713.15 Federal Penalties for Medical Assistance Fraud (MAM)

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Section 1128B of the Social Security Act [42 USC 1320a-7b] provides federal penalties for fraudulent acts and false reporting in connection with your application for or receipt of Medical Assistance benefits.

• A person may be prosecuted in Federal Court for deliberate statements that are known to be false and which affect eligibility for any benefit or payment under the Medical Assistance program.

• A person may also be prosecuted for concealing or failing to disclose any event that affects their right to any benefit or payment, or its conversion to a use other than intended. The law also provides a penalty for a kickback, bribe, or rebate in connection with the furnishing of Medical Assistance.

Conviction of an offense could result in loss of Medical Assistance benefits for a period not to exceed 1 year. Penalties are fines up to $25,000 or imprisonment for not more than 5 years, or both.