Chinese Community Hit by Crackdown on Medicaid Fraud

As authorities step up the fight against Medicaid fraud, many Chinese residents have received government notices telling them that they do not meet the eligibility requirements for Medicaid, the World Journal reports. This is the second crackdown since the end of 2010, community leaders told the newspaper.

Ming Sheng Zhao of the Chinese Consolidated Benevolent Association said that in 2011, about 300 Chinese residents sought help from the organization after receiving claims or notices for fraud investigations. In January, more than ten such cases have come to light. At this point, it is not clear how many raids will take place this year.

On Jan. 31, 2012, Brooklyn District Attorney Charles J. Hynes and Commissioner of the Human Resources Administration Robert Doar announced the indictments of eight suspects for falsely collecting government benefits. One of those indicted was Anna Fan, 36, suspected of hiding personal assets and receiving $8,077 in Medicaid benefits. She was charged with fraudulently receiving benefits and fabricating documents. She faces up to seven years in prison.

Zhao says that for the most part, Chinese residents become the target of investigations as the result of one of two situations:

The first is when out-of-state residents use their New York-based family’s address to receive New York Medicaid and visit one of the many Chinese physicians here in New York.

The second is when Chinese recipients of Medicaid have real estate property and large savings in their bank accounts.

According to Zhao, these investigations are prompted by reduced government budgets and abuse of the system. On the other hand, he said, some Medicaid recipients were misled by health care staff and believed they were eligible for benefits.

Zhao provides advice to those being investigated.

He suggested that they negotiate with the Human Resources Administration, which provides translation services.

If the individual has financial problems, they can bring documentation and try to pay back the claims in installments. In some cases, the person purchased real estate under their business or corporation but because they are the sole proprietor of their business, the property makes them ineligible for Medicaid. Of course, they can always retain an attorney to represent them, though if the matter reaches the litigation stage, it might turn into a criminal case.

He emphasizes that documents are key in explaining discrepancies that may have caught the eye of investigators.

If a person’s account shows large savings, he or she could still provide documents to explain the source of the deposits, Zhao said.

For example, one father was holding his underage son’s $100,000 civil suit payments in his account. The father could show the court documents proving that the money belonged to his son.

In some cases, people have relatives overseas who wire transfer money to their account when applying for an immigrant investor visa. In such situations, the wire transfer receipt can be used as proof.

One Comment

  1. Terrible to hear about yet another case of this. Authorities are stepping up their fight against Medicaid Fraud.

    Contact NYC Top Medicaid Fraud Attorney Inna Fershteyn


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