2006 New York Code - False Statements; Actions For Treble Damages.

 
    § 145-b. False statements; actions for treble damages. 1. (a) It shall
  be  unlawful for any person, firm or corporation knowingly by means of a
  false statement or representation, or by deliberate concealment  of  any
  material  fact,  or  other  fraudulent  scheme  or  device, on behalf of
  himself or others, to attempt to obtain or to obtain payment from public
  funds for  services  or  supplies  furnished  or  purportedly  furnished
  pursuant to this chapter.
    (b)  For  purposes  of  this  section,  "statement  or representation"
  includes, but is not limited to: a claim for payment made to the  state,
  a  political  subdivision of the state, or an entity performing services
  under contract to the state or a political subdivision of the state;  an
  acknowledgment,  certification,  claim,  ratification  or report of data
  which serves as the basis for a claim or a rate  of  payment,  financial
  information  whether in a cost report or otherwise, health care services
  available or rendered, and the qualifications of a person that is or has
  rendered health care services.
    (c) For purposes of this section, a person, firm  or  corporation  has
  attempted to obtain or has obtained public funds when any portion of the
  funds  from which payment was attempted or obtained are public funds, or
  any public funds are used to reimburse or make prospective payment to an
  entity from which payment was attempted or obtained.
    2. For any violation of subdivision one,  the  local  social  services
  district  or the state shall have a right to recover civil damages equal
  to three times the amount by which any figure is falsely  overstated  or
  in  the  case of non-monetary false statements or representations, three
  times the amount of damages which the state,  political  subdivision  of
  the  state, or entity performing services under contract to the state or
  political subdivision of the state sustain as a result of the  violation
  or  five  thousand  dollars,  whichever  is greater.   Amounts collected
  pursuant to a judgment under this section shall be  apportioned  between
  the  local  social  services  district  and the state in accordance with
  regulations  of  the  department  or  the  department  of   health,   as
  appropriate.  The  remedy  provided  by  this  subdivision  shall  be in
  addition to any other remedy provided by law.
    3. If any provider or supplier of services in the program  of  medical
  assistance  is  required  to  refund or repay all or part of any payment
  received by said provider or  supplier  under  the  provisions  of  this
  chapter and title XIX of the federal social security act, said refund or
  repayment shall bear interest from the date the payment was made to said
  provider  or  supplier to the date of said refund or repayment. Interest
  shall be at the maximum legal rate in effect on the date the payment was
  made to said provider or supplier.
    4. (a) The department of health may require the payment of a  monetary
  penalty  as  restitution to the medical assistance program by any person
  who fails to comply with the standards of the medical assistance program
  or of generally accepted medical practice in  a  substantial  number  of
  cases or grossly and flagrantly violated such standards and receives, or
  causes  to  be  received  by  another  person,  payment from the medical
  assistance program when such person knew, or had reason to know, that:
    (i) the payment involved the providing or ordering of  care,  services
  or  supplies  that  were medically improper, unnecessary or in excess of
  the documented medical needs of the person to whom they were furnished;
    (ii)  the care, services or supplies were not provided as claimed;
    (iii)  the person who ordered or prescribed care, services or supplies
  which was medically improper, unnecessary or in excess of the documented
  medical need of the person to whom they were furnished was suspended  or
  excluded  from  the  medical  assistance  program  at the time the care,
  services or supplies were furnished; or
    (iv)  the services or supplies for which  payment  was  received  were
  not, in fact, provided.
    (b)   Such penalty shall be in lieu of requiring a person to refund or
  repay all or part of any payment from  the  medical  assistance  program
  received  by such person or caused to be received by another person as a
  result of a violation of the terms of this subdivision.    In  no  event
  shall  the monetary penalty imposed exceed two thousand dollars for each
  item or service which was  the  subject  of  the  determination  herein,
  except  that  where  a  penalty under this section has been imposed on a
  person within the previous five years, such  penalty  shall  not  exceed
  seven  thousand  five hundred dollars for each item or service which was
  the subject of the determination herein.
    (c)    Amounts  collected  pursuant  to  this  subdivision  shall   be
  apportioned  between the local social services district and the state in
  accordance with the regulations of the department of health.