1. The target letter from the Investigator at the Human Resources Administration is merely a request. It’s not a subpoena ordered by a Judge, it’s not a Summons and Complaint in which you must Answer or you will default. The choice to response or not is totally up to you.
2. In the event that your case is referred out for Civil Prosecution you may wind up settling the case for much less then initially claimed by the HRA Investigators. Why is this? New York City outsources the civil cases to law firm who must be paid for their time. The more work they have to do, the more they can bill on a file. The longer the case goes on for the less valuable the claim is worth.
3. The HRA Investigators don’t necessarily do the due diligence to find out whether you were eligible on a month to month basis. They summarize your financial situation and make a determination whether you are eligible or ineligible. In actuality, you very well may be eligible for the majority of a year and only ineligible for a couple of week or months. This will affect the claim amount substantially.
4. Just because you failed to disclose an interest in a piece of real property, or put down the income of all members of the household doesn’t men you intentionally committed medicaid fraud. To bring a successful civil case or criminal case they would have to prove the elements of fraud.
5. You absolutely have the right to have counsel advise you every step of the way in this process. At no point do you have to speak to a medicaid fraud investigator.