June 14, 2012, Introduced by Rep. Olumba and referred to the Committee on Families, Children, and Seniors.
A bill to amend 1977 PA 72, entitled
"The medicaid false claim act,"
by amending sections 3, 4, 5, 6, 7, and 12 (MCL 400.603, 400.604,
400.605, 400.606, 400.607, and 400.612), section 6 as amended by
1984 PA 333 and sections 7 and 12 as amended by 2008 PA 421.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 3. (1) A person shall not knowingly make or cause to be
made a false statement or false representation of a material fact
in an application for medicaid benefits.
(2) A person shall not knowingly make or cause to be made a
false statement or false representation of a material fact for use
in determining rights to a medicaid benefit.
(3) A person, who having knowledge of the occurrence of an
event affecting his initial or continued right to receive a
medicaid benefit or the initial or continued right of any other
person on whose behalf he has applied for or is receiving a
benefit, shall not conceal or fail to disclose that event with
intent to obtain a benefit to which the person or any other person
is not entitled or in an amount greater than that to which the
person or any other person is entitled.
(4) A person who violates this section is guilty of a felony,
punishable by imprisonment of not more than 4 years, or a fine of
not
more than $50,000.00 $57,500.00, or both.
Sec. 4. A person who solicits, offers, or receives a kickback
or bribe in connection with the furnishing of goods or services for
which
payment is or may be made in whole or in part pursuant to
under
a program established under Act No.
280 of the Public Acts of
1939,
as amended the social welfare
act, 1939 PA 280, MCL 400.1 to
400.119b, who makes or receives the payment, or who receives a
rebate of a fee or charge for referring an individual to another
person for the furnishing of the goods and services is guilty of a
felony, punishable by imprisonment for not more than 4 years, or by
a
fine of not more than $30,000.00 $34,500.00, or both.
Sec. 5. (1) A person shall not knowingly and wilfully make, or
induce or seek to induce the making of, a false statement or false
representation of a material fact with respect to the conditions or
operation of an institution or facility in order that the
institution or facility may qualify, upon initial certification or
upon recertification, as a hospital, skilled nursing facility,
intermediate care facility, or home health agency.
(2) A person who violates this section is guilty of a felony,
punishable by imprisonment for not more than 4 years, or by a fine
of
not more than $30,000.00 $34,500.00, or both.
Sec. 6. (1) A person shall not enter into an agreement,
combination, or conspiracy to defraud the state by obtaining or
aiding another to obtain the payment or allowance of a false claim
under
the social welfare act, Act No. 280 of the Public Acts of
1939,
as amended, being sections 400.1 to 400.121 of the Michigan
Compiled
Laws.1939 PA 280, MCL 400.1
to 400.119b.
(2) A person who violates this section is guilty of a felony,
punishable by imprisonment for not more than 10 years, or by a fine
of
not more than $50,000.00 $57,500.00, or both.
Sec. 7. (1) A person shall not make or present or cause to be
made or presented to an employee or officer of this state a claim
under the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b,
upon or against the state, knowing the claim to be false.
(2) A person shall not make or present or cause to be made or
presented a claim under the social welfare act, 1939 PA 280, MCL
400.1 to 400.119b, that he or she knows falsely represents that the
goods or services for which the claim is made were medically
necessary in accordance with professionally accepted standards.
Each claim violating this subsection is a separate offense. A
health facility or agency is not liable under this subsection
unless the health facility or agency, pursuant to a conspiracy,
combination, or collusion with a physician or other provider,
falsely represents the medical necessity of the particular goods or
services for which the claim was made.
(3) A person shall not knowingly make, use, or cause to be
made or used a false record or statement to conceal, avoid, or
decrease an obligation to pay or transmit money or property to the
state pertaining to a claim presented under the social welfare act,
1939 PA 280, MCL 400.1 to 400.1196.
(4) A person who violates this section is guilty of a felony
punishable by imprisonment for not more than 4 years or a fine of
not
more than $50,000.00 $57,500.00, or both.
Sec. 12. (1) A person who receives a benefit that the person
is not entitled to receive by reason of fraud or making a
fraudulent statement or knowingly concealing a material fact, or
who engages in any conduct prohibited by this statute, shall
forfeit and pay to the state the full amount received, and for each
claim
a civil penalty of not less than $5,000.00 $5,750.00 or more
than
$10,000.00 $11,500.00 plus triple the amount of damages
suffered by the state as a result of the conduct by the person.
(2) A criminal action need not be brought against the person
for that person to be civilly liable under this section.