WELFARE & INSTITUTIONS CODE
§ 14014
(False Declaration as to Eligibility)
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- Person receiving or encouraging another to receive health care
- For which he or she was not eligible
- On the basis of false declarations
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- Misdemeanor - six months county jail and/or $1,000 fine
- Felony - 16 months, 2 or 3 years in county jail
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WELFARE & INSTITUTIONS CODE
§ 14107
(Fraudulent Claims) |
- Present a false claim for payment
- For goods or services
- With intent to defraud;
- Or knowingly submit false information
- To obtain greater compensation than legally entitled or to obtain authorization to provide goods or services;
- Or knowingly engage in a scheme to defraud the Medi-Cal program
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- Misdemeanor - six months county jail and/or $1,000 fine
- Felony - 2, 3, or 5 years state prison and/or fine not exceeding three times the amount of fraud or improper reimbursement or value of scheme
- If committed under circumstances likely to cause or that do cause two or more persons great or serious bodily injury, an additional, consecutive term of four years shall be imposed for each person so injured
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WELFARE & INSTITUTIONS CODE
§ 14107.2(a)
(Kickbacks, Bribes or Rebates - Solicitation)
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- Solicit or receive any kickback, bribe or rebate in return for either:
- Referring or promising to refer person to provide goods or services, or
- Purchasing, leasing or ordering goods or services
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- Misdemeanor - one year county jail and/or $10,000 fine
- Felony - 16 months, 2 or 3 years in county jail and/or $10,000 fine
(Second offense - straight felony)
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WELFARE & INSTITUTIONS CODE
§ 14107.2(b)
(Kickbacks, Bribes or Rebates - Offer)
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- Offer to pay any kickback, bribe or rebate in return for either:
- Referring or promising to refer person to provide goods or services, or
- Purchasing, leasing or ordering goods or services
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- Misdemeanor - one year county jail and/or $10,000 fine
- Felony - 16 months, 2 or 3 years in county jail and/or $10,000 fine
(Second offense - straight felony)
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PENAL CODE
§ 487
(Grand Theft)
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- Take the property of another with value exceeding $950
- By moving it or carrying it away
- With intent to deprive permanently or for extended period
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- Misdemeanor - one year county jail
- Felony - 16 months, 2 or 3 years in county jail
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PENAL CODE
§ 550(a)(5)
(False Writing)
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- Knowingly prepare, make or subscribe any writing with intent to use it in support of a false insurance claim
- With intent to defraud
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- Felony - 2, 3, or 5 years in county jail plus $50,000 fine or double the amount of fraud, whichever is greater
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PENAL CODE
§ 550(a)(6)
(False Health Care Benefit Claim)
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- Knowingly make or cause to be made any false or fraudulent claim for health care benefit
- With intent to defraud
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When claim or amount at issue is $950 or less:
- Misdemeanor - six months county jail and/or $1,000 fine
When claim or amount at issue exceeds $950:
- Misdemeanor - one year county jail and/or $10,000 fine
- Felony - 2, 3, or 5 years in county jail and/or $50,000 fine or double the amount of fraud, whichever is greater
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PENAL CODE
§ 550(a)(7)
(Claim for Unused Health Care Benefit)
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- Knowingly submit a claim for a health care benefit that was not used by or on behalf of the claimant
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When claim or amount at issue is $950 or less:
- Misdemeanor - six months county jail and/or $1,000 fine
When claim or amount at issue exceeds $950:
- Misdemeanor - one year county jail and/or $10,000 fine
- Felony - 2, 3, or 5 years in county jail and/or $50,000 fine or double the amount of fraud, whichever is greater
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