Bill > H1034

This bill amends Chapter 118E of the General Laws to establish new regulations and penalties for acts involving Federal and State health care programs, including adult foster care and other medical services. Specifically, it outlines criminal penalties for knowingly making false statements or representations on applications for benefits or payments, concealing events that affect eligibility, or converting benefits for unauthorized use, with penalties ranging from fines and imprisonment depending on the severity and the perpetrator's role. The bill also addresses illegal remuneration, prohibiting the solicitation or receipt of kickbacks, bribes, or rebates in exchange for referrals or the purchase of goods and services related to Federal health care programs, and similarly penalizes those who offer or pay such remuneration, though it includes several exceptions for legitimate business practices like discounts, employee compensation, and specific contractual arrangements. Furthermore, it criminalizes knowingly making false statements about the conditions or operations of healthcare institutions to qualify for certification and prohibits charging excessive rates or accepting gifts as a precondition for admitting or continuing a patient's stay in certain facilities when costs are covered by a State plan. The bill defines "Federal health care program" broadly to include any US government-funded health benefit plan and any State health care program, and clarifies that violations can also be considered false claims under federal law, with actual knowledge of the law or specific intent to violate it not being required for prosecution.