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Manhattan Medicaid & Welfare Fraud…cont

The pervasiveness of insurance fraud drives up costs for all consumers and costs the insurance industry billions of dollars each year. One authority estimates that the annual value of insurance fraud approaches $80 billion. Detecting insurance fraud is difficult because of the surreptitious nature by which the criminal perpetrates the fraud.

Depending on the specific issues involved, an alleged wrongful act may be handled as an administrative action or law enforcement may handle it as a criminal matter.

Generally, securities fraud occurs when someone makes a false statement about a company or the value of its stock, and others makes financial decisions based on the false information. Although the crime itself isn’t complicated, securities fraud can be particularly difficult to grasp if you lack an understanding of securities regulation. Below, you’ll find information on common forms of securities fraud and how to protect your assets.

If there is any easy way to make a buck off the health care system, someone is going to make a go for it even if their final prescription calls for an enormous dose of law enforcement. The Manhattan District Attorney’s Office just announced the arrest and indictment of 19 individuals for fraudulently obtaining medicaid benefits in the amount of $350,000. These individuals are charged with Welfare Fraud, Grand Larceny and Offering a False Instrument for Filing. 11 of the defendants allegedly misrepresented on paperwork that they were New Yorkers residing in Manhattan while 8 of the defendants allegedly misrepresented their income and financial resources. Without these misrepresentations, the defendants would not have been entitled to Medicaid.

Although the charges and degrees vary for each defendant, Grand Larceny in the Second Degree and Welfare Fraud in the Second Degree is a class C felony punishable by up to 5 to 15 years in state prison, Grand Larceny in the Third Degree and Welfare Fraud in the Third Degree is a class D felony punishable by up to 2 and 1/3 to 7 years in prison and Offering a False Instrument for Filing in the First Degree is a class E felony punishable by up to 1 and 1/3 to 4 years in state prison.

What happens to each of these defendants remains to be seen. Can they pay back what they allegedly stole? Was there a time where at least part of their claims were legitimate? Did they fill out all the paperwork or did someone do it for them? As I have said time and time again, these defendants need to identify their defense and implement it immediately.

Penalties for fraud offenses may include criminal penalties, civil penalties, or both. Most criminal fraud offenses are considered felony crimes and are punishable by jail, fines, probation, or all of the above. Civil penalties may include restitution (paying the person back) or payment of substantial fines (geared to punish the behavior). The penalties for your offense will depend on the nature, type, scope, and severity of the action and whether it was committed by an individual or an entity, such as a business, corporation or group.

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