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Florida Statutes § 409.920

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“Medicaid provider fraud under the social welfare law”

A health care provider that participates in Medicaid may not:

  • File claims with false information;
  • File claims for items or services that may not be reimbursed by the Medicaid program;
  • Knowingly charging a Medicaid recipient an amount other than an authorized copayment  or failing to credit the Medicaid program for any payment received from a third-party source;
  • Providing false information when the Medicaid program tries to determine a general or specific rate of payment for an item or service provided;
  • Knowingly soliciting or receiving any kind of payment for patient referrals;
  • Providing false information in its application to be a Medicaid-participating provider; and
  • Using a Medicaid provider or recipient’s identification number to file unauthorized claims for reimbursement by the Medicaid program.

Any person who violates this statute is guilty of a felony, subject to fines, and required to repay the Medicaid program any payments wrongfully obtained.

Any person who reports Medicaid fraud is immune from civil liability.

The Attorney General must conduct a statewide program of Medicaid fraud control.

Current as of June 2015