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H.B. 354
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VETOES
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OF VALUE IN CONNECTION WITH THE DELIVERY OF OR PAYMENT FOR HEALTH CARE
SERVICES THAT WHOLLY OR PARTLY ARE REIMBURSED BY OR ARE A REQUIRED
BENEFIT OF A STATE HEALTH PLAN;
(3) WILLFULLY KNOWINGLY AND WILLFULLY DEFRAUD OR ATTEMPT TO
DEFRAUD A STATE HEALTH PLAN OF THE RIGHT TO HONEST SERVICES; OR
(4) WITH THE INTENT TO DEFRAUD MAKE A FALSE REPRESENTATION
RELATING TO HEALTH CARE SERVICES OR A STATE HEALTH PLAN.
230D.
(A) A PERSON WHO HAS APPLIED FOR OR RECEIVED A BENEFIT OR PAYMENT
UNDER A STATE HEALTH PLAN FOR THE USE OF ANOTHER INDIVIDUAL MAY NOT
WILLFULLY KNOWINGLY AND WILLFULLY CONVERT ALL OR ANY PART OF A STATE
HEALTH PLAN BENEFIT OR PAYMENT TO A USE THAT IS NOT FOR THE AUTHORIZED
BENEFICIARY.
(B) A PERSON MAY NOT:
(1) PROVIDE TO ANOTHER INDIVIDUAL ITEMS OR SERVICES FOR WHICH
PAYMENT WHOLLY OR PARTLY IS OR MAY BE MADE FROM FEDERAL OR STATE FUNDS
UNDER A STATE HEALTH PLAN; AND
(2) SOLICIT, OFFER, MAKE, OR RECEIVE A KICKBACK OR BRIBE IN
CONNECTION WITH PROVIDING THOSE ITEMS OR SERVICES OR MAKING OR
RECEIVING A BENEFIT OR PAYMENT UNDER A STATE HEALTH PLAN.
(C) A PERSON MAY NOT SOLICIT, OFFER, MAKE, OR RECEIVE A REBATE OF A
FEE OR CHARGE FOR REFERRING ANOTHER INDIVIDUAL TO A THIRD PERSON TO
PROVIDE ITEMS OR SERVICES FOR WHICH PAYMENT WHOLLY OR PARTLY IS OR MAY
BE MADE FROM FEDERAL OR STATE FUNDS UNDER A STATE HEALTH PLAN.
230E.
A PERSON MAY NOT WILLFULLY KNOWINGLY AND WILLFULLY MAKE, CAUSE TO
BE MADE, INDUCE, OR ATTEMPT TO INDUCE THE MAKING OF A FALSE
REPRESENTATION WITH RESPECT TO THE CONDITIONS OR OPERATION OF A
FACILITY, INSTITUTION, OR STATE HEALTH PLAN IN ORDER TO HELP THE FACILITY,
INSTITUTION, OR STATE HEALTH PLAN QUALIFY TO RECEIVE REIMBURSEMENT
UNDER A STATE HEALTH PLAN.
230F.
(A) A PERSON MAY NOT WILLFULLY KNOWINGLY AND WILLFULLY OBTAIN,
ATTEMPT TO OBTAIN, OR AID ANOTHER INDIVIDUAL IN OBTAINING OR ATTEMPTING
TO OBTAIN A DRUG PRODUCT OR MEDICAL CARE, THE PAYMENT OF ALL OR A PART
OF WHICH IS OR MAY BE MADE FROM FEDERAL OR STATE FUNDS UNDER A STATE
HEALTH PLAN, BY:
(1) FRAUD, DECEIT, MISREPRESENTATION, OR CONCEALMENT;
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- 4428 -
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