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Medical assistance offenses – Wis. Stat. Ann. § 49.49

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Medical Assistance Offenses

Wisconsin prohibits persons from "knowingly and willfully" making false statements while applying for medical assistance benefits or medical assistance payments or using a medical assistance benefit or payment in an unauthorized manner. 

Persons that make false statements in connection with providing medical services are guilty of class H felonies and may be fined a maximum of $25,000. Other persons that make false statements regarding medical services may be subject to a maximum fine of $10,000 and a maximum of 1 year in jail.  Wisconsin may seek to recoup a maximum of 3 times their actual damages in such suit.

Wisconsin prohibits persons from soliciting, accepting, or offering any type of remuneration in exchange for referring an individual for services or items that will be paid for by medical assistance funds. Persons that engage in these prohibited activities are guilty of class H felonies and may be subject to a maximum fine of $25,000.  Wisconsin prohibits providers from knowingly charging medical assistance recipients extra for services paid by the medical assistance program except under specific circumstances.

Current as of June 2015