Fraud and False Statements; Criminal Penalty.

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42-4-406. Fraud and false statements; criminal penalty.

(a) In relation to the delivery of or payment for services or supplies under Medicaid, a person shall not knowingly, in whole or in part:

(i) Make or cause to be made a false or fraudulent claim;

(ii) Deliberately conceal a material fact;

(iii) Make or cause to be made a false statement or misrepresentation which will be used by another person;

(iv) Execute a scheme or artifice to commit fraud.

(b) A person who violates subsection (a) of this section is guilty of:

(i) A misdemeanor punishable by imprisonment of not more than six (6) months, a fine of not more than seven hundred fifty dollars ($750.00), or both, if the amount of the claims for services or supplies under Medicaid is less than one thousand dollars ($1,000.00); or

(ii) A felony punishable by imprisonment for not more than ten (10) years, a fine of not more than ten thousand dollars ($10,000.00), or both, if the amount of the claims for services or supplies under Medicaid is one thousand dollars ($1,000.00) or more.

(c) The department of health shall ensure that the following documents contain a statement, under penalty of perjury and signed by the responsible provider, that all matters stated therein are true and accurate:

(i) An application to become a Medicaid provider;

(ii) All reports stating income or expenses upon which rates of payment by the department of health may be based; and

(iii) Each invoice for payment of a service or supply provided to a person eligible for Medicaid.

(d) A person commits perjury if the person signs or submits, or causes to be signed or submitted a statement under subsection (c) of this section, knowing that the application, report or invoice contains information that is false, in whole or in part. Perjury under this subsection shall be punished as specified in W.S. 6-5-301(b).


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