List of Investigators part of this division
The best way to close a case with this division is to enter into a Settlement Agreement. The Settlement Agreement is a one page document which the client signs. There are three ways that a Settlement Agreement can be structured:
1) the client settles by paying a lump sum settlement amount;
2) the client settles by paying a portion by check and agrees to pay the balance in monthly installments;
3) the client settles by agreeing to pay monthly installments.
Signing a Settlement Agreement with this division is the only way to close a case once this department reviews your case. As your attorneys, we will make sure that the Settlement Agreement states specifically that the client is making a voluntary payment and does not admit any wrongdoing at all.
Typically, Settlement Agreements in this department must be signed at the HRA office located at 151 West Broadway on the 7th floor. They do not permit this type of Settlement Agreement to be signed outside of their office. The client’s signature is then notarized by a notary public at the HRA, and a copy is made for the client.
Making payments under the Settlement Agreement
If you agree to make payments under a Settlement Agreement, it may take several months for the billing department to start sending you a bill. As a general rule, the payment is due on the first day of the month. The department gives you a 15 day grace period, and the payment is not considered late until after the 15th of the month. Once a client is logged into the billing system, a bill will be sent to you at the address you provided. You owe the money to the HRA even though they have not sent you a bill. So its best to send a money order to the address on the Settlement Agreement and make copies and notes on the dates of payment for your records.
New York City Department of Social Services
Division of Accounts Receivable and Billing
180 Water Street, 9th Floor
New York, NY 10038
The telephone number for the DARB is:
(929) 221-6054 or
If you have any questions about billing, please give them a call.
What types of payments are accepted:
Payment can be made by bank check or money order. The check should have your claim number on the memo line, so that the payment can be traced to your account.
NYC Human Resources Administration
Bureau of Fraud Investigation
Division of Financial Reporting & Analysis(DFRA)
250 Church Street, 12th Floor
New York, New York 10013
Investigators at this location:
Supervisor is Maxo Kernizant
250 Church Street
NYCRR Title 18 DSS Medicaid Guidelines
Legally Responsible Relative – According to the HRA rules, a married person is obligated to support their spouse pursuant to three separates bodies of law:
1) Section 412 of the Family Court Act
2) Section 32 of the Domestic Relations Law
3) Section 101 of the SSL
Parents are obligated to support their children under the age of 21, including stepchildren, adopted children, foster children and children born out of wedlock. This often comes up when a benefits recipient is not married to the father of her child, the father is still obligated to support the child, regardless of what his personal relationship with the child’s mother is. The father’s earnings can make the child ineligible for medicaid even if the parents are not living together or married. The mother may be eligible for benefits for herself only.
The HRA regularly investigates families where the mother and father of a child are not married and the mother and child receive benefits. If the father’s earnings make the child ineligible, the HRA will come after the father and in some cases the mother for repayment. The mother may be eligible depending on other eligibility factors.
The HRA regularly investigates families to determine who lives in the household. They conduct field visits to the home, conduct surveillance, and take photos of people coming in and out. The HRA will search public records to gain information about the benefit recipient. Its common for the HRA to search property records to see who owns the home they live in. They will search DMV records to see where their cars are registered. They will look for tax returns to see where they are filed. The HRA will even make visits to the home and talk to neighbors. The HRA has photos of recipients so they know who to look for when they make field visits.
The HRA vigorously investigates cases where benefit recipients lie about their household composition. Typically, the HRA pursues these cases aggressively. They use investigative techniques to see who really is living there. Often times, a benefit recipient will leave out other members of the household for a variety of reasons. It could be that they used to be in a romantic relationship or married but are no longer considering themselves together. Regardless of what status the relationship is in, the HRA believe these people to be living in the same household for eligibility purposes.
The composition of the household can effect both eligibility into the program and also the amount of benefits that you can receive. The HRA will look at all household memebers’ earnings to determine eligibility.
The HRA investigates houshold composition fraud in a variety of ways, but there are two main reasons for investigating this. First, if an applicant lies on the application and hides a household member, its often because that hidden memebr’s earnings will make them ineligible for benefits. Second, when it comes to SNAP benefits, if a household member listed on the application is not living there, then the amount of benefits should be reduced to reflect the true household size.
250 Church 9th Floor –
Provider Fraud Division
The division is the provider fraud division, the investigators from this division are not investigating individual reciepient fraud and eligibility but are investigating provider fraud on a large scale. The investigators will be focused on the details of the interactions between the patients and the doctors. They are looking into the following questions:
Often times individuals who recieve these typr of target etters can have a medicaid restriction thru the inspector general of medicaid’s office, which will mean the recipient can only see certain providers and go to certain pharmacies. The investigators will review the claim detail report (“CDR”) and see whether the recipient is reciving drugs that would contradict with treatment they are receiving.
If you are the target of a medicaid fraud investigation, call our office 24/7 for a free consultation. We have offices in Brooklyn, Manhattan and Queens.