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Understanding the New Health Care Fraud Legislation

NCJ Number
178645
Journal
Criminal Justice Volume: 12 Issue: 3 Dated: Fall 1997 Pages: 30-59
Author(s)
K. J. Darken
Date Published
1997
Length
4 pages
Annotation
This is a guide to understanding new criminal statutes regarding health care fraud.
Abstract
The article summarizes the key sections of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law No. 104-191. Subtitle E of HIPAA created five new criminal statutes, which prohibit: (1) defrauding a health care program; (2) embezzling, stealing or misapplying funds from a health care program; (3) making false statements or concealing material facts in connection with delivery of or payment for health care benefits; (4) obstructing the communication to a criminal investigator of information regarding federal health care offense or violation; and (5) disposing of assets in order for an individual to become Medicaid eligible. HIPAA also expanded existing money laundering, asset forfeiture and fraud injunction statutes to cover federal health care offenses.

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