713.01 Medical Assistance Fraud (MAM)

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The Special Investigation Unit (SIU) pursues medical assistance fraud pursuant to RSA 167:17-b.

Pursuant to RSA 167:17-b, an individual has committed medical assistance fraud by:

. means of an intentionally false statement or misrepresentation or by impersonation or other fraudulent act to obtain or attempt to obtain, or help or assist any other person in obtaining any health care assistance, benefit, or payment to which he or she is not entitled;

. with intent to defraud DHHS, buying or aiding or abetting in the purchase or the disposal of the property of a person receiving assistance so as to affect the recipient's eligibility for assistance;

. intentionally failing to disclose the receipt of property, wages, income, or resources, or any change in circumstances which would affect his or her eligibility for assistance or his or her initial or continued right to any benefit or payment for the purpose of receiving any assistance, benefit, or payment to which he or she is not entitled; or

. purposely committing any other act that violates any medical assistance regulations, or any state statute relating to medical assistance programs.

Individuals are required to pay back any benefits or services received in error, regardless of whether the individual made a mistake in the information he or she provided to DHHS, or failed to provide to DHHS.