Medicaid Fraud & Healthcare Fraud Attorney in New York

As a top New York Medicaid Fraud lawyer, Inna Fershteyn handles all matters to do with Medicaid Fraud investigations including representing her clients during their interview with a fraud investigator and negotiating a settlement on their behalf if a “0” payback resolution is not within means.

What is Healthcare and Medicaid Fraud?

Healthcare fraud is committed when a consumer or provider of healthcare intentionally submits or causes someone else to submit false information for use in determining the amount of benefits they may receive from a health insurance program. A common form of healthcare fraud is Medicaid Fraud, where an applicant provides false information on their application in order to receive benefits that they are not legally entitled to receive. The Office of Inspector General estimates more than $2 billion is lost annually to Medicaid fraud. 

Medicaid and general healthcare fraud from the provider exists in many forms including the following:

Upcoding - occurs when a provider submits claims for more serious procedures than those actually required for effective treatment

Kickbacks - arrangements made between healthcare providers where one party refers patients to another in exchange for compensation

Unbundling - occurs when the provider submits codes for two or more separate treatments when they were actually performed together. As a general rule, government healthcare programs reimburse in higher amounts for procedures that are performed separately

Unnecessary treatment - healthcare provided at a volume or cost that is higher than appropriate

Medicaid Fraud from the consumer side occurs almost exclusively when an applicant submits false information or omits information about their assets and relevant details about their living situation. A Medicaid Fraud investigation begins with a letter that is sent to the fraud suspect from the Human Resources Administration (HRA) informing them of the investigation and inviting them to an interview with a fraud investigator at a specified date and time. Common reasons for being sent an investigation letter include the following:

  • Failure to report all income on Medicaid application
  • Failure to report increases in income as a result of a raise or new job
  • Failure to report income of someone who lives with you
  • Failure to report income-generating assets
  • Failure to report that healthcare benefits are available to you through your employer
  • You no longer live in NY but still receive benefits in the state

While you may feel pressured to comply with the letter and begin handling the matter yourself, it is highly recommended that you consult with a NYC Medicaid Fraud attorney prior. Any information that you provide to the fraud investigators during your interview will be used against you. That being said, a NYC healthcare fraud attorney can help make sure that your cooperation with the fraud investigators results in the lowest penalty, if any.

Medicaid Fraud & Healthcare Fraud Services We Offer

The Law Office of Inna Fershteyn takes on clients that have been notified of an active Medicaid fraud investigation into their Medicaid eligibility by the Human Resources Administration. After learning about a client’s case during the initial consulting, NYC medicaid fraud attorney Inna Fershteyn then arranges to meet the fraud investigator on the client’s behalf and proceeds to negotiate an offer with the District Attorney’s office to avoid incarceration and potentially reduce the felony conviction from Medicaid Fraud to misdemeanor. As part of her representation, NYC healthcare fraud attorney Inna Fershteyn will work to negotiate a settlement on behalf of the client.

If you are looking to find the best Medicaid Fraud services in New York, call us at (718) 333-2394 to set up a consultation.

The False Claims Act

The False Claims Act, also known as the “Lincoln Law” protects employees as well as contractors, agents and other parties when they report potential fraud within their organizations. Section 3730(h) of the False Claims Act mandates that any who is discharged, demoted, harassed because of their legal involvement in reporting fraud within the organization is entitled to reinstatement or other compensation as deemed by the respective court.

Whistleblowers play an instrumental role in maintaining transparency and accountability of healthcare providers. When whistleblowers report legitimate fraud, they are doing a service to all US taxpayers.

A 10-step guide for whistleblowing in relation to Medicaid fraud can be found here (https://www.medicaidfraudhotline.com/ten-step-whistleblower-guide.php)

Contact a NY Medicaid Fraud & Healthcare Fraud Attorney Today

With over 20 years of valuable experience in the field, the Law Office of Inna Fershteyn touts thousands of successful Medicaid fraud cases closed. If you’ve received an investigation letter from the Human Resources Administration (HRA) and were asked to appear for an interview, call us today and schedule a consultation with NY Medicaid Fraud Attorney Inna Fershteyn.

Testimonials

Inna did a great job closing my HRA case with a “0”. She was very professional and my case was closed in 2 months.  She is the best Medicaid fraud attorney! - Chee Yuen

Thank you so much for all of your  help and speedy processes ! I couldn’t believe how fast you closed my case with the answer I was looking for . You have given me such a peace of mind and it was a perfect way to end the year . If anyone is looking for a Medicaid lawyer ! She is truly the one to go to! - thank you once again! - Khloe Encarnacionare

Inna helped me resolve a complicated matter with HRA Medicaid quickly and easily. Matter was resolved in 3 weeks with satisfactory resolution for both parties. - Marina T.

Inna is the best attorney she closed my HRA case right away.  She did estate planning and Medicaid planning for my family and she was the best.  Before we met Inna we saw 2 other lawyers who were not competent to handle the case and they never said they would try to win my HRA case.  I am really happy. - Jamie Lin

Inna Fershteyn is a wonderful, smart, experienced and amazing person.  She closed my Medicaid fraud case in less than 2 weeks and she got me the best settlement.  She is really a people’s person- you feel like you can talk to her and she is very down to earth and approachable.  All investigators in the HRA office love her as well as she treats everybody with respect.  I feel like Inna was sent to us by a higher power; she let me sleep at night. - Rafaela Nunez

Inna closed my Medicaid fraud investigation claim with the HRA office and she was really nice to work with.  She always returned my phone calls and spent endless time negotiating my claim with the investigator.  I know she handles a lot of Medicaid and HRA and Food stamp fraud cases and I saw her represent various clients.  I was very happy with her. - D Flores

I found Inna Fershteyn online searching for the best HRA medicaid fraud attorney. She came up in all the searches as the top reviewed and top rated medicaid attorney.  And for a reason.  She was really personable and smart and knew the system very well.  She worked very hard on my case and went to every supervisor that she knew in the medicaid fraud office and moved mountains for me.  She closed my very difficult case and I am very grateful. - Serita Mendez

FAQS

  • Can I report fraud anonymously?

While you can report fraud anonymously, remaining anonymous may present itself a challenge once the case is open to the public. That being said, the False Claims Act provides protections to people who help bring fraud within their organizations to light. If you’ve witnessed healthcare fraud within an organization that you’re involved in, call 1-800-HHS-TIPS for information on how to safely provide any useful information you have. 

  • How do I protect myself from retaliation from exposing fraud?

The False Claims Act (FCA), Dodd-Frank and the Sarbanes-Oxley (SOX) Acts were passed into law to grant whistleblowers federal protections when they expose fraud at organizations with which they are involved. If you’ve witnessed fraud at your company and are considering being a whistleblower, take the following steps to ensure that you are as protected as possible.

  1. Hire an Attorney
  2. Maintain As Much Privacy As Possible
  3. Document All Evidence
  4. Follow the Rules
  5. Prepare for Exposure
  6. Listen to Counsel
  • What do I do if I believe there is fraud on a personal Medicaid or healthcare claim?

If you feel that you have a valid claim of fraud with supporting evidence, then we highly recommend that you seek counsel from an attorney specializing in Healthcare fraud, Medicaid fraud, and Whistleblowing. An attorney will walk you through the process of filing the claim and advise you on how to proceed. To report a fraud you may call the hotline of the Department of Health and Human Services Office of the Inspector General at 1-800-HHS-TIPS (1-800-447-8477).