Health care fraud
Official text prohibited actmental stateif conditionpenaltylegal term
(a) Whoever knowingly and executes, or to execute, a scheme or artifice—
(1) to defraud any health care benefit program; or
(2) to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program,
in connection with the delivery of or payment for health care benefits, items, or services, shall be or imprisoned not more than 10 years, or both. If the violation results in (as defined in section 1365 of this title), such person shall be or imprisoned not more than 20 years, or both; and if the violation results in death, such person shall be , or imprisoned for any term of years or for life, or both.
(b) With respect to violations of this section, a person need not have actual knowledge of this section or specific intent to commit a violation of this section.
History: (Added Pub. L. 104–191, title II, §242(a)(1), Aug. 21, 1996, 110 Stat. 2016 (PDF, 25 MB); amended Pub. L. 111–148, title X, §10606(b), Mar. 23, 2010, 124 Stat. 1008.)
Simplified explanation
It is a federal crime to knowingly and willfully carry out, or try to carry out, a scheme to cheat a health care benefit program or to get its money or property by lying, in connection with health care services or payments.