According to reports, FBI Director Kash Patel plans to team up with Nassau County Executive Bruce Blakeman to tackle widespread Medicaid fraud scams ongoing in New York state. The duo plans on creating a coordinated effort led by the FBI and the Nassau Police Department to specifically go after New York state’s alleged Medicaid fraud involving Nassau University Medical Center.
The healthcare organization is alleging that New York state has illegally and unfairly withheld over $1 billion in Medicaid funds over the past 20 years by refusing to pay out valid insurance claims.
The state’s refusal to pay out these valid claims could be, according to Attorney General Pam Bondi, a violation of federal Medicaid laws and an intentional breach of contract with the federal government.
After looking into the situation, it’s clear that these allegations have been ongoing for a long time. The Nassau Health Care Corporation, which oversees the hospital, decided to initiate a lawsuit last year regarding the situation. The lawsuit names Nassau County Interim Finance Authority as being grossly negligent in handling the hospital’s claims. NIFA reportedly assumed financial control of the medical center in 2020 but failed to acknowledge the widespread Medicaid fraud and reduced aid were creating a financially distressing situation for both the hospital and some of the patients.
Now, the company additionally believes they are being retaliated against.
Facing Fraud Charges in New York
Under the law in New York, fraud is defined as falsely representing facts by conduct or words that are misleading or in a way that conceals relevant information that should be disclosed. Fraud is deliberate, and Medicaid fraud happens when someone intentionally misrepresents their situation in order to receive monetary benefits through the Medicaid program.
Some of the most common forms of Medicaid fraud are phantom billing, upcoding, unbundling services, arranging kickback agreements, double billing, patient identity theft, prescription drug fraud, and misrepresenting qualifications.
Medicaid fraud is taken very seriously in New York. Each individual violation could lead to up to 10 years in prison. If the fraud led to a serious bodily injury for a patient, then the violation could result in up to 20 years in prison. Each violation could also result in fines of up to $250,000 for individuals and $500,000 for organizations.
If you’re a healthcare provider, then you will likely have your medical license suspended or revoked entirely. You might also face mandatory supervision requirements and more stringent reporting requirements. You might also be excluded from participating in the Medicaid program for a minimum of five years depending on the nature of your specific violation. Unfortunately, a conviction often leads other private insurance companies to also terminate contracts with your organization.
The best way to avoid all these consequences is to prevent a Medicaid fraud conviction. A solid lawyer can help you navigate your situation and help you minimize the fallout from facing charges.
Schedule a free phone call with our team to discuss your case and get a free evaluation from our lawyers.
