November 27, 2018, Introduced by Rep. Noble and referred to the Committee on Law and Justice.
A bill to amend 1977 PA 72, entitled
"The medicaid false claim act,"
by amending section 7 (MCL 400.607), as amended by 2008 PA 421.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
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 according 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.
(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, or both.
(4) If the amount of the false or fraudulent claim is less
than $1,000.00, the person is guilty of a misdemeanor punishable by
imprisonment for not more than 1 year or a fine of not more than
$2,000.00 or 3 times the amount of the false or fraudulent claim,
whichever is greater, or both imprisonment and a fine.
(5) If any of the following apply, the person is guilty of a
felony punishable by imprisonment for not more than 5 years or a
fine of not more than $10,000.00 or 3 times the amount of the false
or fraudulent claim, whichever is greater, or both imprisonment and
a fine:
(a) The amount of the false or fraudulent claim is $1,000.00
or more but less than $20,000.00.
(b) The person violates subsection (4) and has 1 or more prior
convictions for committing or attempting to commit an offense under
this section.
(6) If any of the following apply, the person is guilty of a
felony punishable by imprisonment for not more than 10 years or a
fine of not more than $15,000.00 or 3 times the amount of the false
or fraudulent claim, whichever is greater, or both imprisonment and
a fine:
(a) The amount of the false or fraudulent claim is $20,000.00
or more but less than $50,000.00.
(b) The person violates subsection (4) or (5) and has 2 or
more prior convictions for committing or attempting to commit an
offense under this section.
(7) If the amount of the false or fraudulent claim is
$50,000.00 or more but less than $100,000.00, the person is guilty
of a felony punishable by imprisonment for not more than 15 years
or a fine of not more than $25,000.00 or 3 times the amount of the
false or fraudulent claim, whichever is greater, or both
imprisonment and a fine.
(8) If the amount of the false or fraudulent claim is
$100,000.00 or more, the person is guilty of a felony punishable by
imprisonment for not more than 20 years or a fine of not more than
$50,000.00 or 3 times the amount of the false or fraudulent claim,
whichever is greater, or both imprisonment and a fine.
(9) The amount of the false or fraudulent claims submitted in
separate incidents according to a scheme or course of conduct may
be aggregated to determine the total amount of the false or
fraudulent claim submitted.
(10) If the prosecuting attorney intends to seek an enhanced
sentence based on the defendant having 1 or more prior convictions,
the prosecuting attorney shall include on the complaint and
information a statement listing the prior conviction. The existence
of the defendant's prior conviction shall be determined by the
court, without a jury, at sentencing or at a separate hearing for
that purpose before sentencing. The existence of a prior conviction
may be established by any evidence relevant for that purpose,
including, but not limited to, 1 or more of the following:
(a) A copy of the judgment of conviction.
(b) A transcript of a prior trial, plea-taking, or sentencing.
(c) Information contained in a presentence report.
(d) The defendant's name.
Enacting section 1. This amendatory act takes effect 90 days
after the date it is enacted into law.