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Federal and State Program Integrity in Indiana

In addition to federal law, the state of Indiana has passed its own laws concerning fraud and abuse of Medicaid and the Children’s Health Insurance Program (CHIP).  Indiana makes it a Class D felony to knowingly or intentionally file a false Medicaid claim, use false information to obtain payment from Medicaid, or obtain unauthorized payment from Medicaid by concealing information.1  The penalties that can be imposed for violations of Medicaid rules include denial of payment, termination from the Medicaid program, and civil monetary penalties.2  Indiana also has an Anti-kickback statute for the CHIP Program, which makes it a Class A misdemeanor to provide services for payment and knowingly and willingly receive a bribe or kickback.3

 

Footnotes

  • 1. Ind. Code §35-43-5-7-1
  • 2. Ind. Code §12-15-22-1
  • 3. Ind. Code §12-17.6-6-6

 

Federal and State Program Integrity in Indiana

Subtopic Statute/Regulation Description
Fraud and abuse provisions about Medicaid or Medicare: False claims submitted to Medicaid or Medicare Definition and Required Punishment for Medicaid Fraud – Ind. Code Ann.§ 35-43-5-7.1 The law states that it is Medicaid fraud, a  Class D felony, for any person to: 1.      Knowingly or intentionally...
Penalties for false claims Definition and Required Punishment for Medicaid Fraud – Ind. Code Ann.§ 35-43-5-7.1 The law states that it is Medicaid fraud, a  Class D felony, for any person to: 1.      Knowingly or intentionally...
Punishment for Violations of Medicaid Rules or Laws – Ind. Code Ann.§ 12-15-22-1 Indiana imposes one of the following penalties for violation of a Medicaid rule or law: 1.      Denial of payment to the...
Punishment for Violations Under the Children's Health Insurance Program – Ind. Code Ann.§ 12-17.6-6-6 The law states that any person who provides services  under the Children’s Health Insurance Program (CHIP) for payment, and knowingly and...