Section 47.05.210. Medical assistance fraud.

   (a) A person commits the crime of medical assistance fraud if the person
        (1) knowingly submits or authorizes the submission of a claim to a medical assistance agency for property, services, or a benefit with reckless disregard that the claimant is not entitled to the property, services, or benefit;
        (2) knowingly prepares or assists another person to prepare a claim for submission to a medical assistance agency for property, services, or a benefit with reckless disregard that the claimant is not entitled to the property, services, or benefit;
        (3) except as otherwise authorized under the medical assistance program, confers, offers to confer, solicits, agrees to accept, or accepts property, services, or a benefit
             (A) to refer a medical assistance recipient to a health care provider; or
             (B) for providing health care to a medical assistance recipient if the property, services, or benefit is in addition to payment by a medical assistance agency;
        (4) does not produce medical assistance records to a person authorized to request the records;
        (5) knowingly makes a false entry in or falsely alters a medical assistance record;
        (6) knowingly destroys, mutilates, suppresses, conceals, removes, or otherwise impairs the verity, legibility, or availability of a medical assistance record knowing that the person lacks the authority to do so; or
        (7) violates a provision of AS 47.07 or AS 47.08 or a regulation adopted under AS 47.07 or AS 47.08.
   (b) Medical assistance fraud under (a)(1), (2), or (3) of this section is
        (1) a class B felony if the portion of the claim or claims submitted in violation of (a)(1) or (2) of this section, or the value of the property, services, or benefit that is in violation of (a)(3) of this section, is $25,000 or more;
        (2) a class C felony if the portion of the claim or claims submitted in violation of (a)(1) or (2) of this section, or the value of the property, services, or benefit that is in violation of (a)(3) of this section, is $500 or more but less than $25,000;
        (3) a class A misdemeanor if the portion of the claim or claims submitted in violation of (a)(1) or (2) of this section, or the value of the property, services, or benefit that is in violation of (a)(3) of this section, is less than $500.
   (c) Medical assistance fraud under (a)(4), (5), or (6) of this section is a class A misdemeanor.
   (d) Medical assistance fraud under (a)(7) of this section is a class B misdemeanor.

Authorities

47.05.220;47.05.230;47.05.240;47.05.310;47.05.330

Notes

Implemented As

7 AAC 100.910
7 AAC 100.912
7 AAC 105.470
7 AAC 105.480
7 AAC 105.490

References

7 AAC 100.910
7 AAC 100.912
7 AAC 105.420
7 AAC 105.480
7 AAC 125.160
AS 47.05.220 Notice of charges.
AS 47.05.230 Determination of value; aggregation of amounts.
AS 47.05.240 Exclusion from medical assistance programs.
AS 47.05.310 Criminal history; criminal history check; compliance.
AS 47.05.330 Centralized registry.

History

(Sec. 3 ch 66 SLA 2003)