Medicaid Recipient Target Letters
The first time a recipient of medicaid benefits is alerted to the fact that they are the subject of a medicaid fraud investigation is the receipt of the “target” or “call” letter. This letter will request that a recipient of benefits come down to the Human Resources Administration’s office for an interview. The letter will also request that the individual bring down various documents with them. The letter will arrive either by personal delivery by an investigator or by mail.
Sample Medicaid Recipient Target Letter
The first thing to understand in a target letter is the introductory sentence. The “office is conducting an investigation concerning your eligibility for medicaid. This sentence should alert recipients that the inquiry is limited to whether they are eligible or not. There are mandated medicaid guidelines for household size. At this juncture in the investigative process, you have not been charged with welfare fraud or filing a false instrument or any other other crimes that often occur in medicaid fraud criminal cases.
As you can see the investigator would like you to come down to their office to have an interview with them and another investigator from the human resources administration. The purpose of this interview is to obtain as much material and information from you that could help them in determining your eligibility. Once has to keep in mind that the investigators are hired for one purpose and one purpose only to investigate medicaid fraud. If they find that you are culpable for intentional criminal conduct they have an obligation to pursue their claim.
Medicaid Fraud Document Request
The next part of the letter which will be important to consider is the documents that are requested. These documents can at a minimum provide you with some insight into what the issues are in your medicaid fraud investigation.
Proof of Identity
This is used for dual purposes. That the individual appearing before the HRA is the individual who is the subject of their medicaid fraud investigation and more importantly where the individual resides. Why can this be an issue? Medicaid is county based program. This means that you must reside in the county in which you applied for benefits. If you and your family reside in Nassau County but applied for benefits in Queens County this would be potential fraud.
Again this is used to establish identity, address, and also can be an opening to determine whether you have a car and if so, how you pay for the car, gas, insurance, parking, etc. Remember these are investigators, they are seeking any leads to any information that can help them in their fraud investigation.
This is used to determine if you are legally married. If so, where does your spouse reside? Do you have children? If so, where they go to school? What county? Is it public school or private school? When were you married? Where did you live at the time?
Income Tax Documents:
Personal and business income tax documents will be requested. Income tax documents provide a wealth of information to the investigator. It will detail gross and net income, it will detail expenses, dependents, addresses, real estate, etc. My firm represents a fair amount of small business owners who dictate what their salary is and what expenses can be deducted from their income. Although you may liberally deduct expenses for tax purposes, the investigators at the HRA will not see it the same way
Rental Lease For Your Apartment
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Letters of Support
If you recieve a medicaid fraud target letter feel free to call our office 24/7 at (212) 300-5196 for a free no-risk consultation.
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.