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The department of health, department of family services, health care licensing boards, state agencies and the agents, contractors and subcontractors of these entities shall refer to the unit all cases where reasonable cause likely exists that fraud, waste, abuse, bribery or kickbacks relating to Medicaid has occurred, is occurring or will occur, as well as suspected cases of patient abuse, neglect or exploitation under Medicaid.
42-4-406. Fraud and false statements; criminal penalty.
(a)In relation to the delivery of or payment for services…#
(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;#
(i) Make or cause to be made a false or fraudulent claim;
(ii)Deliberately conceal a material fact;#
(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;