In New York, Medicaid is offered to recipients who qualify based on federal regulations and guidelines. Local Medicaid agencies review applications to determine eligibility. Although the agency enforces strict regulations for this insurance coverage, the occurrence of fraud continues. Medicaid Fraud Lawyers Orange County NY fight back against allegations of these violations.
Lying About or Hiding Income Sources
Fraud occurs when applicants lie about their income. In fact, applicants who commit fraud often hide additional sources of income. Under applicable laws, parents may acquire Medicaid based on their own income. If a stepparent is involved, the agency doesn’t include their income in the eligibility process. However, applicants who are married to state workers don’t qualify for these benefits. If the applicant doesn’t disclose the spouse’s income for this reason, they have committed fraud.
Applying for Benefits When the Child Doesn’t Live with You
Parents who have a qualifying income may acquire Medicaid coverage for their child. Through extended programs, these parents may acquire their owner Medicaid coverage. However, if the child doesn’t live with them on a full-time basis, they don’t qualify for coverage based on residency requirements.
Using the Medicaid Coverage of Another Individual
Fraud is apparent if an individual who isn’t covered through the plan uses the coverage of another individual. This occurs when the non-eligible individual acquires any Medicaid-related service by using a covered individual’s name and insurance. When this form of fraud is discovered, coverage is suspended and the fraudulent user must repay the benefits used.
Providing False Information to a Government Agency
Any information found on a Medicaid application that is invalid could result in a perjury charge. These actions are defined as providing false information to a government agency. It is a form of fraud in which the applicant hopes to acquire coverage through falsification of the document.
New York courts enforce any form of Medicaid fraud. These actions may include undiscovered income sources, claiming the wrong marital status, or claiming children who don’t live with the applicant. These actions could result in hefty fines and the potential of a prison sentence. Anyone who is accused of these actions should hire Medicaid Fraud Lawyers Orange County NY by contacting Mark Aberasturi for more information today.
