What constitutes Medicaid fraud: And when should you hire a criminal lawyer?

The Many Faces of Fraudulence

Medicaid fraud stands as one of the nation’s greatest liabilities risks for agencies operating in the health sector (or even those who offer insurance). It’s tricky, entangling, and overall difficult to assess as there are millions of claims each year alone (some valid, others not).

Countless numbers of these are false claims — in essence, individuals (in some cases, even corrupt corporations or small businesses, too) attempting to cheat the system by any means.

When one tries to bend the rules, it can affect not only the coverage offered in the local market but also that of others honestly attempting to obtain or further their Medicaid DOC (Degree of Coverage).

A few examples of such common fraud include the following:

• Willful, openly neglectful statements or testimonies using false evidence (such as misrepresenting/adding/leaving out facts about one’s current coverage and payments while not stating honest amounts)
• Stealing another person’s identity and hacking their Medicaid benefits on their behalf
• Billing for visits or services that never occurred or were never offered + overbilling (usually by fraudulent providers or even companies)
• Card sharing: When recipients claim reimbursements for those not listed as eligible beneficiaries
• Basic collusion (most common case): Creating false claims for malpractice or incidents that never occurred

About Spodek Law Group: A Convict’s Best Defense Strategy

A quick note on this: If you need a good lawyer to handle any fraud claim on your behalf, Spodek Law Group is an NYC group of criminal attorneys devoted to justice. They don’t rest until you do.

When your case involves loan fraud, tax fraud, pharmacy fraud, SNAP fraud, subpoenas, or even drug offenses, Spodek Law Group will represent you from start to finish. Spodek Law Group covers civil RICO cases as well. Contact Spodek Law Group today!

When to “Lawyer Up”

Having the right criminal defense attorney(s) on your side can literally make the difference between a full life sentence and a 20-year imprisonment with parole. Much more so, the rule applies if you’re guilty and hold no plea otherwise.

In all such cases, the best thing you can do is hear a specialist speak on your behalf and not say anything but “I would like my lawyer” until your attorney appears.

The phrase “Anything you say can and will be used against you”… holds true from the very moment the cuffs are placed on you and you’re officially arrested.

Anything said before such action isn’t covered under Miranda rights, meaning you can have all prior words said (with certain exceptions) “stricken from the record”. 

Final Thought?

Regardless of how deep a hole you’ve dug through incidental self-incrimination, having a solid defense attorney with a strong background in fraud litigation can assist in helping both Judge and Jury see things from another point-of-view. They’ll present you in the most favorable light, even with all cards not stacked in your favor. Medicaid fraud demands no less.

Countless numbers of these are false claims — in essence, individuals (in some cases, even corrupt corporations or small businesses, too) attempting to cheat the system by any means.