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Mark I. Cohen, ESQ. NYC Criminal Attorney

NYC Health Care Fraud Attorney

Attorney Mark I. Cohen is a leading New York City based Medicaid Fraud lawyer, who represents New Yorkers in fraud investigations conducted by the New York City Human Resource Administration (NYCHRA) into Medicaid, Family Health Plus program, public assistance and food stamp fraud.
In New York City investigations into alleged Medicaid fraud are primarily conducted by the Department of Social Services Bureau of Fraud Investigations. Most investigations commence when the authorities uncover unreported or under reported income alleged by an applicant for benefits. Typically, investigators will contact the person(s) by letter soliciting an investigative interview and paperwork in support of the original application for benefits.
If you are targeted in an investigation by (NYCHRA) you should NOT communicate you should not communicate with the investigators nor appear at the interview without the assistance of Mark I. Cohen, NYC Medicaid Fraud Lawyer. This will avoid the risk of a targeted person making statements that will incriminate themselves and, possibly, lead to a criminal prosecution for health care fraud.

If you are a member of the heath care industry and are facing a possible fraud investigation, indictment or have been charged with healthcare fraud it is imperative that you get in touch with a qualified NYC health care fraud attorney Mark I. Cohen.

What Is Health Care Fraud?

Article 177 of New York Penal Law addresses the crime of health care fraud.  The following list describes the health care fraud laws in New York:

Health Care Fraud in the 1st Degree

  • Health Care Fraud in the First Degree (Penal Law § 177.25) is defined as when the individual intends to defraud a health plan, and then knowingly and willfully gives false or incomplete information in order to receive reimbursement or payment from a health care plan to which they are not entitled
  • First-degree charges require the total amount stolen to exceed $1 million and occur in a one-year period
  • Considered a B non-violent felony
  • Penalties
    • a minimum of 1 to 3 years of incarceration, and a maximum sentence of 8 1/3 to 25 years

Health Care Fraud in the 2nd Degree

  • Health Care Fraud in the Second Degree (Penal Law § 177.20) involves the same mental state as first-degree charges, but the total amount stolen must be up to $50,000 in a one-year period
  • Considered a C non-violent felony
  • Penalties:
    • potentially includes probation for first-time offenders, but punishable by up to a maximum of 5 to 15 years in state prison

Health Care Fraud in the 3rd Degree

  • Health Care Fraud in the Third Degree (Penal Law § 177.15) requires the total health care funds stolen to exceed $10,000 in a one-year period
  • Considered a D non-violent felony
  • Penalties
    • potentially includes probation for first-time offenders, and the maximum sentence is up to 2 1/3 to 7 years’ incarceration

Health Care Fraud in the 4th Degree

  • Health Care Fraud in the Fourth degree (Penal Law § 177.10) is considered an E non-violent felony
  • Fourth-degree charges require total health care funds stolen to exceed $3,000 in a one-year period
  • Penalties
    • most likely includes probation for first-time offenders, and the maximum sentence is 1 1/3 to 4 years in prison

Health Care Fraud in the 5th Degree

  • Health Care Fraud in the Fifth Degree (Penal Law § 177.05) is considered a Class A misdemeanor
  • Fifth-degree charges do not require a total stolen dollar amount or a time period constraint
  • Penalties
    • most misdemeanor crimes do not exceed 1 year in jail, and many times first-time offenders are not sentenced to incarceration

Defending NYC Health Care Fraud Charges

Health care fraud is not a crime alleged to have been committed by accident or negligence. Someone who has committed health care fraud must be found to have acted intentionally to receive health care payments, reimbursements, and other benefits. Therefore, defending a New York health care fraud case often focuses on the question of intent. It is not uncommon for unfocused staff members to make billing or coding mistakes which are not considered intentional health care fraud. In addition, anyone with experience in the medical field can attest to the regulations around billing and insurance having quite a bit of complexity and honest mistakes are a fairly common occurrence. The government will attempt to frame errors as serious criminal matters, but an experienced New York health care fraud attorney will endeavor to protect your medical career as well as the careers of your associates.

The Importance of an Experienced New York City Health Care Fraud Attorney

New York health care fraud cases are often very complex, and there is a lot on the line during federal health care fraud investigations. Mark I. Cohen is an experienced health care fraud attorney. If you have been charged with health care fraud crime contact Mark I. Cohen to maximize your chances of preserving your freedom, reputation, and assets.

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