Brooklyn Medicaid/Medicare Fraud Lawyer
Federal and State Defense for Healthcare Fraud Charges in Brooklyn
Healthcare fraud investigations involving Medicaid and Medicare billing have become increasingly aggressive in Brooklyn. With its large concentration of medical professionals, pharmacies, home health agencies, and outpatient clinics, Brooklyn is a frequent target for both federal and state enforcement actions. If you are under investigation or have been charged with healthcare fraud, you need a seasoned Brooklyn Medicaid/Medicare fraud lawyer to protect your rights and defend your future.
At Sosinsky Law, we represent healthcare providers and businesses facing high-stakes fraud allegations in the Eastern District of New York (EDNY). With decades of experience defending against complex criminal charges, attorney Fred Sosinsky understands how these cases are developed and prosecuted. We respond quickly, build powerful defenses, and pursue every legal avenue to protect your license, livelihood, and freedom. Call (212) 285-2270 today for a confidential consultation.
Medicaid Fraud Control Unit (MFCU) and Brooklyn Investigations
In New York, the Medicaid Fraud Control Unit (MFCU) operates within the Office of the New York State Attorney General. MFCU is tasked with identifying and prosecuting Medicaid fraud by providers and with investigating abuse or neglect of patients in healthcare facilities. It works closely with federal agencies such as the U.S. Department of Health and Human Services (HHS), the FBI, and the U.S. Attorney’s Office for the Eastern District of New York.
MFCU investigations often involve:
Billing for services that were not provided
Submitting false documentation
Patient recruitment schemes
Fraudulent home health care claims
Brooklyn-based providers are frequently targeted due to the volume of government-funded healthcare services delivered in the borough. If you have been contacted by MFCU or federal investigators, it is critical to seek legal representation immediately.
What Constitutes Medicaid and Medicare Fraud?
Healthcare fraud generally involves submitting false claims to Medicaid or Medicare to receive payments that are not owed. Some of the most common allegations include:
Phantom billing for services never rendered
Billing for medically unnecessary services
Misrepresenting patient diagnoses to justify claims
Unbundling procedures to bill separately
Receiving or paying illegal referral fees or kickbacks
These allegations are often charged under federal statutes such as:
18 U.S.C. §1346 (Healthcare fraud)
18 U.S.C. §§1341 and 1343 (Mail and wire fraud)
42 U.S.C. §1320a-7b (Anti-Kickback Statute)
False Claims Act (31 U.S.C. §3729)
At the state level, MFCU can charge providers under:
N.Y. Penal Law §175.35 (Offering a false instrument)
N.Y. Social Services Law §145-b (False statements regarding Medicaid)
Convictions can result in long prison sentences, massive fines, asset forfeiture, and loss of professional licenses.
Clients We Represent in Brooklyn
Sosinsky Law defends a wide range of clients involved in the healthcare industry, including:
Physicians and specialists
Nurse practitioners and PAs
Dentists and chiropractors
Home health agency owners and aides
Pharmacists and pharmacy operators
Medical billing professionals
Clinic and DME business operators
We understand how each role in the healthcare system can be implicated in fraud allegations and how to develop defense strategies tailored to your unique circumstances.
Signs You May Be Under Investigation
Investigations into Medicaid or Medicare fraud rarely begin with an arrest. More often, providers first learn they are under scrutiny when they receive:
A grand jury subpoena for documents or testimony
A civil investigative demand from MFCU
A target letter from the U.S. Attorney’s Office
A visit from investigators or agents at your home or practice
These actions suggest that criminal charges are possible or even imminent. Do not respond without first consulting a healthcare fraud defense attorney. Everything you say or provide can be used against you
Common Allegations in Brooklyn Healthcare Fraud Cases
1. Billing for Services Not Rendered
This includes claims for treatments that never occurred or appointments patients never attended. In some cases, billing errors are mistaken for fraud.
2. Kickbacks and Illegal Referrals
Offering or accepting money or other compensation in exchange for patient referrals violates both federal and state laws. Prosecutors scrutinize marketing arrangements, lease agreements, and professional relationships for signs of fraud.
3. Upcoding and Unbundling
These are allegations that the provider used billing codes for more expensive services or separated procedures into individual claims to increase payment.
4. Fraudulent Home Health Care Billing
Home care agencies in Brooklyn are frequent targets. Claims may involve aides not being qualified, patients not being eligible, or hours being inflated.
5. Pharmacy and Prescription Billing Fraud
Prosecutors may claim that pharmacies submitted claims for medications not dispensed or participated in unnecessary prescription schemes.
Defense Strategies for Medicaid and Medicare Fraud Charges
At Sosinsky Law, we take a comprehensive, fact-driven approach to defending healthcare fraud cases. Our strategies often include:
Lack of Intent
Federal and state charges require proof that the provider acted knowingly and willfully. Mistakes, miscommunications, or poor supervision do not equate to criminal intent.
No Personal Responsibility for Billing
Many healthcare providers delegate billing to staff or external vendors. We present evidence showing that you were not involved in fraudulent activity.
Legitimate Medical Justification
We use expert medical testimony and patient records to demonstrate that services were medically necessary and appropriately billed.
Compliance with Safe Harbor Laws
Alleged kickback arrangements may fall within federal or state safe harbor exceptions. We review contracts and business relationships for regulatory compliance.
Procedural Violations
We challenge the legality of subpoenas, searches, or interrogations. If investigators overstepped their authority, key evidence may be excluded from the case.
Potential Penalties in Brooklyn Healthcare Fraud Cases
Convictions in Medicaid or Medicare fraud cases can result in:
Federal prison sentences of up to 10 or 20 years
State incarceration for violations of New York laws
Fines exceeding hundreds of thousands of dollars
Orders of restitution and asset forfeiture
Loss of medical or professional licenses
Permanent exclusion from participation in government healthcare programs
Given the stakes, you cannot afford to face these charges without experienced legal counsel.
Why Choose Sosinsky Law for Your Defense
Fred Sosinsky is a seasoned federal criminal defense attorney with extensive experience handling healthcare fraud cases in Brooklyn. He understands the unique procedural issues, legal standards, and prosecutorial strategies involved in these complex cases. Clients rely on Sosinsky Law for:
Decades of successful defense in EDNY federal court
Experience with MFCU investigations and prosecutions
Collaboration with billing, coding, and medical experts
Strategic guidance from investigation through trial or resolution
Our goal is to resolve your case with the least possible damage to your career, your finances, and your future.
Contact a Brooklyn Medicaid and Medicare Fraud Lawyer Today
If you are facing a Medicaid or Medicare fraud investigation in Brooklyn, time is critical. The sooner you contact Sosinsky Law, the sooner we can begin protecting your rights and preparing your defense. Call (212) 285-2270 today to speak with an experienced Brooklyn Medicaid/Medicare fraud lawyer. We provide confidential consultations and aggressive representation throughout Brooklyn and the Eastern District of New York.