205.8463 Fraudulent acts -- Penalties.
533 words·~2 min read·
/ky/chapter-205/205-8463A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)No person shall knowingly or wantonly devise a scheme or plan a scheme or
artifice, or enter into an agreement, combination, or conspiracy to obtain or aid
another in obtaining payments from any medical assistance program under this
chapter by means of any fictitious, false, or fraudulent application, claim, report, or
document submitted to the Cabinet for Health and Family Services, or intentionally
engage in conduct which advances the scheme or artifice.
(2)No person shall intentionally, knowingly, or wantonly make, present, or cause to be
made or presented to an employee or officer of the Cabinet for Health and Family
Services any false, fictitious, or fraudulent statement, representation, or entry in any
application, claim, report, or document used in determining rights to any benefit or
payment.
(3)No person shall, with intent to defraud, knowingly make, or induce, or seek to
induce the making of a false statement or false representation of a material fact with
respect to the conditions or operations of an institution or facility in order that the
institution or facility may qualify, upon initial certification or upon recertification,
as a hospital, skilled-nursing facility, intermediate-care facility, home-health
agency, or other provider of services to the Medical Assistance Program.
(4)No person shall, in any matter within the jurisdiction of the Cabinet for Health and
Family Services under this chapter, knowingly falsify, conceal, or cover up by any
trick, scheme, or device a material fact, or make any false, fictitious, or fraudulent
statement or representation, or make or use any false writing or document knowing
the same to contain any false, fictitious, or fraudulent statement or entry.
(a)Any person who violates subsections
(1)and
(2)of this section shall be guilty
of a Class B misdemeanor unless:
1. The sum total of benefits or payments claimed in any application, claim,
report, or document, or in any combination or aggregation thereof, is
valued at five hundred dollars ($500) or more but less than one thousand
dollars ($1,000), in which case it is a Class A misdemeanor;
2. The sum total of benefits or payments claimed in any application, claim,
report, or document, or in any combination or aggregation thereof, is
valued at or above one thousand dollars ($1,000), in which case it is a
Class D felony; or
3. The person has three
(3)or more convictions under subparagraph 1. of
this paragraph within the last five
(5)years, in which case it is a Class D
felony. The five
(5)year period shall be measured from the dates on
which the offenses occurred for which the judgments of conviction were
entered.
(b)If any person commits two
(2)or more separate violations of subsections
and
(2)of this section within ninety
(90)days, the offenses may be combined
and treated as a single offense, and the value of the property in each offense
may be aggregated for the purpose of determining the appropriate charge.
(6)Any person who violates the provisions of subsection
(3)of this section shall be
guilty of a Class C felony.
(7)Any person who violates the provisions of subsection
(4)of this section shall be
guilty of a Class D felony.