| Code Section |
Description |
Penalty |
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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- Felony or misdemeanor, depending on amount of fraud under guidelines of Penal Code section 487 (over $400 felony)
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WELFARE & INSTITUTIONS CODE
§ 14107
(Fraudulent Claims) |
- Present claim for payment
- With intent to defraud
- For goods or services
- To obtain greater compensation than legally entitled
- Knowing the information is false
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- Misdemeanor - one year county jail and $1,000 fine.
- Felony - 2, 3, or 5 years and fine not exceeding three times the amount of fraud or improper reimbursement or value of scheme or artifice.
- If the execution of a scheme or artifice to defraud is committed under circumstances likely to cause or that do cause two or more persons great bodily injury, or serious bodily injury, a term of four years, in addition and consecutive to the term of imprisonment imposed, shall be imposed for each person who suffers great bodily injury or serious bodily injury.
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WELFARE & INSTITUTIONS CODE
§ 14107.2(a)
(Kickbacks, Bribes or Rebates)
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- Solicits or receives any kickback, bribe or rebate to either:
- Refer or promise to refer person for service or merchandise
- Purchasing, leasing or ordering service or merchandise
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- Misdemeanor - one year county jail and $10,000 fine.
- Felony - state prison and $10,000 fine. (Second offense - straight felony)
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WELFARE & INSTITUTIONS CODE
§ 14107.2(b)
(Kickbacks, Bribes or Rebates)
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- Offer to pay any kickback, bribe or rebate to either:
- Refer or promise to refer person for service or merchandise
- Purchasing, leasing or ordering service or merchandise
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- Misdemeanor - one year county jail and $10,000 fine
- Felony - state prison and $10,000 fine. (Second offense - straight felony)
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PENAL CODE
§ 487
(Grand Theft)
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- A person takes the property of another
- With specific intent to deprive permanently
- Took or carried away property
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PENAL CODE
§ 550(a)(5)
(Prepare or Make a False Writing)
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- Knowingly prepare, make, or subscribe any writing with intent to present or use it in support of any false or fraudulent claim
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- Misdemeanor - One year county jail and $1,000 fine.
- Felony - 2, 3, or 5 years state prison plus $50,000 fine or double the amount of fraud, whichever is greater
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PENAL CODE
§ 550(a)(6)
(Making a False Claim)
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- Knowingly make or cause to be made any false or fraudulent claim for health care benefit
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When claim or amount at issue is $950 or less:
- Misdemeanor - One year county jail and $1,000 fine.
When claim or amount at issue exceeds $950:
- Felony - 2, 3, or 5 years state prison plus $50,000 fine or double the amount of fraud, whichever is greater or by county jail one year and fine of $1,000
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PENAL CODE
§ 550(a)(7)
(Submitting a False Claim)
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- Knowingly submit a claim for a health care benefit which 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 - One year county jail and $1,000 fine.
When claim or amount at issue exceeds $950:
- Felony - 2, 3, or 5 years state prison plus $50,000 fine or double the amount of fraud, whichever is greater or by county jail one year and fine of $1,000
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