Pennsylvania HB216 amends fraud and abuse control laws to define prohibited acts, criminal penalties, and civil remedies for medical assistance.
Pennsylvania HB216 amends the Human Services Code to strengthen fraud and abuse control within the medical assistance program. The bill defines prohibited acts by providers, including knowingly presenting false claims, submitting duplicate claims, and providing unnecessary or inadequate services. It establishes criminal penalties for these acts, ranging from misdemeanors to felonies, depending on the amount of excess payments involved. Additionally, the bill outlines civil remedies, such as the repayment of excess benefits plus interest and the termination of provider agreements.
Included in complete analysis
- Overview
- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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