The Committee on Judiciary proposes the following amendment (SJ-915.SW0002S):
Amend the bill, as and if amended, SECTION 1, by striking Section 43-7-60(A)(1), (2), and (3) and inserting:
(1) "provider" includes Provider" means a person who provides goods, services, or assistance and who is entitled or claims to be entitled to receive reimbursement, payment, or benefits under the state'sState Medicaid programProgram. "Provider" also includes an owner, a billing agent, and a person acting as an employee, representative, or agent of the provider.(2) "false False claim, statement, or representation" means a claim, statement, or representation made or presented, or attempted to be made or presented, in any form including, but not limited to, a claim, statement, or representation which is computer generated or transmitted or made, produced, or transmitted by an electronic means or device.
(3) "State Medicaid Program" includes means the state or federal agency which administers or assists in the administration of the State Medicaid Program, a Managed Care Organization, or similar entity contracted under the State Medicaid Program to provide goods, services, or assistance.
Amend the bill further, SECTION 1, by striking Section 43-7-60(D) and inserting:
(D) A person who knowingly makes a false claim, statement, or misrepresentation, and any other person who knowingly assists, abets, solicits, or conspires with a person to make a false claim, statement, or misrepresentation, is guilty of a: A person who violates the provisions of this section subsection (B) or subsection (C), or a person who knowingly aids, assists, abets, solicits, or conspires with another person to violate the provisions of subsection (B) or subsection (C), is guilty of medical assistance provider fraud, a: Class A misdemeanor and, upon conviction, must be imprisoned not more than three years and fined not more than one thousand dollars for each offense.(1) Class A misdemeanor for a first offense violation, if the amount of the economic advantage or benefit sought or received is less than five thousand dollars and, upon . Upon conviction, the person must be imprisoned not more than three years or fined not more than one thousand dollars, or both.;
(2) Class F felony for a first offense violation, if the amount of the economic advantage or benefit sought or received is five thousand dollars or more but less than fifty thousand dollars. Upon conviction, the person must be fined not less than five thousand nor more than twenty thousand dollars or imprisoned not more than five years, or both.; or
(3) Class E felony for a first offense violation, if the amount of the economic advantage or benefit sought or received is fifty thousand dollars or more. Upon conviction, the person must be fined not less than twenty thousand nor more than fifty thousand dollars or imprisoned not more than ten years, or both.
Amend the bill further, SECTION 1, by striking Section 43-7-60(F) and inserting:
(E)(F) In addition to all other remedies provided by law, the Attorney General may bring an action to recover damages equal to three times the amount of an overstatement or overpayment and the court may impose a civil penalty of two thousand dollars for each false claim, representation, or overstatement made to a state or federal agency which administers funds under the state's Medicaid program. Upon a finding that the provider has violated a provision of this section, the state agency which administers the Medicaid program may impose other administrative sanctions against the provider authorized by law. A civil or criminal action brought under this section may be filed or brought in either the county where the false claim, statement, or representation violation originated, or in the county in which the false claim, statement, or representation violation was received by the Health and Human Services Finance Commission Department of Health and Human Services or other agency of the State responsible for administering the state's Medicaid Program.Amend the bill further, SECTION 2, by striking Section 43-7-70(B) and inserting:
(B) A person who violates subsection (A), and any other or a person who knowingly aids, assists, abets, solicits, or conspires with a another person to make a false claim, statement, or misrepresentation as described in to violate subsection (A), is guilty of a:A person who violates the provisions of this section is guilty of medical assistance recipient fraud, a Class A misdemeanor and, upon conviction, must be imprisoned not more than three years or fined not more than one thousand dollars, or both.(1) Class A misdemeanor for a first offense violation, if the amount of the economic advantage or benefit sought or received is less than five thousand dollars and, upon. Upon conviction, the person must be imprisoned not more than three years or fined not more than one thousand dollars, or both.;
(2) Class F felony for a first offense violation, if the amount of the economic advantage or benefit received is five thousand dollars or more but less than fifty thousand dollars. Upon conviction, the person must be fined not less than five thousand nor more than twenty thousand dollars or imprisoned not more than five years, or both.; or
(3) Class E felony for a first offense violation, if the amount of the economic advantage or benefit received is fifty thousand dollars or more. Upon conviction, the person must be fined not less than twenty thousand nor more than fifty thousand dollars or imprisoned not more than ten years, or both.
Amend the bill further, SECTION 2, by striking Section 43-7-70(D) and inserting:
(D) In addition to all other remedies under this section, the Attorney General may bring a civil action to recover damages equal to three times the amount of the overpayment by the state agency that administers funds under the State Medicaid Program. A civil or criminal action brought under this section may be filed or brought in either the county where the false claim, statement, or representation violation originated, or in the county in which the false claim, statement, or representation violation was received by the Health and Human Services Finance Commission Department of Health and Human Services or other agency of the State responsible for administering the State Medicaid Program.Renumber sections to conform.
Amend title to conform.