What are the California Medi-Cal Fraud Statutes?

The STATE OF CALIFORNIA DEPARTMENT OF JUSTICE OFFICE OF THE ATTORNEY GENERAL has published a list of the statutes it uses to prosecute Medi-Cal fraud and the penalties.  Here is their list and explanations.  (You Can See this in Table Form at their Criminal Fraud Website)

WELFARE & INSTITUTIONS CODE § 14014
(False Declaration as to Eligibility)

Person receiving or encouraging another to receive health care for which he or she was not eligible
On the basis of false declarations

Misdemeanor - six months county jail and/or $1,000 fine
Felony - 16 months, 2 or 3 years in county jail

WELFARE & INSTITUTIONS CODE § 14107

(Fraudulent Claims)
Present a false claim for payment
For goods or services
With intent to defraud;
Or knowingly submit false information
To obtain greater compensation than legally entitled or to obtain authorization to provide goods or services; Or knowingly engage in a scheme to defraud the Medi-Cal program

Misdemeanor - six months county jail and/or $1,000 fine
Felony - 2, 3, or 5 years state prison and/or fine not exceeding three times the amount of fraud or improper reimbursement or value of scheme
If committed under circumstances likely to cause or that do cause two or more persons great or serious bodily injury, an additional, consecutive term of four years shall be imposed for each person so injured

WELFARE & INSTITUTIONS CODE § 14107.2(a)
(Kickbacks, Bribes or Rebates - Solicitation)

Solicit or receive any kickback, bribe or rebate in return for either:
Referring or promising to refer person to provide goods or services, or
Purchasing, leasing or ordering goods or services
Misdemeanor - one year county jail and/or $10,000 fine
Felony - 16 months, 2 or 3 years in county jail and/or $10,000 fine
(Second offense - straight felony)

WELFARE & INSTITUTIONS CODE § 14107.2(b)
(Kickbacks, Bribes or Rebates - Offer)

Offer to pay any kickback, bribe or rebate in return for either:
Referring or promising to refer person to provide goods or services, or
Purchasing, leasing or ordering goods or services
Misdemeanor - one year county jail and/or $10,000 fine
Felony - 16 months, 2 or 3 years in county jail and/or $10,000 fine
(Second offense - straight felony)

PENAL CODE § 487
(Grand Theft)
Take the property of another with value exceeding $950
By moving it or carrying it away
With intent to deprive permanently or for extended period
Misdemeanor - one year county jail
Felony - 16 months, 2 or 3 years in county jail

PENAL CODE § 550(a)(5)
(False Writing)

Knowingly prepare, make or subscribe any writing with intent to use it in support of a false insurance claim with intent to defraud

Felony - 2, 3, or 5 years in county jail plus $50,000 fine or double the amount of fraud, whichever is greater

PENAL CODE § 550(a)(6)
(False Health Care Benefit Claim)

Knowingly make or cause to be made any false or fraudulent claim for health care benefit
With intent to defraud
When claim or amount at issue is $950 or less:

Misdemeanor - six months county jail and/or $1,000 fine
When claim or amount at issue exceeds $950:

Misdemeanor - one year county jail and/or $10,000 fine
Felony - 2, 3, or 5 years in county jail and/or $50,000 fine or double the amount of fraud, whichever is greater

PENAL CODE § 550(a)(7)
(Claim for Unused Health Care Benefit)
Knowingly submit a claim for a health care benefit that was not used by or on behalf of the claimant
When claim or amount at issue is $950 or less:

Misdemeanor - six months county jail and/or $1,000 fine
When claim or amount at issue exceeds $950:

Misdemeanor - one year county jail and/or $10,000 fine
Felony - 2, 3, or 5 years in county jail and/or $50,000 fine or double the amount of fraud, whichever is greater

The Horowitz office is located in Lafayette, California (Contra Costa County).  We are criminal defense specialists (State Bar of California, Board of Legal Specialization) and we regularly defend fraud cases throughout the State of California.