Ohio Revised Code|Section 2913.40 | Medicaid fraud.

                                                
(A) As used in this section:  
(1) "Statement or representation" means any oral, written,  electronic, electronic impulse, or magnetic communication that is  used to identify an item of goods or a service for which  reimbursement may be made under the medicaid program or that  states income and expense and is or may be used to determine a  rate of reimbursement under the medicaid program.
(2) "Provider" means any person who has signed a provider  agreement with the department of medicaid to provide goods or  services pursuant to the medicaid program or any person who has  signed an agreement with a party to such a provider agreement  under which the person agrees to provide goods or services that  are reimbursable under the medicaid program.
(3) "Provider agreement" has the same meaning as in section  5164.01 of the Revised Code.
(4) "Recipient" means any individual who receives goods or  services from a provider under the medicaid program.
(5) "Records" means any medical, professional, financial, or  business records relating to the treatment or care of any  recipient, to goods or services provided to any recipient, or to  rates paid for goods or services provided to any recipient and any  records that are required by the rules of the medicaid director to  be kept for the medicaid program.
(B) No person shall knowingly make or cause to be made a  false or misleading statement or representation for use in  obtaining reimbursement from the medicaid program.
(C) No person, with purpose to commit fraud or knowing that  the person is facilitating a fraud, shall do either of the  following:
(1) Contrary to the terms of the person's provider agreement,  charge, solicit, accept, or receive for goods or services that the  person provides under the medicaid program any property, money, or  other consideration in addition to the amount of reimbursement  under the medicaid program and the person's provider agreement for  the goods or services and any cost-sharing expenses authorized by  section 5162.20 of the Revised Code or rules adopted by the  medicaid director regarding the medicaid program.
(2) Solicit, offer, or receive any remuneration, other than  any cost-sharing expenses authorized by section 5162.20 of the  Revised Code or rules adopted by the medicaid director regarding  the medicaid program, in cash or in kind, including, but not  limited to, a kickback or rebate, in connection with the  furnishing of goods or services for which whole or partial  reimbursement is or may be made under the medicaid program.
(D) No person, having submitted a claim for or provided goods  or services under the medicaid program, shall do either of the  following for a period of at least six years after a reimbursement  pursuant to that claim, or a reimbursement for those goods or  services, is received under the medicaid program:
(1) Knowingly alter, falsify, destroy, conceal, or remove any  records that are necessary to fully disclose the nature of all  goods or services for which the claim was submitted, or for which  reimbursement was received, by the person;
(2) Knowingly alter, falsify, destroy, conceal, or remove any  records that are necessary to disclose fully all income and  expenditures upon which rates of reimbursements were based for the  person.
(E) Whoever violates this section is guilty of medicaid  fraud. Except as otherwise provided in this division, medicaid  fraud is a misdemeanor of the first degree. If the value of  property, services, or funds obtained in violation of this section  is one thousand dollars or more and is less than seven thousand  five hundred dollars, medicaid fraud is a felony of the fifth  degree. If the value of property, services, or funds obtained in  violation of this section is seven thousand five hundred dollars  or more and is less than one hundred fifty thousand dollars,  medicaid fraud is a felony of the fourth degree. If the value of  the property, services, or funds obtained in violation of this  section is one hundred fifty thousand dollars or more, medicaid  fraud is a felony of the third degree.
(F) Upon application of the governmental agency, office, or  other entity that conducted the investigation and prosecution in a  case under this section, the court shall order any person who is  convicted of a violation of this section for receiving any  reimbursement for furnishing goods or services under the medicaid  program to which the person is not entitled to pay to the  applicant its cost of investigating and prosecuting the case. The  costs of investigation and prosecution that a defendant is ordered  to pay pursuant to this division shall be in addition to any other  penalties for the receipt of that reimbursement that are provided  in this section, section 5164.35 of the Revised Code, or any other  provision of law.
(G) The provisions of this section are not intended to be  exclusive remedies and do not preclude the use of any other  criminal or civil remedy for any act that is in violation of this  section.