Section 22-45-8 – Suspension or exclusion from participation as provider of person convicted of committing offense.
22-45-8. Suspension or exclusion from participation as provider of person convicted of committing offense. Any person providing a good or a service under the program who has been determined to have committed an offense under §§22-45-2 to 22-45-7, inclusive, may be suspended or excluded from participation as a provider or an employee of a provider […]
Section 22-45-9 – Access to records by attorney general, state medicaid control unit, and grand jury.
22-45-9. Access to records by attorney general, state medicaid control unit, and grand jury. The attorney general and the state medicaid fraud control unit, upon reasonable request, and the grand jury, upon subpoena therefore, shall have full access to all records held by a provider or by any other person on his behalf, which could […]
Section 22-45-10 – Use of other civil or criminal remedy not precluded.
22-45-10. Use of other civil or criminal remedy not precluded. The provisions of this chapter are not intended to be exclusive remedies and do not preclude the use of any other criminal or civil remedy. Source: SL 1986, ch 187, §10.
Section 22-45-11 – Limitation on civil action.
22-45-11. Limitation on civil action. No civil action may be brought under this chapter more than six years after the cause of action accrues. Source: SL 1986, ch 187, §11.
Section 22-45-1 – Definition of terms.
22-45-1. Definition of terms. Terms as used in this chapter mean: (1)”Benefit,” any benefit authorized under the medical services program of the State Department of Social Services; (2)”Claim,” any communication, whether oral, written, electronic, or magnetic, which is utilized to identify a good, item, or service as reimbursable under the program; (3)”Person,” any individual, corporation, […]
Section 22-45-2 – Action by which claimant commits an offense–Violation a felony.
22-45-2. Action by which claimant commits an offense–Violation a felony. A person commits an offense if he: (1)Makes or causes to be made a claim, knowing the claim to be false, in whole or in part, by commission or omission; or (2)Makes or causes to be made a statement or representation for use in obtaining […]
Section 22-45-3 – Application to participate as provider–Perjury for submitting false statements–Violation a felony.
22-45-3. Application to participate as provider–Perjury for submitting false statements–Violation a felony. Each application to participate as a provider in the program, each report stating income or expense upon which rates of payment are or may be based, and each invoice for payment for a good or a service provided to the recipient shall contain […]
Section 22-45-4 – Action of person aiding provider with goods or services or referring individuals to provider for which additional value received an offense–Violation a felony.
22-45-4. Action of person aiding provider with goods or services or referring individuals to provider for which additional value received an offense–Violation a felony. A person commits an offense if he: (1)Acting on behalf of a provider, purchases or leases goods, services, materials, or supplies for which payment may be made, in whole or in […]
Section 22-45-5 – Offense of acceptance of amount in addition to amount legally payable under program–Violation a felony.
22-45-5. Offense of acceptance of amount in addition to amount legally payable under program–Violation a felony. A person commits an offense if he, acting on behalf of a provider providing a good or a service to a recipient under the program, charges, solicits, accepts, or receives anything of additional value in addition to the amount […]
Section 22-45-6 – Failure to keep necessary records upon which claim is based–Violation a misdemeanor.
22-45-6. Failure to keep necessary records upon which claim is based–Violation a misdemeanor. A person commits an offense if he: (1)Having submitted a claim for or received payment for a good or a service under the program, intentionally fails to maintain such records as are necessary to disclose fully the nature of all a good […]