New York Medicaid-Medicare Fraud Frequently Asked Questions

Medicaid fraud occurs when someone knowingly makes false statements to get Medicaid to pay for medical services. It can involve providers billing for services not provided, performing unnecessary tests, providing contraindicated medical services or supplies, making unnecessary referrals, or charging separately for services usually offered at a packaged rate. A Medicaid fraud investigation can lead to both state and federal charges.

A Medicaid recipient can be charged with Medicaid fraud if they make false statements on a Medicaid application, loan their Medicaid card to another person, intentionally receive duplicative medical services or supplies, or re-sell items provided by Medicaid.

Medicare fraud occurs when a person or company tries to collect Medicare reimbursement money under false pretenses. It can involve submitting duplicate billing for medical treatment, billing for medical services that were not performed, intentionally misrepresenting services performed, or submitting fraudulent cost reports. Medicare fraud, whether it is intentional or not, can be committed by a variety of health care professionals including physicians, assistants to physicians, and hospital administrators.

Medicaid is jointly funded by each state and the federal government. Medicaid fraud can implicate both federal and state law. Penalties for Medical fraud can include restitution, fines, prison, program exclusion, and suspension of medical license.

The skilled attorneys at the Law Offices of Stephen Bilkis & Associates have more than 20 years of experience successfully representing clients in New York charged with felonies and misdemeanors, and have the skill and resources to put on the best defense possible. Contact us at 800.NY.NY.LAW (800.696.9529) to schedule a free, no obligation consultation regarding your case. We represent clients in the following locations: Nassau County, Bronx, Brooklyn, Long Island, Manhattan, Staten Island, Suffolk County, Queens, and Westchester County.