and are difficult to challenge in a significant way.

Can I pay back the DSS Department of Social Services in installments?

The priority of the office of special investigations is to collect as much as they can with as much of it upfront as possible. It is possible in some cases to enter into an installment agreement, with assistance from an experienced attorney. It’s easier to get low installments on Medicaid cases than on SNAP cases. If you got a letter from the Department of Social Services and you are looking for an attorney, you can contact us at attorneyalbertgoodwin@gmail.com.

How much does it cost to hire an attorney?

The fee for a Medicaid fraud or food-stamp fraud attorney to represent you during a Medicaid or SNAP food stamp ion by the Department of Social Services would depend on your situation, which will be explained in the letter or during a meeting with the Department of Social Services or.

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 a person does not reside in the household, can the Department of Social Services still say that they do?

Even if you claim that a person does not reside in the household, the Department of Social Services Office of Special Investigations can still consider them to be a part of the household and target them as a part of the Medicaid and SNAP investigation process. We often see a person not listed as part of the household receiving a letter from the bureau of fraud investigation as well. A children’s father is considered to be a part of the household often just by virtue of being the father, and often with the following additional factors:

• spends time in the household
• married to the mother of the children
• list the household address on his tax returns
• claim children as dependents
• claims the mother of the children as a dependent
• has his name on the deed, lease or the utility bills
• provides material support for the family

Separated people living together

We live together, but I am of the opinion that we form separate households, we are two different families, why is the Department of Social Services saying that we are in one household?

The Suffolk County Department of Social Services views everyone living in the household as being the same household, even if the people themselves don’t consider themselves that way. The Medicaid administration would be especially concerned if the people in the house are related – let’s say, grandmother or uncle. It’s different if people are just roommates. In a situation where there is a family, especially where the father of the children is not listed on an application or recertification, a fraud investigation is a frequent occurrence.

Is there a way to beat a Medicaid or SNAP fraud investigation? Read about the 9 things we always do in an Department of Social Services SNAP or Medicaid fraud investigation plus the 5 things you should never do in a Suffolk County Department of Social Services SNAP or Medicaid fraud investigation.

I got a letter from the Department of Social Services and it’s unclear. What does it actually say?

Here is the standard text of the letter in its entirety:

County of Suffolk Department of Social Services
Office of Special Investigations

This office is conducting an investigation concerning your eligibility to receive public benefits. These services may include one or more of the following programs: Temporary Cash Assistance, SNAP, Medicaid, Child Care and/or HEAP.

Our records indicate that you may have received overpayments to which you were not entitled because of the following:

( ) Family Composition
( ) Unreported Income or Benefits
( ) Unreported Assets
( ) Other

If the investigation uncovers evidence which indicates fraudulent receipt of benefits or services, further action may be taken.

A telephone interview has been arranged for you with investegator ___ who can be reached at _____ to discuss these matters. Please call this number on _______ at _____. If you are unable to keep this appointment,then you may also call the above listed number to arrange a new appointment date and time.

(Or, An interview has been arranged for you with an investigator. Please report on the following date to the address checked off below:

( ) CORAM CENTER, 80 Middle Country Rd., Coram, New York
( ) SOUTH WEST CENTER, 2 south 2nd St., Deer Park, New York
( ) SMITHTOWN CENTER, 200 Wireless Blvd., Hauppage, New York
( ) SOCIAL SERVICES – Mary Gordon Building, 3085 VEt’s Memorial Highway, Ronkonkoma, New York
( ) RIVERHEAD CENTER, 893 East Main Street, Riverhead, New York

PLEASE DO NOT CALL THE ABOVE NUMBER UNLESS YOU WISH TO RESCHEDULE YOUR APPOINTMENT. THIS MATTER CANNOT BE DISCUSSED OVER THE TELEPHONE.)

Any other appointments scheduled by this Agency must also be kept. If you are presently receiving Temporary Cash Assistance, failure to keep this appointment may result in action to close your case. Failure to keep this appointment will not affect your SNAP eligibility.

At the interview, if it is determined that you received an overpayment of benefits or services through fraud or deliberate concealment of a material fact, one of the results may be that you may be requested to sign an Affidavit and Confession of Judgment (COJ). If a COJ is requested and signed, it will be filed with the County Clerk, become a lien on any real property you own within Suffolk County, may be erected upon through garnishment of salary and may be used against you in any criminal, civil or administrative proceeding. You do not have to sign a COJ, however other legal actions may be taken against you.

ALL PERSONS INTERVIEWED HAVE A RIGHT TO HAVE LEGAL COUNSEL OR A LAY PERSON PRESENT DURING THE APPOINTMENT. THERE ARE COMMUNITY LEGAL SERVICES AVAILABLE TO ASSIST YOU.

(Please bring this letter, your Social Services identification Card and the following items with you:

PHOTO ID, MOST RECENT BANK STATEMENTS FROM ALL BANK ACCOUNTS, PAY STUBS, TAX RETURNS)

In addition you may be asked to supply additional documentation as a result of this interview. You may fax this documentation to the attention of the above named investigator.

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If you think that the Department of Social Services Medicaid Fraud Division is investigating you for SNAP or Medicaid fraud, contact an attorney immediately.

We at the Law Offices of Albert Goodwin represent people who got a letter from the Department of Social Services Office of Special Investigations. We also represent clients in defending criminal charges associated with Medicaid and SNAP fraud. You can reach Albert Goodwin, Esq. at (718) 509-9774.