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Health Care Fraud

On November 1, 2006, New York Legislature added a new article to the State's Penal Law, article 177. Titled "Health Care Fraud", Article 177 was designed to punish those with conjured schemes to defraud health insurance companies and managed health plans.

According to New York Penal Law § 177.00, a health plan can refer to any privately or publicly funded health insurance plan or contract, where any health care item is provided and payment is issued to the person or service providing the health care item. Common healthcare services include Medicaid and Medicare.

Healthcare in the United States can be complicated, but those that abuse the system will face severe punishments in New York. The State considers health care fraud a serious crime. Those that face conviction could spend as many as 25 years in prison.

It is important for those charged with health care fraud to contact an experienced New York criminal defense attorney to assist in providing legal guidance.

Health Care Fraud Attorney in Queens, New York

If you have been charged with health care fraud, contact Law Office of Rochelle S. Berliner to discuss your legal options in fighting the charge.

Rochelle S. Berliner is an experienced criminal defense attorney operating out of Queens, New York. Law Office of Rochelle S. Berliner understands the difficulties a criminal charge can place upon a person's life, now and in the future.

If you have been arrested in Queens County, New York County, Bronx County, or Kings County, call our office as soon as possible. Law Office of Rochelle S. Berliner can assist you in fighting health care fraud charges.

Call 718-261-5600 to schedule a consultation and learn more about how our experienced lawyers can help you.



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New York Health Care Fraud under New York Penal Code § 177.05

Criminal charges for health care fraud in New York are broken down in to five degrees. The punishment for health care fraud may range from minor misdemeanor charges to serious felony charges. The most severe health care fraud charge is first-degree healthcare fraud. Health care fraud in the first-degree is punishable as a class B felony.

On the other hand, health care fraud in the fifth degree is charges as a class A misdemeanor. A defendant will be charged according to the value of property received due to defrauding health plans.


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Fifth-Degree Healthcare Fraud

To be charged with health care fraud in the fifth degree, under New York Penal Code § 177.05, a person must, with intent to defraud a health plan, provide false information in order to receive some sort of payment, service, or item from a health care provider. If convicted, healthcare fraud is punishable as a class A misdemeanor. Class A misdemeanors are could subject a person to up to one year in jail.


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Fourth-Degree Healthcare Fraud NY § 177.10

Under New York Penal Code § 177.10 a person may be charged with health care fraud of the fourth degree, if he or she has committed the crime of health care fraud and received wrongful payments, on several occasions, that exceed more than $3,000 within one year.

Fourth-degree healthcare fraud is charged as a class E felony. Class E felonies are punishable by up to four years in prison.


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Third-Degree Health Care Fraud NY § 177.15

Healthcare fraud of the third degree occurs when a person commits health care fraud and wrongfully receives payments from a single health care place that exceeds $10,000 within one year.

Third-degree healthcare fraud is charged as a class D felony. Class D felonies are punishable by up to seven years in prison.


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Second-Degree Health Care Fraud NY § 177.20

Healthcare fraud of the second degree occurs when, like other healthcare fraud infractions, a person commits healthcare fraud and wrongfully receives more than $50,000 dollars within one year.

Second-degree healthcare fraud is charged as a class C felony, punishable by 15 years in prison.


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First-Degree Health Care Fraud NY § 177.25

Health care fraud of the first degree is punishable as class B felony, punishable by up to 25 years in prison.

A person may be charged with first-degree healthcare fraud in New York, if he or she commits healthcare fraud and wrongfully receives over $1,000,000 within one year.


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The Office of Medicaid Inspector General

Due to the legislative efforts of constructing Article 177, a new bureaucracy in the New York State Department of Health was created. The new department is called the Office of Medicaid Inspector General (OMIG).

The OMIG attempts to enhance the integrity of the New York State Medicaid program by detecting and preventing health care fraud and abuse. It also tries to recover Medicaid funds that were improperly expended, all the while promulgating the highest quality of patient care.

Health care fraud and abuse can involve a whole host of medical professions from physicians, pharmacists, beneficiaries and more. OMIG coordinates investigations, including auditing, detection, and review of all Medicaid providers and recipients.

OMIG works closely with federal and state programs and departments, in addition to law enforcement to ensure that everyone involved with the Medicaid process is complying with the correct laws and regulations.


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Additional Resources

Office of the Medicaid Inspector General – Learn more about the OMIG and what it attempts to accomplish in New York by visiting its official website. OMIG looks to provide New York with a clear and well-functioning Medicaid system.

New York State Laws | Article 177 – Visit an informative website containing all of the New York's regulations and statutes. This exhaustive resource offers readers a change to look over every article passed through the state Legislation.


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Find an Attorney for Health Care Fraud in Queens County, New York

If you have been charged with committing Health care fraud, it is important that you contact an experienced, New York criminal defense attorney as soon as possible. Criminal convictions can change lives and New York does not take health care fraud lightly.

Law Office of Rochelle S. Berliner reviews the cases of clients in Queens County, Kings County, New York County, and Bronx County. Law Office of Rochelle S. Berliner has defended clients in New York for years, building up a reputation as a reliable, trustworthy, and hardworking law firm in Queens.

Call Law Office of Rochelle S. Berliner today at 718-261-5600 to schedule a consultation and learn more about what legal steps you can take for a health care fraud charge.


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Rochelle Berliner
Rochelle Berliner

Rochelle Berliner grew up in Queens, NY. She started New York Law School in January 1989 and graduated in June 1991. Immediately after law school, she started working at the New York County District Attorney’s Office, where she stayed for approximately 14 years...

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