§ 108A-64. Medical assistance recipient fraud. - North Carolina Statutes

§ 108A‑64.  Medicalassistance recipient fraud.

(a)        It shall be unlawful for any person to knowingly andwillfully and with intent to defraud make or cause to be made a false statementor representation of a material fact in an application for assistance underthis Part, or intended for use in determining entitlement to such assistance.

(b)        It shall be unlawful for any applicant, recipient or personacting on behalf of such applicant or recipient to knowingly and willfully andwith intent to defraud, conceal or fail to disclose any condition, fact orevent affecting such applicant's or recipient's initial or continuedentitlement to receive assistance under this Part.

(b1)      It is unlawful for any person knowingly, willingly, and withintent to defraud, to obtain or attempt to obtain, or to assist, aid, or abetanother person, either directly or indirectly, to obtain money, services, orany other thing of value to which the person is not entitled as a recipientunder this Part, or otherwise to deliberately misuse a Medicaid identificationcard. This misuse includes the sale, alteration, or lending of the Medicaididentification card to others for services and the use of the card by someoneother than the recipient to receive or attempt to receive Medicaid programcoverage for services rendered to that individual.

Proof of intent to defraud does not require proof of intent to defraudany particular person.

(c)        (1)        A person who violates aprovision of this section shall be guilty of a Class I felony if the value ofthe assistance wrongfully obtained is more than four hundred dollars ($400.00).

(2)        A person who violates a provision of this section shall beguilty of a Class 1 misdemeanor if the value of the assistance wrongfullyobtained is four hundred dollars ($400.00) or less.

(d)        For purposes of this section the word "person"includes any natural person, association, consortium, corporation, bodypolitic, partnership, or other group, entity or organization. (1981, c. 275, s. 1; 1993, c. 539, s. 817; 1994, Ex.Sess., c. 24, s. 14(c); 1995, c. 317, s. 1.)