Medical assistance fraud; penalties
HRS §346-43.5
in effect346-43.5. Medical assistance fraud; penalties
(a) A person commits the offense of medical assistance fraud if:
(1) The person knowingly makes or causes to be made
to the medical assistance program any false statement or representation of a
material fact in any application for any benefit or payment for furnishing
services or supplies, or for the purpose of obtaining greater compensation than
that to which the person is legally entitled, or for the purpose of obtaining
authorization for furnishing services or supplies; or
(2) The person knowingly makes or causes to be made
any false statement or representation of a material fact in any application for
any medical assistance benefit or renewal of any medical assistance benefit, or
in any statement, document, or record, in written, printed, or electronic form,
in support of, or connected with, that application for or renewal of medical
assistance benefits.
(b) A person convicted under subsection (a)(2)
shall pay restitution equivalent to the amount of medical assistance benefits
paid by the State on behalf of that person.
(c) For purposes of
this section, the term "medical
assistance benefit" means health care
coverage or services, including medical, behavioral health, dental, or
long-term care services, provided to or paid for on behalf of a person by the
State, regardless of source of funding. Payment for medical assistance
benefits may be made through capitated payments, insurance premiums, copayments,
any payments made by the State to that person's health care providers, and any
other payments made by the State on behalf of the person for health care
coverage or services.
(d) The offense of medical assistance fraud is
a class C felony.
(e) The remedies provided under this section
are not exclusive and shall not preclude the use of any other criminal or civil
remedy.
[L 1980, c 210, §1; am L 2016, c 94, §1]
Source: Hawaii State Legislature (capitol.hawaii.gov), via Internet Archive capturesURL: http://www.capitol.hawaii.gov/hrscurrent/Vol07_Ch0346-0398/HRS0346/HRS_0346-0043_0005.htmFetched: 11/10/2026