Medicaid Provider and Recipient Fraud
Take action
Record your position on this measure.
Create an account to record your position, submit testimony, or contact your legislator.
Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Overview
This bill aims to strengthen penalties for fraud within South Carolina’s Medicaid program. It proposes tiered violations and penalties for false claims, statements, and representations made by providers and recipients, and for inaccurate applications for assistance. The bill also grants the Attorney General broader authority to investigate and pursue fraud cases, including the power to issue subpoenas and seek civil penalties.
Key provisions
- Creates tiered violations and penalties for false claims, statements, and representations by Medicaid providers.
- Establishes tiered violations and penalties for false statements or representations on Medicaid applications.
- Authorizes the Attorney General to issue administrative subpoenas to investigate Medicaid fraud.
- Allows the Attorney General to pursue civil actions to recover overpayments.
- Provides for consent agreements to resolve fraud cases without admitting guilt.
- Defines ‘provider’ broadly to include billing agents and representatives.
- Specifies criminal penalties for Medicaid provider fraud, varying based on the amount of economic advantage gained.
- Establishes civil penalties for Medicaid recipient fraud, increasing with each subsequent violation.
Who is affected
- Medicaid Providers
- Medicaid Recipients
- South Carolina Residents Receiving Medicaid Benefits
Bill text
Read the latest version inline or switch to a previous version.
Text extraction is in progress. View the official source.
Arguments
Reasons offered for and against this legislation.
Arguments in favor
No arguments in favor have been submitted.
Submit yoursArguments opposed
No arguments opposed have been submitted.
Submit yours