Healthcare providers in New York face a rising level of scrutiny as federal and state authorities continue to crack down on Medicaid fraud. One of the first things to know is that a fraud case begins long before official criminal charges are filed.
Healthcare fraud investigations may involve federal or state agencies, or both working together. If you find out you are the subject of such an investigation, do not wait until you officially face action. Speaking with a qualified defense attorney right away can help you substantially.
What starts an investigation
There are several ways a healthcare provider can become the target of an investigation. Both private insurance companies and state agencies are increasingly adopting the use ofsoftware to detect suspect billing patterns. Agencies may also respond to a tip from a patient, an employee or another provider.
Top mistakes to avoid
People are prone to panic when they learn they may face Medicaid fraud allegations. This is indeed a serious situation where your freedom and livelihood are potentially on the line. However, it is important to not let your fears push you into irrational actions that can severely damage your case.
Do not instruct your employees to lie to investigators, even if you do not think you are actually covering up any criminal misdeeds and just want to avoid misunderstanding. Similarly, do not alter, hide or destroy any papers, no matter how minor or irrelevant.
Another instinct many people have, especially those who have never been in trouble with the law, is to fall over themselves trying to help the investigators. They reason this will convince the investigators of their innocence.
However, you should understand that investigators, no matter how friendly they may seem, are not there to clear things up for you. Do not give them anything they do not have a warrant for. Avoid speaking with them before consulting with your attorney, who can prepare you for this interaction properly.